Therezita M.P.G. Castro
Full Text Available O papilomavírus (HPV é um DNA vírus do grupo papovavírus, que é altamente transmissível sexualmente, sendo freqüente na região ano-genital e raro na mucosa oral. A sua implantação oral pode ser por auto-inoculação ou pelo contato oro-sexual. As manifestações orais associadas ao HPV são: papiloma, condiloma acuminado, verruga vulgar, hiperplasia epitelial focal, leucoplasias, líquen plano e carcinoma. O diagnóstico é dado pelo exame da lesão e confirmado pela biópsia, com a identificação do tipo de HPV pelas técnicas de biologia molecular (captura híbrida e PCR. O tratamento, dependendo da lesão, pode ser clínico e/ou cirúrgico, obtendo assim a cura clínica, pois o vírus permanece no epitélio da mucosa mesmo após o tratamento.The human papillomavirus (HPV is a DNA virus, of the papovavirus group, that is highly sexually transmittable. It is common in the anal and genital parts and rarely in the oral mucosa. The oral implantation can be by self-inoculation or by oral-sexual contact. The oral manifestations related to HPV are: papilloma, condyloma acuminatum, verruca vulgaris, focal epithelial hyperplasia, leukoplasia, lichen planus, and the squamous cell carcinoma. The diagnosis is performed by lesion exam and confirmed by biopsy, showing the HPV genotype by molecular biology techniques (hybrid capture and PCR. The treatment, depending on the lesion, can be clinical or surgical, allowing clinical cure, because the virus remains in the epithelium of the mucosa even after the treatment.
José Alberto Del Porto
Full Text Available O autor revê o conceito de transtorno bipolar como um processo em evolução. Suas raízes podem ser encontradas no trabalho de Araeteus da Capadócia, que assumia serem a melancolia e a mania duas formas da mesma doença. A compreensão atual da doença bipolar começou na França, através dos trabalhos de Falret (1851 e Baillarguer (1854. Os conceitos fundamentais de Kraepelin mudaram as bases da nosologia psiquiátrica, e o conceito unitário de Kraepelin sobre a insanidade maníaco-depressiva passou a ser amplamente aceito. Depois de Kraepelin, no entanto, as idéias de Kleist e Leonhard, na Alemanha, e o trabalho subseqüente de Angst, Perris e Winokur enfatizaram a distinção entre as formas monopolares e bipolares da depressão. Mais recentemente a ênfase mudou novamente para o espectro bipolar, que em suas formas leves expande-se às bordas dos temperamentos normais. Finalizando, o autor sumariza os aspectos polêmicos da nosologia da doença bipolar e seus limites com as esquizofrenias, a doença esquizoafetiva e as psicoses ciclóides.The author reviews the evolution of the concept of bipolar disorder as an ongoing process. Its roots can be found in the work of Araeteus of Capadocia, who assumed that melancholia and mania were two forms of the same disease. The modern understanding of bipolar disorder began in France, through the work of Falret (1851 and Baillarger (1854. The pivotal concepts of Emil Kraepelin changed the basis of psychiatric nosology, and Kraepelin's unitary concept of manic-depressive insanity was largely accepted. Kraepelin and Weigandt's ideas on mixed states were the cornerstone of this unitary concept. After Kraepelin, however, the ideas of Kleist and Leonhard, in Germany, as well as the work of Angst, Perris and Winokur, emphasized the distinction between unipolar and bipolar forms of depression. More recently, the emphasis has shifted again to the bipolar spectrum, which, in its mild forms, expanded to the
Human papillomaviruses (HPV) are a group of related viruses. They can cause warts on different parts of your body. There are ... cancer. There are two categories of sexually-transmitted HPV. Low-risk HPV can cause genital warts. High- ...
Adriana Cavalcanti de Aguiar
Full Text Available As Diretrizes Curriculares Nacionais (DCN para cursos de Medicina orientam mudanças nos currículos e processos de ensino-aprendizagem-avaliação para desenvolvimento de competências e habilidades profissionais. O presente trabalho, iniciativa da Associação Brasileira de Educação Médica (Abem, investiga os significados e a apropriação da noção de competência por estudiosos da avaliação educacional na medicina. Foram realizadas dez entrevistas mediante roteiro com questões abertas e respondentes selecionados a partir de sua produção acadêmica sobre o assunto. Suas narrativas foram submetidas a análise de conteúdo mediante análise temática. Os resultados enfocam o significado da competência, o papel dos sujeitos e do contexto na construção da competência e a relação entre avaliação de competência e construção da integralidade em saúde. Observa-se que, embora de modos heterogêneos, o conceito de competência tem sido apropriado de modo fértil pelos especialistas brasileiros. No entanto, o estudo sugere que a consolidação de uma "cultura de avaliação" nas escolas médicas demandará investimentos em núcleos de estudo e pesquisa para aprofundamento de conceitos, objetivos, seleção de conteúdos, pactuação de critérios, elaboração de instrumentos e treinamento de avaliadores nas instituições brasileiras.
Conceitos atuais sobre o crescimento e desenvolvimento transversal dos maxilares e oportunidade de expansão mandibular Transversal growth and development of the jaws - news opportunities for mandibular expansion
Adriano Marotta Araujo
Full Text Available O interesse do ortodontista pelo crescimento e desenvolvimento do complexo crâniofacial vem se estendendo por décadas e inúmeros trabalhos já foram realizados nessa área. Necessitamos da compreensão do processo normal de maturação óssea e estruturas adjacentes para podermos diagnosticar uma deformidade dentofacial, bem como identificar fatores etiológicos intrínsecos e extrínsecos que atuam em conjunto, proporcionando alterações na dimensão transversal das bases ósseas e dos arcos dentários. Várias são as filosofias de tratamento para correção das deformidades transversais e recentemente com o advento de novos protocolos de tratamento, essa necessidade de compreensão do desenvolvimento das estruturas faciais parece ter aumentado. Restringindo-se às modificações transversais da maxila e da mandíbula do nascimento até a idade adulta, paradigmas foram instituídos e alguns perpetuam até hoje, entre eles a possibilidade ou não de expansão do arco dentário mandibular. Os propósitos desse trabalho são: 1 revisar alguns dos conceitos relacionados ao crescimento e desenvolvimento transversal dos maxilares presentes na literatura e 2 discutir a possibilidade de expansão no arco dentário mandibular.The growth and adaptation of the craniofacial complex has been a longstanding interest of orthodontists who understand that normal growth changes provide an essential reference for diagnosis and treatment planning. With recent developments there has been increased research activity pertaining to transverse developmental changes on both treated and untreated subjects. Of particular importance, implants studies evaluating normal developmental changes of the skeletal bases have forced orthodontists to reconsider the long notions established from longitudinal descriptions of the dental arches changes. These more recent studies defy the notion that transverse mandibular arch dimensions are immutable. The purpose of this paper is to
Osteodistrofias do Osso Temporal: Revisão dos Conceitos Atuais, Manifestações Clínicas e Opções Terapêuticas Osteodysplasia of the Temporal Bone: Up-date Concepts, Clinical Presentations and Therapeutic Options
Oswaldo Laércio M. Cruz
Full Text Available Sob a designação de osteodistrofias do osso temporal, podemos encontrar uma série de doenças que apresentam em comum a desorganização da arquitetura ou da composição do tecido ósseo. A otospongiose é, com larga margem, a osteodistrofia mais comum nessa localização e suas alterações, repercussões clínicas e tratamentos são amplamente discutidos na literatura. Entretanto, formas menos freqüentes, como a displasia fibrosa e a osteogênese imperfeita, não são entidades raras e merecem atenção. Este artigo tem como objetivo discutir essas formas menos comuns de osteodistrofia do temporal através de uma revisão sobre os conceitos atuais dessas entidades, da apresentação de três exemplos clínicos e a discussão sobre opções de tratamento.Osteodysplasia of the temporal bone included a significant amount of osseous diseases sharing bone matrix structural and composition damage. Otospongiosis is, by far, the most frequent form of this involvement in the temporal bone. Nevertheless, fibrous dysplasia and osteogenesis imperfecta are not rare and deserve attention. In this article, the authors present a discussion about the recent concepts of those less frequent forms of osteodysplasia of temporal bone, its options of treatment, illustrated with three clinical cases.
Drug reaction with Eosinophilia and Systemic Symptoms (DRESS / Drug-induced Hypersensitivity Syndrome (DIHS: a review of current concepts Reação a drogas com eosinofilia e sintomas sistêmicos (DRESS / Síndrome da hipersensibilidade induzida por droga (DIHS: revisão dos conceitos atuais
Paulo Ricardo Criado
ção sequencial de herpesvirus e associação com alelos do HLA. O pronto reconhecimento da síndrome e a retirada da droga desencadeante são os passos mais importantes e essenciais no tratamento dos doentes acometidos. Os corticosteróides são as medicações de escolha para o tratamento da síndrome, podendo ser associados imunoglobulina intravenosa e em, alguns casos selecionados, Ganciclovir. O artigo traz uma revisão dos conceitos atuais que envolvem essa importante manifestação de reação adversa a drogas.
Pedrinho Arcides Guareschi
... atuais da Psicologia Social. Escolho quatro pontos que julgo relevantes e urgentes: 1. A psicologia numa sociedade midiada e numa cultura midiada: como lidar com a subjetividade em tal ambiente? 2. A psicologia e o resgate do humano: o que permanece de especificamente psquico diante do avano das cincias neurolgicas, genticas e biolgicas em g...
Vaccine - HPV; Immunization - HPV; Gardasil; HPV2; HPV4; Vaccine to prevent cervical cancer; Genital warts - HPV vaccine; Cervical dysplasia - HPV vaccine; Cervical cancer - HPV vaccine; Cancer of the cervix - HPV vaccine; Abnormal ...
Fernando González Rey
Este artigo apresenta e discute diferentes desafios que a psicologia tem que enfrentar em seus estudos sobre assuntos relacionados com a saúde, que, sobre o ponto de vista do autor, são impossíveis de desenvolver com os estudos atuais sobre saúde e psicologia clínica. O autor enfatiza desafios concretos: o primeiro que é colocado está relacionado com a elaboração teórica do conceito de saúde, que tem sido praticamente ignorado na literatura psicológica, a qual tem se centrado no problema da d...
... detects the presence of HPV, the virus that causes cervical cancer, in your system. Certain types of HPV — including ... have any of the types of HPV that cause cervical cancer. Depending on your test results, your doctor may ...
... Yourself Against HPV en español Vacuna contra el virus del papiloma humano (VPH) What Is HPV and Why Is It a Problem? Human papillomavirus (HPV) is one of the most common sexually transmitted diseases (STDs) . HPV is the virus that causes genital warts . Besides genital warts, an ...
Carolina Rouanet; Danyelle Reges; Eva Rocha; Vivian Gagliardi; Gisele Sampaio Silva
ABSTRACT Spinal cord injury (SCI) affects 1.3 million North Americans, with more than half occurring after trauma. In Brazil, few studies have evaluated the epidemiology of SCI with an estimated incidence of 16 to 26 per million per year. The final extent of the spinal cord damage results from primary and secondary mechanisms that start at the moment of the injury and go on for days, and even weeks, after the event. There is convincing evidence that hypotension contributes to secondary injury...
... Growth Problems Cervical Cap HPV Vaccine Genital Warts (HPV) KidsHealth > For Teens > Genital Warts (HPV) Print A ... HPV infection. How Do People Know They Have HPV? Most HPV infections have no signs or symptoms. ...
Full Text Available Apesar da ampla utilização do conceito de qualidade conjugal, identifica-se falta de clareza conceitual acerca das variáveis que o compõem. Esse artigo apresenta revisão da literatura na área com o objetivo de mapear o conceito de qualidade conjugal. Foram analisadas sete principais teorias sobre o tema: Troca Social, Comportamental, Apego, Teoria da Crise, Interacionismo Simbólico. Pelos postulados propostos nas diferentes teorias, podem-se identificar três grupos de variáveis fundamentais na definição da qualidade conjugal: recursos pessoais dos cônjuges, contexto de inserção do casal e processos adaptativos. Neste sentido, a qualidade conjugal é resultado do processo dinâmico e interativo do casal, razão deste caráter multidimensional.
Marcos Barbosa de Oliveira
Full Text Available O objetivo da palestra foi o de apresentar um apanhado sucinto da história das investigações sobre conceitos nas últimas décadas, com isso contribuindo para a divulgação da Ciência Cognitiva. O episódio central dessa história é a guinada resultante das pesquisas realizadas por Eleonor Rosch e outros a partir do inicio dos anos setenta. Estas pesquisas colocam em cheque a CONCEPÇÃO CLÁSSICA DE CONCEITOS (caracterizada na primeira parte da exposição. O fato de que o abandono da concepção clássica não é uma alternativa viável, dá origem ao que chamamos de PROBLEMA DA CONCILIAÇÃO, ou seja, o de compatibilizar a concepção clássica com as descobertas modernas. A apresentação se encerra com algumas sugestões para a solução do problema.
Why get vaccinated?HPV vaccine prevents infection with human papillomavirus (HPV) types that are associated with cause ... at http://www.cdc.gov/hpv. HPV Vaccine (Human Papillomavirus) Information Statement. U.S. Department of Health and ...
... May 4). Revised Cervical Cancer Screening Guidelines Require Reeducation of Women and Physicians. ACOG [On-line news ... PressAnnouncements/ucm187003.htm. Issued October 16, 2009. Accessd March 23, 2009. National Cancer Institute. Fact Sheet. HPV ...
Full Text Available http://dx.doi.org/10.5007/1807-9288.2009v5n2p130 Este artigo apresenta e discute os conceitos de gameplay e jogabilidade a partir de definições de diversos autores, aponta suas semelhanças e diferenças, justifica porque não podem ser considerados equivalentes e propõe um entendimento para o conceito de gameplay.
... Listen Español Text Size Email Print Share HPV (Human Papillomavirus) Vaccine: What You Need to Know (VIS) ... Why get vaccinated? HPV vaccine prevents infection with human papillomavirus (HPV) types that are associated with many ...
Fernando González Rey
Full Text Available Este artigo apresenta e discute diferentes desafios que a psicologia tem que enfrentar em seus estudos sobre assuntos relacionados com a saúde, que, sobre o ponto de vista do autor, são impossíveis de desenvolver com os estudos atuais sobre saúde e psicologia clínica. O autor enfatiza desafios concretos: o primeiro que é colocado está relacionado com a elaboração teórica do conceito de saúde, que tem sido praticamente ignorado na literatura psicológica, a qual tem se centrado no problema da doença. Neste sentido, o autor propõe abandonar a definição de saúde em termos de normalidade, equilíbrio ou ausência de sintomas. Para este propósito, o autor utiliza o conceito de distress e o explica com diferente enquadramento teórico, levando em conta sua complexa constituição subjetiva e social no curso da vida do sujeito. O outro desafio coloca a necessidade de incluir o problema da saúde entre outros já desenvolvidos pelas psicologias social e educacional, enfatizando a importância de um estudo intradisciplinar do problema da saúde em psicologia.This paper presents and discusses different challenges that psychology has to face in its approach to health issues, which, from my point of view, are impossible to develop within the current approaches to health and clinical psychology. I emphasize concrete challenges: the first deals with the theoretical elaboration of the concept of health, which has been practically ignored in the psychological literature that focus mostly on the matter of disease. In this sense, I propose to abandon the definition of health in terms of normality, equilibrium, or absence of symptoms. For this purpose, I take the concept of distress and explain it within a different theoretical framework, taking into account its complex subjective and social constitution on the subject’s life course. The other challenges relate to the need to include the matter of health among those developed by social and
Lídia Suzana Rocha de Macedo
Full Text Available Diversas definições de self coexistem nas teorias e práticas psicológicas. Essa variedade é resultante de bases epistemológicas a partir das quais se adotam estratégias diferentes para abordar e demarcar os limites do objeto em questão e descrevê-lo. Este estudo teve como objetivo oferecer uma revisão dos conceitos de self e uma reflexão sobre como esse conceito se articula nas diferentes abordagens teóricas da psicologia. Destaca-se que dilemas centrais à psicologia do desenvolvimento atravessam o conceito de self. Por essa razão, apresenta-se a tese de que, ao analisar cada definição de self, deve-se buscar responder como cada teoria colocou-se diante das dicotomias estabilidade versus transformação, específico versus universal e mundo interno versus mundo externo.
Human papillomaviruses (HPVs) are a group of more than 200 related viruses that can cause several cancers including cervical cancer, anal cancer, and oropharyngeal cancer. Learn more about how HPV is transmitted, the different types of HPV, HPV vaccines, and HPV treatment.
Full Text Available 0 objetivo deste trabalho é defender uma certa leitura de Foucault, em especial no que se refere aos conceitos de saber e de verdade, frequentemente tomados em sentido corrente. A razão é que, se Foucault for lido assim, algumas de suas hipóteses perdem completamente seu vigor e sua produtividade, tomando-se inúteis para perceber — e este é um de seus propósitos — a especificidade do funcionamento de certos discursos, seja no que se refere a sua forma de produção quanto no que se refere as relações entre os discursos.
Bosch, F Xavier; Robles, Claudia; Díaz, Mireia
Human papillomavirus (HPV)-related screening technologies and HPV vaccination offer enormous potential for cancer prevention, notably prevention of cervical cancer. The effectiveness of these approaches is, however, suboptimal owing to limited implementation of screening programmes and restricted...... indications for HPV vaccination. Trials of HPV vaccination in women aged up to 55 years have shown almost 90% protection from cervical precancer caused by HPV16/18 among HPV16/18-DNA-negative women. We propose extending routine vaccination programmes to women of up to 30 years of age (and to the 45-50-year...... age groups in some settings), paired with at least one HPV-screening test at age 30 years or older. Expanding the indications for HPV vaccination and much greater use of HPV testing in screening programmes has the potential to accelerate the decline in cervical cancer incidence. Such a combined...
Thiago Miranda dos Santos Moreira
Full Text Available Resumo Vivemos uma crise de autoridade no mundo moderno e seu impacto no âmbito educacional tem sido objeto de análises e críticas sob diferentes perspectivas. De acordo com Hannah Arendt, esse não é um fenômeno gerado na esfera da educação, não obstante, seu impacto nesse âmbito apareça aos olhos da autora como o sintoma mais evidente da profundidade e seriedade desta crise. Este trabalho tem por objetivo analisar o conceito de autoridade na obra de Hannah Arendt, propondo uma abordagem que busca romper com as perspectivas que veem a autoridade como um epifenômeno do poder. Desse modo, busca-se lançar um olhar sobre a autoridade como um elemento consubstancial à educação e não como um mero instrumento de poder, submissão e sujeição de indivíduos. Assim, num primeiro momento, será apresentada a perspectiva de Alain Renaut, filósofo francês que, em sua abordagem da autoridade, dialoga direta e criticamente com Arendt. Em seguida, será apresentada a origem do conceito sob a perspectiva de Hannah Arendt, bem como sua relação com a educação.
... Consumers Consumer Information by Audience For Women HPV (human papillomavirus) Share Tweet Linkedin Pin it More sharing ... Español In Chamorro In Urdu In Vietnamese HPV (human papillomavirus) is a sexually transmitted virus. It is ...
Lin, Ken; Roosinovich, Elena; Ma, Barbara; Hung, Chien-Fu
It is now well established that most cervical cancers are causally associated with HPV infection. This realization has led to efforts to control HPV-associated malignancy through prevention or treatment of HPV infection. Currently, commercially available HPV vaccines are not designed to control established HPV infection and associated premalignant and malignant lesions. To treat and eradicate pre-existing HPV infections and associated lesions which remain prevalent in the U.S. and worldwide, effective therapeutic HPV vaccines are needed. DNA vaccination has emerged as a particularly promising form of therapeutic HPV vaccines due to its safety, stability and ability to induce antigen-specific immunity. This review focuses on improving the potency of therapeutic HPV vaccines through modification of dendritic cells (DCs) by  increasing the number of antigen-expressing/antigen-loaded DCs,  improving HPV antigen expression, processing and presentation in DCs, and  enhancing DC and T cell interaction. Continued improvement in therapeutic HPV DNA vaccines may ultimately lead to an effective DNA vaccine for the treatment of HPV-associated malignancies. PMID:20066511
Longuet, M; Beaudenon, S; Orth, G
The genomes of two novel human papillomavirus (HPV) types, HPV68 and HPV70, were cloned from a low-grade cervical intraepithelial neoplasia and a vulvar papilloma, respectively, and partially sequenced. Both types are related to HPV39, a potentially oncogenic virus. HPV68 and HPV70 were also detected in genital intraepithelial neoplasia from three patients and one patient, respectively. Comparison with sequence data in the literature indicates that the subgenomic ME180-HPV DNA fragment, clone...
Juliana Eugênia Caixeta
Full Text Available O objetivo deste trabalho foi identificar os significados que compõem o conceito complexo identidade feminina. Quatorze mulheres de 44-74 anos, atendidas num programa de alfabetização de adultos, fizeram parte de discussões em grupo sobre ser mulher, nas quais dados orais, escritos e imagéticos (fotografia foram coletados, durante treze sessões semanais de uma hora e meia, em média. Os dados foram transcritos na íntegra e submetidos a uma análise temática dialógica. Os resultados explorados neste artigo estão relacionados ao papel social da mulher. Cada papel social foi analisado, considerando-se três grupos temáticos: atividade do papel, seus modos de execução e suas conseqüências. As mulheres estudadas apresentaram identificações múltiplas: mãe/avó, filha, esposa, dona de casa, mulher-trabalhadora 1 (remunerada e mulher-trabalhadora 2 (dona-de-casa, merecendo destaque o par de papéis sociais mãe-esposa, que definiram outros aspectos sobre o ser mulher.
Full Text Available Human papillomavirus 16 (HPV16 species group (alpha-9 of the Alphapapillomavirus genus contains HPV16, HPV31, HPV33, HPV35, HPV52, HPV58 and HPV67. These HPVs account for 75% of invasive cervical cancers worldwide. Viral variants of these HPVs differ in evolutionary history and pathogenicity. Moreover, a comprehensive nomenclature system for HPV variants is lacking, limiting comparisons between studies.DNA from cervical samples previously characterized for HPV type were obtained from multiple geographic regions to screen for novel variants. The complete 8 kb genomes of 120 variants representing the major and minor lineages of the HPV16-related alpha-9 HPV types were sequenced to capture maximum viral heterogeneity. Viral evolution was characterized by constructing phylogenic trees based on complete genomes using multiple algorithms. Maximal and viral region specific divergence was calculated by global and pairwise alignments. Variant lineages were classified and named using an alphanumeric system; the prototype genome was assigned to the A lineage for all types.The range of genome-genome sequence heterogeneity varied from 0.6% for HPV35 to 2.2% for HPV52 and included 1.4% for HPV31, 1.1% for HPV33, 1.7% for HPV58 and 1.1% for HPV67. Nucleotide differences of approximately 1.0% - 10.0% and 0.5%-1.0% of the complete genomes were used to define variant lineages and sublineages, respectively. Each gene/region differs in sequence diversity, from most variable to least variable: noncoding region 1 (NCR1 /noncoding region 2 (NCR2 >upstream regulatory region (URR> E6/E7 > E2/L2 > E1/L1.These data define maximum viral genomic heterogeneity of HPV16-related alpha-9 HPV variants. The proposed nomenclature system facilitates the comparison of variants across epidemiological studies. Sequence diversity and phylogenies of this clinically important group of HPVs provides the basis for further studies of discrete viral evolution, epidemiology, pathogenesis and
Joel M. Palefsky
Full Text Available While much is known about the natural history of cervical human papillomavirus (HPV infection and its consequences, including cervical intraepithelial neoplasia and cervical cancer, relatively little is known about the natural history of anogenital HPV infection and diseases in men. In part this reflects difficulties in penile sampling and visual assessment of penile lesions. Anal HPV infection and disease also remain poorly understood. Although HPV is transmitted sexually and infects the genitals of both sexes, the cervix remains biologically more vulnerable to malignant transformation than does the penis or anus in men. An understanding of male HPV infection is therefore important in terms of reducing transmission of HPV to women and improving women's health. However, it is also important due to the burden of disease in men, who may develop both penile and anal cancer, particularly among HIV-positive men who have sex with men. Improved sampling techniques of the male genitalia and cohort studies in progress should provide important information on the natural history of anogenital HPV infection and disease in men, including risk factors for HPV acquisition and transmission. The impact of HPV vaccination in women on male anogenital HPV infection will also need to be assessed.
... Are Linked with HPV Each Year? Rates by Race and Ethnicity HPV-Associated Anal Cancer HPV-Associated ... file ePub file RIS file Page last reviewed: March 6, 2017 Page last updated: March 6, 2017 ...
de Melker, Hester; Kenter, Gemma; van Rossum, Tekla; Conyn-van Spaendonck, Marina
Vaccination against the human papilloma virus (HPV) has been included in the national Vaccination Programme of the Netherlands for 12-year-old girls since 2010. Vaccination coverage for the birth cohort of 1997 was 56.; there is a gradual increase in uptake. Continuous safety monitoring brought no new unknown serious side effects to light; many girls suffered from transient symptoms such as painful arm, fatigue and headache. After the current vaccines that protect against HPV types 2 and 4 types, respectively and induce some cross protection, vaccines are being developed that can induce broader protection. HPV vaccination of 12-year-old girls is cost-effective, even for relatively low vaccination coverage. The potential protection of HPV vaccination extends beyond prevention of cervical cancer by preventing other oncological manifestations of HPV infection in women as well as men and genital warts. The preventive HPV vaccines do not appear to be effective in treating existing abnormalities.
Full Text Available O presente trabalho objetiva efetuar uma reflexão sobre os atuais desafios encontrados pelos profissionais da contabilidade do Brasil para evidenciar uma Demonstração Contábil que retrate a realidade das empresas e apresentar uma proposta para ampliar a capacidade informativa das Demonstrações Contábeis. No mundo atual faz-se necessário que a informação Contábil possua qualidade e credibilidade. Entretanto, a crescente complexidade das atividades empresariais e determinadas restrições tributárias nos fazem deparar com críticas fundamentadas quanto à necessidade de seu aprimoramento. Paralela à analise das dificuldades existentes, é colocada a extrema dificuldade de mudanças substanciais na atual normatização contábil. Visando propiciar um aperfeiçoamento mais imediato da contabilidade é proposta a apresentação, de forma voluntária, de uma nova informação contábil denominada "Demonstração do Patrimônio Líquido Efetivo". Essa parte do Patrimônio Líquido Societário efetua ajustes visando evidenciar um valor mais realista dos ativos e dos passivos. A análise da relação custo × benefício dessa nova Demonstração é efetuada concluindo-se que essa informação adicional poderá constituir-se em uma grande evolução, aprimorando o atual produto gerado pela contabilidade brasileira com um custo reduzido. A sua aplicação poderá ser um fator diferencial para uma empresa que divulga as Demonstrações Contábeis para os usuários externos e poderá ser também de grande utilidade para ampliar a capacidade informativa de todos os usuários internos.This paper aims to debate the current challenges Brazilian accountants face when trying to disclose, through the financial statements, what is really happening in their companies. Furthermore, a proposal is presented that aims to improve the informational capacity of accounting in terms of quality. A world where accounting information does not inspire confidence and
Full Text Available A evolução que se tem verificado ao nível das Tecnologias da Informação e da Comunicação (TIC têm tido impacto significativo no quotidiano, muito particularmente na vida dos jovens. Se de facto o desenvolvimento de ferramentas tecnológicas constitui, por um lado, vantagem para a construção de projetos e cenários educativos inovadores e medeia, com vantagens significativas, a forma como as crianças e jovens se expressam, comunicam, constroem a sua identidade é também inegável, por outro lado, e comumente reconhecido que a par destas vantagens há riscos importantes associados à utilização da Internet e das TIC – como é o caso do cybebullying! Neste artigo reflectem-se as principais linhas de investigação que se produziram, nos últimos anos, na área do Cyberbullying. Apresenta-se assim, neste trabalho, uma leitura critica e fundamentada na recente investigação, de alguns temas relevantes nesta área de investigação, nomeadamente a definição do conceito de cyberbullying, a caracterização dos atores envolvidos, a referenciação das tecnologias usadas, a identificação e descrição dos comportamentos associados, bem como o alcance, a prevalência e o impacto do fenómeno e das emoções e sentimentos associados. Finalmente tecem-se alguns comentários relativos às dificuldades da investigação sobre a temática e aos desenvolvimentos da mesma no futuro.
João Cláudio Todorov
Full Text Available O conceito de operante surge nos anos 30 como necessidade, dada a dificuldade encontrada por Skinner para analisar seus dados usando como ferramenta o conceito de reflexo. O presente trabalho apresenta a evolução do conceito até o presente, quando a unidade de análise não tem mais a ver com a estrutura do comportamento: a nova ferramenta é o conceito de contingência tríplice.
Camila Fernanda Bassetto
Full Text Available O objetivo deste trabalho é realizar uma meta-análise dos resultados atuais do SARESP, considerando a proficiência em matemática de alunos do 3º ano do Ensino Médio da rede pública estadual. Essa meta-análise permitiu identificar descompassos no conjunto do sistema educacional como um todo nos diversos seguimentos envolvidos, direta ou indiretamente, que contribuem para o processo de ensino-aprendizagem do indivíduo. Comparando os resultados atuais do SARESP, foi possível perceber a grande deficiência apresentada pelos alunos da 3ª série do Ensino Médio em resolver problemas matemáticos envolvendo conceitos simples e do cotidiano, classificando-os em níveis abaixo do adequado, quando comparado com os níveis de desempenho esperados para à série em que se encontram. Diante deste fato, o qual não deixa de ser inaceitável, conclui-se que há uma urgente necessidade de buscar explicações e formas de superação para essa situação. Caso contrário, o nível educacional brasileiro permanecerá “abaixo do básico”.
... caused by persistent infection and genital warts ( 22 ). Analyses of data from women participating in a clinical ... is to contact the insurance plan or the clinic. Most private insurance plans cover HPV vaccination. The ...
... test; Cancer of cervix - HPV DNA test References Hacker NF. Cervical dysplasia and cancer. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ...
Following the release of a consensus statement from the NCI-Designated Cancer Centers urging HPV vaccination in the United States, Dr. Noel Brewer discusses the country’s low vaccination rates and how clinicians can help to improve them.
Full Text Available A coletânea Culturas juvenis no século XXI, organizada por Silvia Helena Simões Borelli e João Freire Filho apresenta 16 ensaios de pesquisadores sobre o tema da juventude em contextos urbanos atuais. Destaca-se, no conjunto da obra, uma notável pluralidade de objetos e de abordagens das práticas culturais da chamada “condição jovem”, apresentando debates teóricos sobre a juventude quase sempre apoiados em extensas pesquisas empíricas. Por meio de “análises sistemáticas de variados aspectos do circuito de produção e apropriação cultural juvenil” (p. 7, o leitor é convidado a refletir sobre os diversos usos e práticas culturais associados à juventude, reconhecendo suas complexidades, dilemas e riquezas. Assim, a música (tema abordado em quase um terço dos artigos, o grafite, o audiovisual, os best-sellers literários, a internet e os celulares se tornam objetos de análise, com os quais os jovens articulam modos de pertencimento perpassados por sua condição etária e pelas diversas formas de violência e incertezas a que são expostos. O texto de apresentação da “orelha”, com a ilustre assinatura de Guillermo Orozco Gómez, já aponta para as “marcas singulares” das novas gerações, “manifestas em sons, imagens e palavras propagadas pela música, pelos muros, indumentárias e adereços, telas de computadores, celulares, TVs e pelas comunidades de fãs”. O artigo de abertura, do influente pesquisador Jesús Martín-Barbero, intitula-se “A mudança na percepção da juventude: sociabilidades, tecnicidades e subjetividades entre os jovens”. Nesse texto, Barbero apresenta uma releitura dos significados da “condição juvenil”, que se caracteriza por um “excesso de tempo livre” e pela “longa ‘fila de espera’ para encontrar trabalho” (p. 16. Sua análise baseia-se em diversos estudos sobre práticas culturais dos jovens, definidos como “sujeitos íntima e estruturalmente mediados por
Full Text Available Este artigo persegue o conceito de consciência na obra de Vigotski, o principal problema de sua psicologia. Resume a importância do contexto sociopolítico da União Soviética para o desenvolvimento de sua teoria, que se iniciou com influências da reflexologia e do pavlovismo, integrando progressivamente os amplos conhecimentos do autor (nas artes, na filosofia clássica e marxista até a neuropsicologia e a psicologia experimental. Através da leitura de trabalhos produzidos de 1924 a 1934, este artigo revisa as ocorrências semânticas da palavra consciência, identificando seus fundamentos monistas e materialistas, extraindo seus sentidos principais e incluindo o conceito no enfoque histórico-cultural. O conceito é desmembrado em suas três acepções basilares (processo de tomada de consciência da realidade externa e interna; atributo de conteúdos e processos psicológicos; sistema psicológico que se articulam, produzindo um dos fundamentos da psicologia geral vigotskiana e articulando neuropsicologia, ética e ontologia.
... and Media Resources News Newsletters Events Redirect for HPV Vaccine FAQ Recommend on Facebook Tweet Share Compartir ... to the address below. http://www.cdc.gov/hpv/parents/questions-answers.html File Formats Help: How ...
Antonio George de Matos Cavalcante
Full Text Available A DPOC é uma causa importante de morbidade e mortalidade em escala global. As manifestações clínicas e funcionais da DPOC resultam de danos pulmonares provocados por um conjunto de mecanismos, incluindo o estresse oxidativo, a inflamação, o desequilíbrio do sistema protease-antiprotease e a apoptose. O estresse oxidativo é central na gênese da DPOC, pois além de provocar dano direto às estruturas pulmonares, amplifica os demais mecanismos. Os eventos celulares e moleculares responsáveis pelo dano pulmonar antecedem em muito a expressão clínica e funcional da DPOC. Os broncodilatadores, principais drogas empregadas atualmente no tratamento da DPOC, não são eficazes em reduzir a progressão da doença. Avanços na compreensão da patogênese da DPOC aliados a esforços renovados na pesquisa básica e clínica deverão permitir sua detecção na fase pré-clínica e possibilitar um monitoramento mais adequado de sua atividade, além de permitir a introdução de novas modalidades de agentes terapêuticos capazes de impedir eficazmente sua progressão.Worldwide, COPD is a major cause of morbidity and mortality. The clinical and functional manifestations of COPD result from lung injury occurring through various mechanisms, including oxidative stress, inflammation, protease-antiprotease imbalance and apoptosis. Oxidative stress is central to the pathogenesis of COPD, since it can directly damage lung structures and exacerbate the other mechanisms involved. The cellular and molecular events involved in such lung injury are believed to occur long before the clinical and functional expression of COPD. Although the use of bronchodilators is currently the principal treatment for COPD, bronchodilators have little or no effect on disease progression. A better understanding of the pathogenesis of COPD, together with renewed efforts in basic and clinical research, will allow the diagnosis of COPD at a pre-clinical stage and provide more appropriate monitoring of disease activity, as well as leading to the development of novel therapeutic agents that will effectively prevent the progression of the disease.
Tebet, Marcos Antonio
O tratamento da espondilólise e da espondilolistese permanece um desafio para ortopedistas, neurocirurgiões e pediatras. Nas espondilolisteses, tem sido claramente demonstrado na última década que a morfologia sacro-pélvica está anormal e que isso pode estar associado a uma anormal orientação sacro-pélvica e também alterar o equilíbrio sagital global da coluna. Este artigo apresenta a classificação SDSG (Spinal Deformity Study Group) da espondilolistese lombossacral. As propostas de tratament...
Angelina M.B. Bilate
Full Text Available Chagas disease continues to be a significant public health problem, as ca. 10 million people are still infected with T. cruzi in Latin America. Decades after primary infection, 30% of individuals can develop a form of chronic inflammatory cardiomyopathy known as Chagas disease cardiomyopathy (CCC. Data from both murine models and human studies support the view that an autoimmune response as well as a parasite-driven immune response involving inflammatory cytokines and chemokines may both play a role in generating the heart lesions leading to CCC. This review aims to summarize recent advances in the understanding of the immunopathogenesis of Chagas disease cardiomyopathy.A doença de Chagas continua sendo importante problema de saúde pública uma vez que cerca de 10 milhões de indivíduos ainda estão infectados pelo T. cruzi. Décadas após a infecção primária, aproximadamente 30% dos indivíduos podem desenvolver uma cardiomiopatia inflamatória crônica, a chamada Cardiomiopatia Chagásica Crônica (CCC. Dados de modelos murinos e de estudos em humanos apóiam a visão de que tanto respostas auto-imunes como as determinadas pelo parasita em conjunto com citocinas e quimiocinas inflamatórias participam da geração das lesões cardíacas típicas da CCC. A presente revisão tem como objetivo sumarizar os recentes avanços no entendimento da imunopatogênese da Cardiomiopatia Chagásica Crônica.
Nicol, A.F.; Andrade, C.V.; Russomano, F.B.; Rodrigues, L.L.S.; Oliveira, N.S.; D.W. Provance Jr
Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment o...
Cason, John; Bible, Jon; Mant, Christine
The vast majority of anogenital carcinomas are caused by high-risk human papillomaviruses (HPVs), and among Western nations HPV-16 is usually the most predominant cancer-associated type. As a DNA virus, HPV type 16 has a relatively stable genome that is believed to have co-evolved with its host over the millennia. Nevertheless, among the "wild" populations of HPV-16 that are circulating, a large number of variants have been identified, and these may have considerably different pathogenic potentials. In this chapter, methods for screening and characterizing HPV-16 sequence variants are described. In particular, we describe methods for the identification of variation within the HPV-16 E5 open reading frame and for the detection of the nt 131 A-->G mutation of the E6 ORF, using restriction fragment length polymorphism assays. In addition, we describe approaches for DNA sequencing and analysis. Such methods are likely to be of particular interest to those involved in epidemiological investigations of virus transmission and pathogenicity studies.
Francisco da Costa Júnior
Full Text Available Este artigo apresenta parte dos resultados de uma pesquisa bibliográfi ca sobre os conceitos de loucura na Psiquiatria e na Saúde Mental. Foram analisadas publicações indexadas na base de dados LILACS entre 1999 e 2004. A pesquisa mais ampla foi feita por áreas temáticas e, no presente artigo, nos concentramos em duas delas: as que afi rmam conceitos de loucura como doença médica e as que defi nem loucura rejeitando explicitamente a concepção psiquiátrica de loucura, mas o fazem discutindo a loucura baseadas em concepções que mantêm diálogo com os objetos perceptivos (diagnósticos descritivos que a Psiquiatria concebeu ao longo de sua história. Estas últimas conceituações, que por vezes são chamadas de alternativas mas freqüentemente são anteriores aos conceitos atuais da Psiquiatria (da loucura como doença genética, por exemplo, apontam construtos teóricos que afirmam uma concepção de mente (de psicológico desde um modo mais individualizado até como algo resultante das inter-relações sociais. Discute-se, por fi m, como esses conceitos de loucura fazem parte de concepções de mundo (e, conseqüentemente, de ser humano distintas e mesmo mutuamente excludentes em relação aos conceitos propriamente psiquiátricos, sendo que há uma visão de mundo mais naturalista na Psiquiatria e, na Saúde Mental, uma visão mais sociológica e coletivista, e elas têm entrado em choque para além das problematizações teóricas em torno da loucura.
Calazans, Roberto; Reis,Leandro Nogueira dos
Neste artigo, refazemos o percurso freudiano a propósito do conceito de paranoia em sua obra. Esse percurso se fará a partir dos textos considerados pré-psicanalíticos, passando por aquele que é considerado o texto maior de Freud sobre as psicoses (o Caso Schereber), culminando com suas análises que levam em consideração sua segunda teoria sobre o funcionamento psíquico e sobre o conflito pulsional. Nosso objetivo é demonstrar como Freud, em sua elaboração das questões relativas à psicose, e ...
Reginaldo Santana Figueiredo
Full Text Available O presente trabalho tem por objetivo a sistematização e a apresentação dos conceitos fundamentais da Teoria dos Jogos, a formalização matemática dos principais conceitos clássicos de solução de um jogo e ilustrar sua aplicação ao problema da distribuição de custo conjunto. Como produto de uma pesquisa de alguns anos, conseguimos reunir sistematicamente o conjunto de conceitos de solução de jogos donde se derivam todos conceitos encontrados nos textos atuais. Apresentamos os conceitos de solução para os chamados jogos cooperativos através do conceito de objeção e contra-objeção de forma a mostrar que os mesmos podem ser vistos como um processo de negociação.This paper presents the basic concepts of Game Theory and the mathematical formalizations of classic concepts of game solutions. We surveyed the fundamental concepts from where we derive the concepts of game solutions that can be found in the modern papers. We feature the concepts to the game named cooperative-games by concepts of objection and counterobjection to show that they can be understood as a negotiation process. In addition, we show how the Game Theory can be applied to the problem of the assignment of joint cost.
Else, Elizabeth A.; Swoyer, Ryan; Zhang, Yuhua; Taddeo, Frank J; Bryan, Janine T.; Lawson, John; Van Hyfte, Inez; Roberts, Christine C.
Real-time type-specific multiplex human papillomavirus (HPV) PCR assays were developed to detect HPV DNA in samples collected for the efficacy determination of the quadrivalent HPV (type 6, 11, 16, and 18) L1 virus-like particle (VLP) vaccine (Gardasil). Additional multiplex (L1, E6, and E7 open reading frame [ORF]) or duplex (E6 and E7 ORF) HPV PCR assays were developed to detect high-risk HPV types, including HPV type 31 (HPV31), HPV33, HPV35, HPV39, HPV45, HPV51, HPV52, HPV56, HPV58, and H...
Leonardo Loureiro Winter
Full Text Available O presente artigo trata do estabelecimento do conceito de paradoxo em música segundo a acepção do compositor suíço-brasileiro Ernst Widmer (1927-1990. A partir de uma declaração do compositor da importância do paradoxo na obra “As Quatro Estações do Sonho” op. 129, foram investigadas as utilizações do termo e aplicações na estrutura musical tendo como suporte a análise da produção teórica e declarações de Widmer. A pesquisa indicou, em relação ao paradoxal, a presença de dois elementos inter-relacionados: o comportamento eclético e a relativização de conceitos, além de identificar elementos contrastantes na estrutura musical segundo o entendimento do compositor.
Full Text Available Adolescents who are sexually active have the highest rates of prevalent and incident HPV infection rates with over 50–80% having infections within 2–3 years of initiating intercourse. These high rates reflect sexual behavior and biologic vulnerability. Most infections are transient in nature and cause no cytologic abnormality. However, a small number of adolescents will not clear the infection. Persistence of HPV is strongly linked to the development of high-grade squamous intra-epithelial lesions (HSIL and invasive cancer. The HSIL detected, however, does not appear to progress rapidly to invasive cancer. Understanding the natural history of HPV in adolescents has shed light into optional treatment strategies which include watchful observation of atypical squamous cells of undetermined significance (ASCUS and low grade (LSIL. The association between age of first intercourse and invasive cancer cannot be ignored. Consequently, initiating screening at appropriate times in this vulnerable group is essential. In addition, with the advent of the HPV vaccine, vaccination prior to the onset of sexual activity is critical since most infections occur within a short time frame post initiation.
... breastfeeding. The father of the baby received the HPV vaccine around the time that I got pregnant. Is there a risk to the baby? No. There is no evidence that vaccines given to men will affect the sperm. In general, exposures that fathers have are unlikely ...
Dr. Walter Kinney, a gynecologic oncologist with The Permanente Medical Group in Sacramento, California, talks about Pap and human papillomavirus (HPV) cotesting in women aged 30 and over. Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC). Date Released: 6/9/2010.
Nicol, A F; Andrade, C V; Russomano, F B; Rodrigues, L L S; Oliveira, N S; Provance, D W
Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.
Full Text Available Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.
... STD on Facebook Sexually Transmitted Diseases (STDs) HPV Vaccine Information For Young Women Language: English Español (Spanish) ... media/releases/2016/p1020-hpv-shots.html A vaccines is available to prevent the human papillomavirus (HPV) ...
Favre, M; Croissant, O; Orth, G
The cloning and partial characterization of human papillomavirus (HPV) type 29 is presented. By hybridization analyses, this virus appears to be related to HPV types associated with common warts and HPV types associated with flat warts.
A summary of results from a large randomized clinical trial that shows a new human papillomavirus (HPV) vaccine effectively prevented infection and disease caused by seven HPV types that cause cancer and two HPV types that cause genital warts.
Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.
... Español (Spanish) Recommend on Facebook Tweet Share Compartir Human papillomavirus (HPV) can cause serious health problems, including ... any health problems. What is genital HPV? Genital human papillomavirus (also called HPV) is the most common ...
Kocjan, Boštjan; Poljak, Mario; Oštrbenk, Anja
Introduction: HPV-52 is one of the most frequent human papillomavirus (HPV) genotypes causing significant cervical pathology. The most widely used HPV genotyping assay, the Roche Linear Array HPV Genotyping Test (Linear Array), is unable to identify HPV- 52 status in samples containing HPV-33, HPV-35, and/or HPV-58. Methods: Linear Array HPV-52 analytical specificity was established by testing 100 specimens reactive with the Linear Array HPV- 33/35/52/58 cross-reactive probe, but not with the...
Full Text Available Pier Luigi Lopalco Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy Abstract: Starting in 2006, vaccination against human papillomavirus (HPV has been progressively implemented in most developed countries. Two vaccines have been successfully used, a bivalent vaccine targeting HPV-related cancers (bHPV and a quadrivalent vaccine (qHPV targeting both HPV-related cancers and genital warts. Between December 2014 and June 2015, a new nonavalent HPV vaccine (9vHPV was granted marketing authorization in the USA and Europe. The 9vHPV was developed from the qHPV and includes five additional HPV types that should increase the level of protection toward HPV-related cancers. Efficacy and/or immunogenicity of 9vHPV has been assessed in eight clinical studies. The 9vHPV vaccine induced a very robust immune response against all vaccine types, with seroconversion rates close to 100%. The safety profile of 9vHPV is comparable to that of qHPV. Local reactions, especially swelling, have been more frequently reported after 9vHPV than qHPV, and this slightly increases when the 9vHPV is coadministered with other vaccines. The additional coverage offered by the 9vHPV may prevent a significant proportion of HPV-related cancers (variable between 8% and 18% depending on the local distribution of high-risk HPV types in the population. It is impossible, at present, to anticipate the actual impact of the wide use of the 9vHPV in comparison with the bHPV or the qHPV, since it depends on many variables including duration of protection, potential cross-protection toward nonvaccine types, and herd immunity effect. Keywords: human papillomavirus vaccine, immunogenicity, vaccine safety, cervical cancer, head and neck cancer, genital warts
Lopalco, Pier Luigi
Starting in 2006, vaccination against human papillomavirus (HPV) has been progressively implemented in most developed countries. Two vaccines have been successfully used, a bivalent vaccine targeting HPV-related cancers (bHPV) and a quadrivalent vaccine (qHPV) targeting both HPV-related cancers and genital warts. Between December 2014 and June 2015, a new nonavalent HPV vaccine (9vHPV) was granted marketing authorization in the USA and Europe. The 9vHPV was developed from the qHPV and includes five additional HPV types that should increase the level of protection toward HPV-related cancers. Efficacy and/or immunogenicity of 9vHPV has been assessed in eight clinical studies. The 9vHPV vaccine induced a very robust immune response against all vaccine types, with seroconversion rates close to 100%. The safety profile of 9vHPV is comparable to that of qHPV. Local reactions, especially swelling, have been more frequently reported after 9vHPV than qHPV, and this slightly increases when the 9vHPV is coadministered with other vaccines. The additional coverage offered by the 9vHPV may prevent a significant proportion of HPV-related cancers (variable between 8% and 18%) depending on the local distribution of high-risk HPV types in the population. It is impossible, at present, to anticipate the actual impact of the wide use of the 9vHPV in comparison with the bHPV or the qHPV, since it depends on many variables including duration of protection, potential cross-protection toward nonvaccine types, and herd immunity effect.
Full Text Available The species Alphapapillomavirus 7 (alpha-7 contains human papillomavirus genotypes that account for 15% of invasive cervical cancers and are disproportionately associated with adenocarcinoma of the cervix. Complete genome analyses enable identification and nomenclature of variant lineages and sublineages.The URR/E6 region was sequenced to screen for novel variants of HPV18, 39, 45, 59, 68, 70, 85 and 97 from 1147 cervical samples obtained from multiple geographic regions that had previously been shown to contain an alpha-7 HPV isolate. To study viral heterogeneity, the complete 8 kb genome of 128 isolates, including 109 sequenced for this analysis, were annotated and analyzed. Viral evolution was characterized by constructing phylogenic trees using maximum-likelihood and Bayesian algorithms. Global and pairwise alignments were used to calculate total and ORF/region nucleotide differences; lineages and sublineages were assigned using an alphanumeric system. The prototype genome was assigned to the A lineage or A1 sublineage.The genomic diversity of alpha-7 HPV types ranged from 1.1% to 6.7% nucleotide sequence differences; the extent of genome-genome pairwise intratype heterogeneity was 1.1% for HPV39, 1.3% for HPV59, 1.5% for HPV45, 1.6% for HPV70, 2.1% for HPV18, and 6.7% for HPV68. ME180 (previously a subtype of HPV68 was designated as the representative genome for HPV68 sublineage C1. Each ORF/region differed in sequence diversity, from most variable to least variable: noncoding region 1 (NCR1 / noncoding region 2 (NCR2 > upstream regulatory region (URR > E6 / E7 > E2 / L2 > E1 / L1.These data provide estimates of the maximum viral genomic heterogeneity of alpha-7 HPV type variants. The proposed taxonomic system facilitates the comparison of variants across epidemiological and molecular studies. Sequence diversity, geographic distribution and phylogenetic topology of this clinically important group of HPVs suggest an independent evolutionary
Fischer, Sonja; Bettstetter, Marcus; Becher, Andrea; Lessel, Marlene; Bank, Cyril; Krams, Matthias; Becker, Ingrid; Hartmann, Arndt; Jagla, Wolfgang; Gaumann, Andreas
The aim of the present population-based cohort study was to analyze the association between the prevalence of 32 types of human papilloma virus (HPV) in 615 female patients with abnormal cervical cytopathology findings. In total, 32 HPV types were screened by DNA array technology. HPV infection was detected in 470 women (76.42%), 419 of whom (89.15%) were infected with ≥1 high-risk (HR)-HPV type. HPV16, which is recognized as the main HR-HPV type responsible for the development of cervical cancer, was observed in 32.98% of HPV+ participants, followed by HPV42 (18.09%), HPV31 (17.66%), HPV51 (13.83%), HPV56 (10.00%), HPV53 (8.72%) and HPV66 (8.72%). The prevalence of HR-HPV types, which may be suppressed directly (in the case of HPV16 and 18), or possibly via cross-protection (in the case of HPV31) following vaccination, was considerably lower in participants ≤22 years of age (HPV16, 28.57%; HPV18, 2.04%; HPV31, 6.12%), compared with participants 23-29 years of age (HPV16, 45.71%; HPV18, 7.86%; HPV31, 22.86%), who were less likely to be vaccinated. Consequently, the present study hypothesizes that there may be a continuous shift in the prevalence of HPV types as a result of vaccination. Furthermore, the percentage of non-vaccine HR-HPV types was higher than expected, considering that eight HPV types formerly classified as 'low-risk' or 'probably high-risk' are in fact HR-HPV types. Therefore, it may be important to monitor non-vaccine HPV types in future studies, and an investigation concerning several HR-HPV types as risk factors for the development of cervical cancer is required.
Product news. Efficacy of Quadrivalent HPV Vaccine against HPV Infection and Disease in Males. Anna R Giuliano, Joel M Palefsky, Stephen Goldstone, Edson D Moreira, Mary E Penny, Carlos Aranda, Eftyhia Vardas, Harald Moi, Heiko Jessen, Richard Hillman, Yen-Hwa Chang, Daron Ferris, Danielle Rouleau, Janine ...
Larsson, Gabriella Lillsunde; Helenius, Gisela; Andersson, Sören; Sorbe, Bengt; Karlsson, Mats G
The objectives of this study are to investigate the human papilloma virus (HPV) distribution in vaginal cancer and to evaluate HPV-genotype as well as HPV16-variant impact on prognosis. Sixty-nine patients diagnosed with primary vaginal carcinoma (1975-2002) were included in the study. Detection of twelve high-risk HPV (hr HPV) and two low-risk HPV (lr HPV) was performed with realtime-PCR. Samples positive for HPV-16 were analyzed for variants in the E6-gene with PCR and pyrosequencing. 53.6% (37/69) of the tumors were found to be HPV-positive, mostly for HPV-16 (N=26). Other HPV-types were HPV-18 (N=2), HPV-31 (N=2), HPV-33 (N=2), HPV-45 (N=1), HPV-52 (N=2), HPV-56 (N=1) and HPV-58 (N=1). Only European subtypes of HPV-16 were represented and the two most common HPV-16-variants were E-p (N=13) and E-G350 (N=11). Patients with HPV-positive tumors (N=37) had a significantly (log-rank test=3.341; p=0.0008) superior 5-year overall survival rate as well as cancer-specific survival rate and progression-free survival rate (p=0.0002; p=0.0004), compared with patients with HPV-negative tumors (N=32). Interestingly, patients with HPV-16-positive tumors had a superior overall survival compared with patients with tumors containing other HPV-genotypes. In a Cox proportional multivariate analysis age, tumor size, and HPV-status were independent and significant prognostic factors with regard to overall survival rate. HPV-status is of prognostic importance in vaginal carcinoma and varies with viral genotype. In this era of HPV-vaccination, genotypes other than those included in the vaccination program could still lead to vaginal carcinoma with unfavorable prognosis. Copyright © 2013 Elsevier Inc. All rights reserved.
Jefferson P. Piva
Full Text Available OBJETIVO: Revisar os conceitos atuais da fisiopatologia, diagnóstico e tratamento da cetoacidose diabética (CAD na infância, assim como as medidas preventivas para evitar o edema cerebral. FONTES DOS DADOS: Os autores selecionaram artigos na MEDLINE com as palavras-chave diabetes, cetoacidose, hiperglicemia e edema cerebral, priorizando estudos realizados em crianças, que tenham textos completos publicados em inglês, português ou espanhol. Revisaram, ainda, capítulos de livros publicados no Brasil descrevendo o tratamento de CAD em unidade de tratamento intensivo pediátrico. Baseados na literatura revisada e em sua experiência, apresentam as medidas mais eficazes e recomendadas no manejo da CAD. SÍNTESE DOS DADOS: Consolida-se cada vez mais a utilização de solução fisiológica (NaCl 0,9% tanto na fase de reposição rápida quanto na fase de hidratação, em substituição às soluções diluídas (hipotônicas, assim como a contra-indicação do uso de bicarbonato de sódio para corrigir acidose metabólica na CAD. A insulina regular deve ser utilizada sob a forma de infusão contínua (0,1 UI/kg/h sem a necessidade de dose de ataque. Para rápidas correções das oscilações da glicemia, é apresentado um esquema prático com duas bolsas de soluções eletrolíticas. Revisam edema cerebral, seu mecanismo fisiopatológico e o tratamento atual. CONCLUSÕES: O uso de infusão contínua de insulina regular associada à reposição hídrica adequada com soluções isotônicas, além de tratamentos efetivos da CAD, preserva a osmolaridade plasmática e previne a ocorrência de edema cerebral.OBJECTIVE:To review current concepts of physiopathology, diagnosis and treatment of diabetic ketoacidosis (DKA in childhood, as well as preventive measures to avoid cerebral edema. SOURCES: The authors selected articles from MEDLINE with the keywords diabetes, ketoacidosis, hyperglycemia and cerebral edema, and priority was given to studies
Haber, Gillian; Malow, Robert M; Zimet, Gregory D
In this editorial we address the controversies surrounding human papillomavirus (HPV) vaccine school-entry mandate legislation, but differentiate between the mandate debate and issues specific to the vaccine itself. Our goal is not to take a stand in favor of or opposed to mandates, but rather to critically examine the issues. We discuss the following arguments against HPV vaccine school-entry requirements: 1. The public health benefit of mandated HPV vaccination is not sufficient to warrant the intrusion on parental autonomy; 2. A vaccine that prevents a non-casually transmitted infection should not be mandated; 3. Opt-out provisions are inherently unfair to parents who oppose HPV vaccination; 4. Limited health care dollars should not be directed toward cervical cancer prevention; and 5. The vaccine is expensive and potential problems with supply suggest that mandates should not be implemented until insurance coverage and supply issues are resolved. Next, we critically evaluate the following critiques of HPV vaccination itself: 1. Giving girls HPV vaccine implies tacit consent to engage in sexual activity; 2. Giving girls this vaccine will confer a false sense of protection from sexually transmitted infections and will lead to sexual disinhibition; 3. Children already have too many vaccinations on the immunization schedule; 4. Long-term side effects of HPV vaccine are unknown; 5. The vaccine's enduring effectiveness is unknown and booster shots may be required; and 6. It is wrong to only target girls with HPV vaccine; boys should be vaccinated as well.
Reusser, Nicole M; Downing, Christopher; Guidry, Jacqueline; Tyring, Stephen K
Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide and can result in pre-malignancies or overt malignancies of the skin and mucosal surfaces. HPV-related illnesses are an important personal and public health problem causing physical, mental, sexual and financial detriments. Moreover, this set of malignancies severely affects the immunosuppressed population, particularly HIV-positive patients and organ-transplant recipients. There is growing incidence of HPV-associated anogenital malignancies as well as a decrease in the average age of affected patients, likely related to the rising number of high-risk individuals. Squamous cell carcinoma is the most common type of HPV-related malignancy. Current treatment options for HPV infection and subsequent disease manifestations include imiquimod, retinoids, intralesional bleomycin, and cidofovir; however, primary prevention with HPV vaccination remains the most effective strategy. This review will discuss anogenital lesions in immunocompromised patients, cutaneous warts at nongenital sites, the association of HPV with skin cancer in immunocompromised patients, warts and carcinomas in organ-transplant patients, HIV-positive patients with HPV infections, and the management of cutaneous disease in the immunocompromised patient.
Nicole M. Reusser
Full Text Available Human papillomavirus (HPV infection is the most common sexually transmitted disease worldwide and can result in pre-malignancies or overt malignancies of the skin and mucosal surfaces. HPV-related illnesses are an important personal and public health problem causing physical, mental, sexual and financial detriments. Moreover, this set of malignancies severely affects the immunosuppressed population, particularly HIV-positive patients and organ-transplant recipients. There is growing incidence of HPV-associated anogenital malignancies as well as a decrease in the average age of affected patients, likely related to the rising number of high-risk individuals. Squamous cell carcinoma is the most common type of HPV-related malignancy. Current treatment options for HPV infection and subsequent disease manifestations include imiquimod, retinoids, intralesional bleomycin, and cidofovir; however, primary prevention with HPV vaccination remains the most effective strategy. This review will discuss anogenital lesions in immunocompromised patients, cutaneous warts at nongenital sites, the association of HPV with skin cancer in immunocompromised patients, warts and carcinomas in organ-transplant patients, HIV-positive patients with HPV infections, and the management of cutaneous disease in the immunocompromised patient.
Vasiljevic, Natasa; Hazard, Kristina; Eliasson, Linda
Two novel human papillomaviruses (HPVs), HPV93 and HPV96, with genomes of 7450 and 7438 bp, respectively, are described. The L1 open reading frame of HPV93 showed highest identity to HPV24 (79%) and that of HPV96 had highest identity to HPV92 (71%). Real-time PCR for HPV92, 93 and 96 on stripped ...... per 45 cells to one copy per 10,000 cells. The E7 proteins of HPV92, 93 and 96 were found to bind the retinoblastoma protein (pRb). These results suggest a possible role for these HPV types in skin carcinogenesis that deserves further study....
Camila Junqueira; Nelson Ernesto Coelho Junior
Ao admitirmos que os quadros borderline e as denominadas patologias da contemporaneidade freqüentemente associadas a esses quadros não são propriamente novos, resta saber como apareciam no passado. Um retorno a Freud sugere que as "neuroses atuais" correspondem às primeiras observações psicanalíticas dessas manifestações; ainda que a hipótese etiológica formulada por Freud sobre as "neuroses atuais", baseada no acúmulo de tensão sexual, precise ser revista. Atualmente seria difícil sustentar ...
Del Porto José Alberto
Full Text Available Este artigo revê o conceito de depressão e a nosologia contemporânea dos estados depressivos e seus diferentes subtipos. São discutidos aspectos relativos ao curso (formas agudas vs crônicas da doença, padrão sazonal, características fenomenológicas (melancolia, quadros psicóticos, quadros atípicos, formas catatônicas da doença, assim como a importância e o significado das alterações psicomotoras para o diagnóstico das chamadas depressões "endógenas" ou "vitais", de acordo com trabalhos contemporâneos (como os de Parker e Widlöcher. Este trabalho aborda também as fronteiras da depressão com o transtorno bipolar, os transtornos de personalidade, a desmoralização e os estados de luto normal, assim como os limites com outras doenças e estados induzidos por drogas.
Full Text Available Neste artigo, refazemos o percurso freudiano a propósito do conceito de paranoia em sua obra. Esse percurso se fará a partir dos textos considerados pré-psicanalíticos, passando por aquele que é considerado o texto maior de Freud sobre as psicoses (o Caso Schereber, culminando com suas análises que levam em consideração sua segunda teoria sobre o funcionamento psíquico e sobre o conflito pulsional. Nosso objetivo é demonstrar como Freud, em sua elaboração das questões relativas à psicose, e à paranoia, mais especificamente, jamais se furtava a encarar os desafios que a clínica impunha. E por não recuar frente a esses desafios é que a sua própria teoria vai se formulando, em uma relação dialética entre os impasses da prática e a necessidade de estabelecer um rigor teórico. O artigo trata, também, da forma como o rigor teórico permite o estabelecimento de um diagnóstico diferencial entre neurose e psicose, além de assentar as bases para que os psicanalistas pós-freudianos pudessem pensar em um direcionamento para tratar a psicose.
José Fernando Bitencourt Lomônaco
Full Text Available Keil investigou se a descoberta de essências internas ou princípios causais subjacentes alterariam as categorizações de crianças sobre conceitos de espécies naturais e artefatos. Esse trabalho replica parte do experimento de Keil (1989, buscando validar seus resultados em nosso meio. Participaram 30 crianças, subdivididas em três grupos de 617, 8/9 e 10/11 anos. Foram narradas a cada criança quatro estórias elaboradas por Keil, previamente traduzidas, duas referentes a espécies naturais e duas a artefatos. Eram relatadas situações em que cientistas "descobriam" que, debaixo dos aspectos superficiais de uma coisa, escondiam-se propriedades definidoras de uma outra coisa. Ao final de cada estória, o experimentador perguntava à criança: "Você acha que são X ou Y?", em que X referia-se à aparência do objeto e Y aos atributos definidores. No tocante a artefatos, os sujeitos não se influenciaram pelos aspectos superficiais, avaliando corretamente a identidade dos artefatos. Todavia, em relação às espécies naturais, somente com o aumento da idade os atributos definidores passaram a ser considerados. Tais achados confirmam os de Keil.
Full Text Available Questiona-se a atual definição de saúde da Organização Mundial da Saúde: "situação de perfeito bem-estar físico, mental e social" da pessoa, considerada ultrapassada, primeiramente, por visar a uma perfeição inatingível, atentando-se as próprias características da personalidade. Menciona-se como principal sustentação dessa idéia, a renúncia necessária a parte da liberdade pulsional do homem, em troca da menor insegurança propiciada pelo convívio social. Discute-se a validade da distincão entre soma, psique e sociedade, esposando o conceito de homem "integrado", e registrando situações em que a interação entre os três aspectos citados é absolutamente cristalina. É revista a noção de qualidade de vida sob um vértice antipositivista. Essa priorização e proposta de resgate do subjetivismo, reverte a um questionamento da atual definição de saúde, toda ela embasada em avaliações externas, "objetivas", dessa situação.
Full Text Available Questiona-se a atual definição de saúde da Organização Mundial da Saúde: "situação de perfeito bem-estar físico, mental e social" da pessoa, considerada ultrapassada, primeiramente, por visar a uma perfeição inatingível, atentando-se as próprias características da personalidade. Menciona-se como principal sustentação dessa idéia, a renúncia necessária a parte da liberdade pulsional do homem, em troca da menor insegurança propiciada pelo convívio social. Discute-se a validade da distincão entre soma, psique e sociedade, esposando o conceito de homem "integrado", e registrando situações em que a interação entre os três aspectos citados é absolutamente cristalina. É revista a noção de qualidade de vida sob um vértice antipositivista. Essa priorização e proposta de resgate do subjetivismo, reverte a um questionamento da atual definição de saúde, toda ela embasada em avaliações externas, "objetivas", dessa situação.
In this 30 second public service announcement, a mother talks about the importance of protecting 11-12 year-old boys and girls with HPV vaccination. (Una madre habla sobre la importancia de proteger a los niÃ±os y las niÃ±as de 11 a 12 aÃ±os con la vacuna contra el VPH.). Created: 1/15/2014 by National Center for Immunizations and Respiratory Diseases (NCIRD). Date Released: 1/15/2014.
Hélio Bernardo Lopes
É neste âmbito que surge, de modo permanente, o recurso ao conceito de média, mormente no estudo das distribuições de frequências. Neste domínio, contudo, o conceito de mais vasta aplicação é o de média aritmética, seja no caso de amostras de dados não classificados, seja no de classificados.
Full Text Available Com base em um corpus de quatro gêneros textuais - entrevistas orais e escritas, artigos jornalísticos e livros de não-ficção - o artigo focaliza o modo como o conceito 'sociedade' é abordado metaforicamente em discursos brasileiros e alemães atuais. Os resultados mostram que certos esquemas imagéticos são mais misturados e dinâmicos no corpus alemão em oposição ao corpus brasileiro, onde a percepção da própria sociedade tende a ser mais estática. Com relação a metáforas conceituais, destacam-se as metáforas negócio, edifício, jogo e observação como mais frequentes no corpus alemão, ao passo que no corpus brasileiro o uso das metáforas personificação, palco, flora, família e guerra é mais frequente. Acrescenta-se também uma microanálise que leva em consideração o contexto e as intenções dos locutores que revelam as funções comunicativas ligadas à preferência de certas metáforas.
Pier Luigi Lopalco Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy Abstract: Starting in 2006, vaccination against human papillomavirus (HPV) has been progressively implemented in most developed countries. Two vaccines have been successfully used, a bivalent vaccine targeting HPV-related cancers (bHPV) and a quadrivalent vaccine (qHPV) targeting both HPV-related cancers and genital warts. Between December 2014 and June 2015,...
Full Text Available Com freqüência o conceito de paisagem parece estar associa- do a esperanças igualmente misteriosas e, de alguma forma, supostamente capazes de transmitir a verdade, em especial desde que, na República Federal da Alemanha, se propagou o ideário ecológico. Para essa afirmativa encontramos reitera-da comprovação nas pesquisas paisagísticas da segunda metade do século 20 que, como me parece, embora tenham sido realizadas numa época em que a industrialização já era um fato onipresente, estão vinculadas3 a uma noção pré-in-dustrial de paisagem, ou seja, a uma paisagem em que a indústria era ainda inexistente. Neste estudo pretendo também chamar a atenção para alguns temas como: o conservado- rismo do interesse pela paisagem, o surgimento da paisa-gem como programa social, a paisagem da era nacional- socialista, a paisagem dos adversários da urbe, a paisagem de cunho antroposófico e, finalmente, o papel da paisagem no século XX e início do século XXI; esses temas poderão contribuir para a compreensão dos motivos que tornam questionável a persistência de um tal conceito de paisagem. About the questionability of landscape notion Abstract Both the notion of landscape and mysterious hopes seem to be linked together and they are believed to somehow tell the truth. In the Federal Republic of Germany this especially seems to have increased after ecological thoughts which began to circulate from the 1970s onwards. In the last quarter of the twentieth century, repeated studies about a so-called landscape picture, at a time of omni-present industrialization adhered to a pre-industrial image of landscape, that is a landscape without industry, document this.4 Further a few points are presented such as the conservative interest in landscape, the development of landscape as a societal program, the landscape in National Socialism, the landscape of those hostile towards
Ana Lúcia Prado
Full Text Available As atividades de leitura e escrita como práticas sociais ampliam sua esfera de apreensão e atuação em espaços virtuais; vistas além da presença do impresso, determinam modos distintos de agir e interagir nas relações interpessoais. Frente a isso emerge um contexto de múltiplas linguagens circulante nas mídias eletrônicas, o que se impacta diretamente nas relações de ensino-aprendizagem. Diante isso, este artigo assume como objetivo descrever diferentes perspectivas teóricas a respeito do conceito das narrativas digitais, com o propósito de delinear as principais reflexões teóricas da terminologia e da inserção no contexto das práticas de letramentos. Para isso, propõe-se uma reflexão teórica a partir das diferentes concepções sobre narrativas digitais, com base nas discussões de Pierre Lévy (1996, 1999, Walter Benjamin (1983, Almeida e Valente (2012 e Papert (1994, em diálogo com outros autores que discutem a temática. A discussão permite certa consonância entre a conceituação e a dinâmica da globalização, uma tendência que demarca significativamente o processo de construção de conhecimento do indivíduo e sua possibilidade de expressão social e cultural, uma vez que representa as características de um momento histórico, social e cultural.
Vidal Aurora Karla de Lacerda
Full Text Available The authors set out in this study to verify the presence of low- and high-risk DNA of human papillomavirus (HPV in oral cancer by means of the hybrid capture Digene® test (São Paulo-SP, Brazil in smears from exfoliative cytology and also to compare the findings with those of conventional light microscopy (hematoxylin-eosin (HE/Papanicolaou. Forty individuals gave their written informed consent to participate in the study and also had their clinical data analyzed. The 40 exfoliative cytology examinations performed to date produced the following results: 29 (72.5% negative for low- and high-risk HPV-DNA; nine (22.5% positive for low- and high-risk HPV-DNA; one (2.5% positive for low-risk HPV-DNA; and one (2.5% positive for high-risk HPV-DNA. There was agreement among the findings for the presence of DNA-HPV for both exfoliative cytology (smear to hybrid capture Digene® test and the cytological smear readings made by conventional light microscopy. It was therefore concluded that the HPV virus may be a cocarcinogen of the mouth cancer as it is in the cervix cancer.
Oliveira, Iraní Tomiatto de
O artigo apresenta uma visão panorâmica da psicoterapia psicodinâmica breve, desde sua origem até os dias atuais. Após a localização histórica de seu surgimento, faz referência aos modelos teóricos e técnicos mais utilizados nas últimas décadas e seus principais representantes. Inclui também algumas das principais contribuições à aplicação destas técnicas à população infantil.Palavras-chave: Psicoterapia Breve, Modelos de Psicoterapia Breve, Psicoterapia Breve de Crianças....
Motta,Mário Martins dos Santos; Coblentz, Jacqueline; Melo, Laura Gomes Nunes de
O edema macular é a principal causa de baixa visual em pacientes diabéticos. Seu mecanismo de formação é complexo e envolve alterações bioquímicas e estruturais. Os autores fazem uma revisão e atualização dos conceitos fisiopatológicos envolvidos na maculopatia diabética.
Martel, Catherine; Plummer, Martyn; Vignat, Jerome; Franceschi, Silvia
HPV is the cause of almost all cervical cancer and is responsible for a substantial fraction of other anogenital cancers and oropharyngeal cancers. Understanding the HPV?attributable cancer burden can boost programs of HPV vaccination and HPV?based cervical screening. Attributable fractions (AFs) and the relative contributions of different HPV types were derived from published studies reporting on the prevalence of transforming HPV infection in cancer tissue. Maps of age?standardized incidenc...
Alsaad, Mohammed A; Shamsuddin, Khadijah; Fadzil, Fariza
Cervical cancer is caused by HPV infection and can be prevented by early vaccination. To assess Syrian women's level of knowledge and determinants of good knowledge of cervical cancer, HPV infection and its vaccines. A cross sectional survey was undertaken among mothers with daughters in sixth grade classes enrolled in primary schools in Aleppo city, Syria. Samples were selected through cluster sampling and data collected using a self-administered questionnaire. Less than a third of the mothers had heard of HPV infection and vaccines against cervical cancer and levels of knowledge were generally low. Good knowledge was associated with high education level, higher family monthly income, having few--less than four children, positive history of cervical cancer screening, and working or having relatives working in the medical field. The main source of information was television and few reported health care providers as a source of knowledge on HPV infection and vaccine. Since knowledge of HPV infection and its connection with cervical cancer and its vaccine are low, more efforts must be made to educate Syrians prior to introduction of any HPV vaccination programme. Public health efforts must focus on educating mothers, the public as well as health care providers.
Vasiljević, Nataša; Scibior-Bentkowska, Dorota; Brentnall, Adam; Cuzick, Jack; Lorincz, Attila
High risk human papillomavirus (HR-HPV) infection is common and only a small minority of infections become persistent and lead to cervical cancers. Women positive for HR-HPV usually require a second test to avoid unnecessary colposcopies and over treatment. Elevated DNA methylation of HR-HPV L1 and L2 genes in high grade disease has emerged as a promising molecular triage tool. Our aim was to accurately measure methylation levels at selected CpG positions in the HPV18, HPV31 and HPV33 genomes. We focused on the L2, L1, URR and E6 regions because these were previously shown to be interesting areas for study. Pyrosequencing was used to measure methylation in 208 HPV18, 207 HPV31, and 126 HPV33 positive women selected from a London colposcopy referral population. After adjustment for multiple testing, at FDR 5%, elevated methylation was significantly associated with cervical intraepithelial neoplasia grades 2 or worse (CIN2+) in all investigated CpGs in HPV18 L2 and L1. Two of 6 L2 and 12 of 15 L1 sites in HPV31 and 6 of 8 L2 and 3 of 13 L1 sites in HPV33 showed significantly elevated methylation in CIN2+. Methylation of CpG sites in the URR and E6 region of the HPV types was low and most differences were not significant. Elevated methylation of CpG sites in the L1 and L2 regions of HPV18, HPV31 and HPV33 is associated with CIN2+ and a panel test may be useful for triage of women with HR-HPV infections. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.
Adjei Boakye, Eric; Tobo, Betelihem B; Rojek, Rebecca P; Mohammed, Kahee A; Geneus, Christian J; Osazuwa-Peters, Nosayaba
Purpose: Gaps remain in the public's knowledge of the human papillomavirus (HPV). We assessed racial/ethnic and gender disparities in knowledge and awareness of HPV and the HPV vaccine among US adults. Data from the Health Information National Trends Survey 4 Cycle 3 (September - December 2013) and Cycle 4 (August - November 2014) were analyzed for 6,862 respondents aged 18 years and older. Weighted multivariable logistic regression models were used to estimate racial/ethnic and gender disparities in HPV knowledge and HPV vaccination awareness. Sixty-six percent of respondents had heard of HPV and the HPV vaccine (57% of men vs. 75% of women). In multivariable analyses, compared with men, women were 225% (95% CI: 2.60 - 4.07) more likely to have heard of HPV, and 281% (95% CI: 3.06 - 4.74) more likely to have heard of the HPV vaccine. Non-Hispanic Blacks were 33% (95% CI: 0.47 - 0.96) and 44% (95% CI: 0.39 - 0.81) less likely than non-Hispanic Whites to have heard of HPV and the HPV vaccine, respectively. Hispanics were 27% (95% CI: 0.52 - 1.02) and 53% (95% CI: 0.34 - 0.64) less likely than non-Hispanic Whites to have heard of HPV and the HPV vaccine, respectively. There was evidence of disparities in HPV and HPV vaccine awareness among men compared with women and non-Hispanic Blacks and Hispanics compared with non-Hispanic Whites. To foster improvements in HPV vaccine uptake and reduce disparities in HPV associated cancers, future interventions must target men and minority populations, for whom knowledge gaps exist.
O que é um conceito no sentido de Hegel é, atualmente, algo praticamente desconhecido. Como exemplo de um conceito, a Filosofia Moderna da Linguagem apresenta aproximadamente o conceito de pílula anticoncepcional. Nenhuma mulher, nem mesmo uma admiradora da dialética, compreenderia, por exemplo, se, no médico passando a receita, o conceito de pílula anticoncepcional começasse a correr e no farmacêutico transmutasse no seu oposto. Ninguém admitiria que com os conceitos fundamentais de nossa vi...
Full Text Available BACKGROUND: An increasing incidence of anal cancer among men, especially men who have sex with men (MSM suggests a need to better understand anal human papillomavirus (HPV infection among this group. METHODS: A cross-sectional study was conducted among MSM in Shenzhen, China. Blood was collected for HIV serological testing and syphilis serological screening, and anal swabs were collected for HPV genotyping. Difference of HPV prevalence between HIV seropositive and HIV seronegative MSM was assessed by chi-square test. Factors associated with anal canal HPV infection were assessed by univariate and multivariate logistic regression. RESULTS: A total of 408 MSM were recruited. HIV and HPV prevalence were 6.9% and 36.4%, respectively. HPV was detected in the anal canal in 71.4% of the HIV-positive MSM and in 33.8% of the HIV-negative MSM (P<0.001. Oncogenic types were seen more often in anal specimens of HIV-positive MSM than in specimens of HIV-negative MSM (P = 0.001. The HPV genotypes detected most frequently were HPV06 (8.2%, HPV16 (7.2%, HPV11 (6.4%, HPV18 (4.7%, HPV58 (4.7%, and HPV52 (4.2%. CONCLUSIONS: In this study, HIV positive MSM had a higher burden of HPV infection, especially oncogenic HPV infection. HPV types 52 and 58 were as popular as those types designed for the currently available vaccine (HPV6, 11, 16, 18.
Márcia Yuri Shinohara
Full Text Available Dando prosseguimento às pesquisas anteriores realizadas pelo Núcleo de Assistência para o Autocuidado da Mulher (NAAM sobre aspectos relativos à menstruação, desenvolvemos um trabalho que estudou os conceitos de 705 mulheres sobre sua menstruação. Foram utilizadas informações do banco de dados do NAAM, obtidos na aplicação do Histórico de Saúde da Mulher no Município de Vargem Grande Paulista. O conceito mais relatado pelas mulheres foi o Normal. Isto talvez explique os dados obtidos em trabalhos anteriores, onde muitas mulheres nada fazem para aliviar os sintomas dolorosos da menstruação. O acesso a estes conceitos próprios é importante para elaborar uma assistência de enfermagem de qualidade respeitando as crenças e valores dentro da cultura das mulheres.
Bruno dos Santos Silva
A presente investigação visa apresentar o conceito de psicopatia, desde seu nascimento, ainda no século XIX, até os autores que forneceram a estrutura como é tida atualmente pela comunidade científica. Em seguida, o referido conceito será analisado à luz de alguns autores da criminologia crítica. Assim, o presente artigo utilizar-se-á das construções da Criminologia para interpretar a conformação do objeto psicopatia e que repercussões institucionais ela pode trazer.
Monteiro, Maria Benedicta; Lima, Maria Luísa; Vala,Jorge
O conceito de identidade social tem, nos últimos anos, sido progressivamente mais utilizado na descrição e explicação do comportamento social. No contexto da psicologia social, este conceito é apresentado por Henri Tajfel na teoria das relações intergrupos, como a causa dos comportamentos de discriminação entre grupos sociais, mas esta relação não se tem conseguido demonstrar empiricamente. Neste artigo, a par da apresentação de uma nova metodologia de avaliação da identidade social, pretende...
Full Text Available ... V.E. parents for prevention publications schedules & records support statements vaccine initiative vaccine safety about bucking the ... GETVAXED.ORG cme Immunizations HPV (Human Papillomavirus) One family's struggles with HPV We provide this video in ...
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Skorstengaard, Malene; Thamsborg, Lise Holst; Lynge, Elsebeth
Background: Denmark is one of the countries where Human papillomavirus (HPV)-vaccination at present includes only girls. However, the burden of HPV-related cancer in men is increasing, which would argue for gender-neutral vaccination. The aim of this study was to examine the burden of HPV......-caused cancers in women and men, and to evaluate the potential of HPV-vaccination in cancer control. Methods: Data were retrieved from the literature on population prevalence of high risk (HR) HPV, on HR HPV-prevalence and genotypes in HPV-related cancers, and on number of cytology samples in cervical screening...... were preventable with HPV vaccination. However, including screening prevented cervical cancers, the burden of cancers caused by HPV-infection would be 1300–2000 in women as compared to 234 in men. Conclusion: Taking screening prevented cervical cancers into account, the cancer control potential of HPV...
Four-fifths of the cervical cancer burden in the world is experienced in developing countries. HPV genotypes 16 and 18 account for 70 per cent of cervical cancers and currently available vaccines targeting these two types confer a high degree of protection against HPV 16/18 infection and related cervical precancerous lesions. However, widespread implementation of HPV vaccination programs are challenged by the unaffordable high costs of the vaccines and the lack of effective vaccine delivery platforms for sexually naïve girls. Other unresolved issues include long-term protection, cross-protection against HPV types not included in the vaccine and whether booster doses will be needed. Sensitivities associated with a vaccine preventing a sexually transmitted infection in girls, lack of awareness, public demand and political will, lack of coordination between cancer control, sexual and reproductive health and vaccine delivery services are additional challenges. Reduced costs, simple vaccine regimes and strengthening vaccine delivery platforms for adolescents should eventually facilitate HPV vaccine introduction in developing countries.
Geraldo De Mori
Full Text Available O discurso cristológico vive nos últimos dois séculos, mas, sobretudo, a partir dos anos 50, tanto do ponto de vista exegético quanto teológico-sistemático, um período de grande fecundidade e transformação. Esse texto não pretende retraçar exaustivamente o caminho percorrido nesse período, com a riqueza que o caracteriza, nem tampouco analisar em detalhes suas atuais orientações. Seu objetivo é mais modesto. Num esforço de sistematização, ele apresentará os acentos dados aos distintos modelos ou figuras da cristologia hoje, mostrando que, para além do risco da fragmentação, essa polifonia da nomeação de Jesus Cristo é benéfica para o saber cristológico e para o fazer teológico.
McBride, Kimberly R.; Singh, Shipra
High human papillomavirus (HPV) prevalence and low HPV vaccine uptake are significant public health concerns. Disparities in HPV-associated cancers and HPV vaccine uptake rates suggest the need for additional research examining factors associated with vaccine acceptance. This study assessed HPV awareness and knowledge and identified…
Ney Cesar de Oliveira King
Full Text Available O estudo de temas relacionados à produtividade ocupa um lugar de destaque na agenda estratégica das empresas desde a gênese dos modelos de produção em massa. Vários modelos, processos e técnicas vêm sendo desenvolvidos com o propósito de melhorar os atuais níveis de desempenho das organizações. O conceito de produtividade evoluiu de uma abordagem unidimensional para um enfoque sistêmico, no entanto as diferentes técnicas desenvolvidas para a sua mensuração tratam de dimensões específicas. Há, portanto, a necessidade de se integrar tais técnicas em um modelo de gestão pela produtividade sistêmica, o que constitui o principal objetivo deste artigo. Partindo da construção de um conjunto de determinantes teóricos que representam a produtividade sistêmica, desenvolveu-se um processo para a sua mensuração utilizando-se como metodologia a abordagem por processos de Cambridge. Tal processo foi refinado via entrevistas e é ilustrado por um caso de simulação.The study of themes related to productivity has occupied a special place in the strategic agenda of enterprises since the beginnings of mass production. Several models, processes and techniques have been developed with the purpose of improving the present performance levels of organizations. The concept of productivity has been following an evolution cycle from one-dimension approach to a systemic view; however, the different techniques used for its measurement are designed only for some of its specific dimensions. There is a need for integrating those techniques through a systemic productivity management model, and this is the main objective of this paper. Starting from a set of theoretical guidelines that represents the systemic productivity management model, a process was developed for its measurement using the Cambridge process approach. This process was refined by interviews with experts and illustrated by a case study simulation.
A new study from NCI researchers finds that the HPV vaccine protects young women from infection with high-risk HPV types at the three primary anatomic sites where persistent HPV infections can cause cancer. The multi-site protection also was observed at l
Leilane Barbosa de Sousa
Full Text Available Este trabalho foi realizado com o objetivo de investigar o nível de conhecimento das mulheres sobre o HPV, para, a partir daí, identificar crenças, mitos e tabus sobre a doença e analisar a influência destes elementos culturais no comportamento da mulher. Realizamos um estudo baseado nos pressupostos da teoria do cuidado transcultural. A pesquisa foi desenvolvida a partir do depoimento de quinze mulheres que realizavam tratamento para HPV. Através da investigação, foi possível perceber que, apesar das inúmeras fontes de informação sobre DST, o HPV ainda é uma doença desconhecida e cercada de mistério. Este desconhecimento, interagindo com fatores culturais, favorece o desenvolvimento de conceitos equivocados, tais como crenças e mitos.Este trabajo fue realizado con el objetivo de investigar el nivel de conocimientos de las mujeres sobre el VPH, para así identificar creencias, mitos y tabúes sobre la enfermedad y analizar la influencia de estos elementos culturales en el comportamiento de la mujer. Realizamos un estudio basado en los supuestos de la teoría del cuidado transcultural. La investigación fue realizada en base a los testimonios de quince mujeres en tratamiento para VPH. A través de la investigación fue posible percibir que, a pesar de las innúmeras fuentes de información sobre ETS, el VPH es aún una enfermedad desconocida y rodeada de misterios. Esta falta de conocimiento asociados a los factores culturales, favorecen el desarrollo de conceptos equivocados, tales como creencias y mitos.This study was carried out in order to investigate the level of women's knowledge about HPV, to identify beliefs, myths and taboos about HPV, as well as to analyze the influence of these cultural elements on women's behavior. We performed a study based on the transcultural care theory. The research was developed from the testimonies of 15 women who were undergoing treatment for HPV. Through the investigation, it was possible to
Berenice Victor Carneiro
Full Text Available Alexitimia é um termo empregado no diagnóstico clínico de pessoas com acentuada dificuldade ou incapacidade para expressar emoções e significa " sem palavras para as emoções" . O objetivo deste artigo é apresentar uma revisão do conceito de alexitimia, enfatizando a importância das recentes contribuições da neurobiologia. É abordado o desenvolvimento do conceito desde os anos 70, ressaltando as contribuições de Sifneos e a estreita relação desse conceito com as doenças psicossomáticas. Em seguida, apresenta-se o conceito a partir de uma perspectiva multifatorial e destaca-se a importância do substrato neurológico para a melhor compreensão da etiologia. Finalmente, sugere-se ser necessária a compreensão integrada do papel dos fatores etiológicos para o tratamento e prevenção.
Cheng, Jiao-ying; Bian, Mei-lu; Ma, Li; Cong, Xiao; Chen, Ying; Liu, Jun
To evaluate clinical efficacy of different HPV methods in screening of cervical cancers. Between August 2011 and November 2011, 424 women in the China-Japan Friendship Hospital were enrolled in this study. All participants were undergone liquid-based cytology test (LCT), Hybrid capture II (HC-II) and real-time (RT) PCR high risk HPV DNA test for HPV16 and HPV18 genotyping. Those results were classified into two group: 424 women at HC-II group with LCT and HC-II test and 421 women at PCR group with LCT and PCR test. All women with atypical squamous cell of undetermined significance (ASCUS) or above in cytological result with high risk HPV positive at two group underwent cervical biopsy by colposcopy.In the mean time, women with negative in cytological results and with HPV 16 and(or) HPV 18 positive also underwent histo-pathological examination by and colposcopy. The results in two groups were discussed:LCT+HC-II group (424 patients) and LCT+PCR12+2 group (421 patients). (1) There was no significant difference in cervical intraepithelial neoplasia (CIN) II or above disease between LCT+HC-II group and LCT+PCR12+2 group (χ(2) = 3.35, P > 0.05).Sensitivity, specificity, positive predictive value and negative predictive value for detection of CINII or above using HC-II and PCR12+2 were 77.8%, 79.4%, 20.4%, 98.1% and 96.3%, 78.2%, 23.2%, 99.7%, respectively. (2) In LCT+PCR12+2 group, it was found 34 women with HPV16 positive, 5 women with HPV 18 positive including 1 women combined with HPV 16 positive, 74 women with other high risk HPV positive and 309 women with HPV negative. Compared to the infection of other high-risk HPV types, HPV 16 and HPV 18 infection leads to a higher chance of cervical lesions with CIN II or above [51.3% (20/39) and 8.1% (6/74) ]. (3) A significant difference of causing cervical cancer and CINII or above was found among women who were infected with HPV 16 and/or HPV 18 infection, with other high-risk HPV types and negative in high-risk HPV
James Sutherland Lawson
Full Text Available Purpose: Human papillomaviruses (HPV may have a role in some breast cancers. The purpose of this study is to fill important gaps in the evidence. These gaps are: (i confirmation of the presence of high risk for cancer HPVs in breast cancers, (ii evidence of HPV infections in benign breast tissues prior to the development of HPV positive breast cancer in the same patients, (iii evidence that HPVs are biologically active and not harmless passengers in breast cancer.Methods: RNA-seq data from The Cancer Genome Atlas (TCGA was used to identify HPV RNA sequences in breast cancers. We also conducted a retrospective cohort study based on polymerase chain reaction (PCR analyses to identify HPVs in archival specimens from Australian women with benign breast biopsies who later developed breast cancer. To assess whether HPVs in breast cancer were biologically active, the expression of the oncogenic protein HPV E7 was assessed by immunohistochemistry (IHC.Results: Thirty (3.5% low risk and 20 (2.3% high risk HPV types were identified in 855 breast cancers from the TCGA data base. The high risk types were HPV 18 (48%, HPV 113 (24%, HPV 16 (10%, HPV 52 (10%. Data from the PCR cohort study, indicated that HPV type 18 was the most common type identified in breast cancer specimens (55% of 40 breast cancer specimens followed by HPV 16 (13%. The same HPV type was identified in both the benign and subsequent breast cancer in 15 patients. HPV E7 proteins were identified in 72% of benign breast specimens and 59% of invasive breast cancer specimens.Conclusions: There were 4 observations of particular interest: (i confirmation by both NGS and PCR of the presence of high risk HPV gene sequences in breast cancers, (ii a correlation between high risk HPV in benign breast specimens and subsequent HPV positive breast cancer in the same patient, (iii HPVs in breast cancer are likely to be biologically active (as shown by transcription of HPV DNA to RNA plus the expression of
Larsen, Christian Grønhøj; Jensen, David H; Carlander, Amanda-Louise Fenger
recorded. The 5-year OS, TTP, and SAP for the HPV+/p16+ subgroup were 77%, 82%, and 33, vs. 30%, 66%, and 6% for the HPV-/p16- group (P HPV+/p16+ subgroup vs. 8.5 months in the HPV-/p16- subgroup (P HPV...... Cox regression model was used to construct predictive, internally validated nomograms. CONCLUSION: The HPV+/p16+ subgroup had improved OS, TTP, and SAP compared with other combinations of HPV and p16 after adjusting for covariates. Nomograms were constructed for 1-, 5- and 10-year survival probability......BACKGROUND: No study has combined tumour and clinical covariates for survival to construct an individual risk-profile for overall survival (OS), time to progression (TTP), and survival after progression (SAP) in patients with HPV+ and HPV- oropharyngeal squamous cell carcinoma (OPSCC). Based...
Paula Barros Antunes
Full Text Available OBJETIVO: A eficácia da eletroconvulsoterapia em tratar sintomas depressivos está estabelecida por meio de inúmeros estudos desenvolvidos durante as últimas décadas. A eletroconvulsoterapia é o tratamento biológico mais efetivo para depressão atualmente disponível. O objetivo deste estudo foi demonstrar o papel da eletroconvulsoterapia no tratamento da depressão e destacar aspectos atuais relativos à sua prática. MÉTODO: Foram revisados na literatura estudos de eficácia, remissão de sintomas, fatores preditores de resposta, assim como aspectos atuais acerca da qualidade de vida, percepção dos pacientes, mecanismo de ação, técnica e prejuízo cognitivos. RESULTADOS: Os principais achados desta revisão foram: 1 a eletroconvulsoterapia é mais efetiva do que qualquer medicação antidepressiva; 2 a remissão da depressão com a eletroconvulsoterapia varia, em geral, de 50 a 80%; 3 Ainda é controverso o efeito da eletroconvulsoterapia nos níveis de fator neurotrófico derivado do cérebro (acho que aqui pode colocar entre parenteses o "BNDF"; 4 a eletroconvulsoterapia tem efeito positivo na melhora da qualidade de vida; 5 os pacientes submetidos à eletroconvulsoterapia, em geral, têm uma percepção positiva do tratamento. CONCLUSÃO: A eletroconvulsoterapia permanece sendo um tratamento altamente eficaz em pacientes com depressão resistente. Com o avanço da sua técnica, a eletroconvulsoterapia tornou-se um procedimento ainda mais seguro e útil tanto para a fase aguda, quanto para a prevenção de novos episódios depressivos.OBJECTIVE: The efficacy of electroconvulsive therapy in treating depressive symptoms has been established by means of innumerable studies developed along the last decades. Electroconvulsive therapy is the most effective biological treatment for depression currently available. The objective of this study was to demonstrate the role of electroconvulsive therapy in the treatment of depression and
Fischer, Sonja; Bettstetter, Marcus; BECHER, ANDREA; LESSEL, MARLENE; BANK, CYRIL; Krams, Matthias; Becker, Ingrid; Hartmann, Arndt; Jagla, Wolfgang; Gaumann, Andreas
The aim of the present population-based cohort study was to analyze the association between the prevalence of 32 types of human papilloma virus (HPV) in 615 female patients with abnormal cervical cytopathology findings. In total, 32 HPV types were screened by DNA array technology. HPV infection was detected in 470 women (76.42%), 419 of whom (89.15%) were infected with ≥1 high-risk (HR)-HPV type. HPV16, which is recognized as the main HR-HPV type responsible for the development of cervical ca...
Jan 27, 2012 ... HPV-6 (5.4%), HPV-81 (4.6%) and HPV-33 (4.2%). Significant association of HPV with non-vegetarian diet (P<0.05) and rural residential areas (P<0.01) were observed. High prevalence of HPV-16 in asymptomatic women of this population, a frequency comparable to invasive cervical cancers, highlights ...
Human papillomavirus (HPV) testing using molecular methods in liquid based cytology (LBC) specimens may be useful as an adjunct to cervical screening by cytology. We compared the positivity rate of the commercially available HPV DNA method hybrid capture 2 (hc2) and the commercially available E6\\/E7 mRNA method PreTect HPV-Proofer in cytological specimens (n=299). LBC specimens collected (n=299) represented the following cervical cytological disease categories: Normal (n=60), borderline nuclear abnormalities (BNA) (n=34), CIN1 (n=121), CIN2 (n=60), CIN3 (n=24). Overall, 69% (205\\/299) of the cases were positive by hc2 and 38% (112\\/299) of the cases were positive by PreTect HPV-Proofer. Concordance rates between the two tests were highest in the high-grade cytology cases (CIN2: 67% and CIN3: 83%) and the normal cytology cases (88%) and lowest in the BNA and CIN1 categories (56% and 52%). HPV DNA viral load analyses were carried out on HPV16 (n=55), HPV18 (n=9) and HPV33 (n=13) samples that were positive by PreTect HPV-Proofer. The sensitivity and specificity of PreTect HPV-Proofer and the hc2 DNA test for the detection of high-grade cytology (i.e. CIN2+) were 71.4% and 75.8% vs 100% and 43.7%, respectively. The relatively low detection rate observed by PreTect HPV-Proofer in the whole range of cytological positive cases, combined with a relatively higher specificity and PPV, suggests that PreTect HPV-Proofer may be more useful than hc2 for triage and in predicting high-grade disease.
Rietbergen, Michelle M; Braakhuis, Boudewijn J M; Moukhtari, Nadia; Bloemena, Elisabeth; Brink, Arjen; Sie, Daoud; Ylstra, Bauke; Baatenburg de Jong, Robert J; Snijders, Peter J F; Brakenhoff, Ruud H; Leemans, C René
Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCCs) have a better prognosis than patients with HPV-negative OPSCCs. Important factors contributing to this better prognosis are relatively low numbers of local/regional recurrences (LRRs) and second primary tumors (SPTs) in patients with HPV-positive OPSCC. These low numbers may be explained in addition by the absence of a 'field cancerization' effect, which is a cause of LRRs and SPTs in patients with HPV-negative OPSCC. We aimed to detect a possible 'field effect' in patients with HPV-positive OPSCC. As HPV is involved in the early stage of carcinogenesis in OPSCCs, its presence is considered a reliable marker for the detection of such a field effect. Therefore, the presence of transcriptionally active HPV was analyzed in the mucosa surrounding HPV-positive OPSCCs. We included 20 patients who were surgically treated for an HPV-positive OPSCC in the period 2000-2006. Of each patient, the formalin-fixed paraffin-embedded tumor sample and all available resection margins were collected. In total, 97 resection margins were investigated with an average of five resection margins per tumor. All samples were analyzed for the presence of tumor and the presence of transcriptionally active HPV by HPV16-E6-mRNA detection. All tumors were HPV16-E6-mRNA positive. HPV16-E6-mRNA could be detected in the resection margins that contained tumor (n = 6). All tumor-negative resection margins (n = 91) scored negative for HPV16-E6-mRNA. In conclusion, transcriptional active HPV could not be detected in the mucosa surrounding an HPV-positive OPSCC, which suggests the absence of field effect. This observation may explain the lower number of LRRs and SPTs in HPV-positive patients. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
de Martel, Catherine; Plummer, Martyn; Vignat, Jerome; Franceschi, Silvia
HPV is the cause of almost all cervical cancer and is responsible for a substantial fraction of other anogenital cancers and oropharyngeal cancers. Understanding the HPV-attributable cancer burden can boost programs of HPV vaccination and HPV-based cervical screening. Attributable fractions (AFs) and the relative contributions of different HPV types were derived from published studies reporting on the prevalence of transforming HPV infection in cancer tissue. Maps of age-standardized incidence rates of HPV-attributable cancers by country from GLOBOCAN 2012 data are shown separately for the cervix, other anogenital tract and head and neck cancers. The relative contribution of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 was also estimated. 4.5% of all cancers worldwide (630,000 new cancer cases per year) are attributable to HPV: 8.6% in women and 0.8% in men. AF in women ranges from 20% in India and sub-Saharan Africa. Cervix accounts for 83% of HPV-attributable cancer, two-thirds of which occur in less developed countries. Other HPV-attributable anogenital cancer includes 8,500 vulva; 12,000 vagina; 35,000 anus (half occurring in men) and 13,000 penis. In the head and neck, HPV-attributable cancers represent 38,000 cases of which 21,000 are oropharyngeal cancers occurring in more developed countries. The relative contributions of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 are 73% and 90%, respectively. Universal access to vaccination is the key to avoiding most cases of HPV-attributable cancer. The preponderant burden of HPV16/18 and the possibility of cross-protection emphasize the importance of the introduction of more affordable vaccines in less developed countries. © 2017 International Agency for Research on Cancer (IARC/WHO); licensed by UICC.
Skorstengaard, Malene; Thamsborg, Lise Holst; Lynge, Elsebeth
Denmark is one of the countries where Human papillomavirus (HPV)-vaccination at present includes only girls. However, the burden of HPV-related cancer in men is increasing, which would argue for gender-neutral vaccination. The aim of this study was to examine the burden of HPV-caused cancers in women and men, and to evaluate the potential of HPV-vaccination in cancer control. Data were retrieved from the literature on population prevalence of high risk (HR) HPV, on HR HPV-prevalence and genotypes in HPV-related cancers, and on number of cytology samples in cervical screening. Data on annual biopsies and conisations were retrieved from the Danish National Health Service Register and the Danish National Patient Register. Incidences of HPV-related cancers in Denmark were extracted from NORDCAN. Number of HPV-caused cancers was calculated from number of HPV-related cancers and the proportion known to be caused by high-risk (HR) HPV. In cross-sectional surveys in Denmark, one fifth of women and almost one third of men were found to be positive for HR HPV. Per year, 548 HPV-caused cancer cases were diagnosed in women and 234 in men, and twice as many cancers in women as in men were preventable with HPV vaccination. However, including screening prevented cervical cancers, the burden of cancers caused by HPV-infection would be 1300-2000 in women as compared to 234 in men. Taking screening prevented cervical cancers into account, the cancer control potential of HPV-vaccination is considerably higher in women than in men. HPV-vaccination could reduce the burden of screening on women and on health care resources. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Krawczyk, Andrea; Stephenson, Ellen; Perez, Samara; Lau, Elsa; Rosberger, Zeev
Background: The human papillomavirus (HPV) vaccine was recently approved for men. To effectively tailor HPV education efforts toward men, it is important to understand what men know about HPV and how this knowledge relates to their decision to receive the vaccine. This study examines how objective HPV knowledge, objective HPV vaccine knowledge,…
Schmeink, C.E.; Gosens, K.C.; Melchers, W.J.G.; Massuger, L.F.A.G.; Bekkers, R.L.M.
PURPOSE: To investigate the effect of implementation of the HPV vaccine on HPV knowledge and HPV vaccine acceptance. METHODS: From June until December 2009 in Nijmegen, the Netherlands, 698 male and female students aged 18-25 years were recruited and interviewed about HPV, cervical carcinoma and HPV
Full Text Available Este artigo tem como objetivo contrastar as perspectivas liberal e republicana sobre o conceito de liberdade. Através da comparação feita entre os dois modelos tecemos considerações sobre a realidade brasileira tendo como foco o atual estado de crises advindas dos casos de corrupção no país.
Arivaldo Leão de Amorim
Full Text Available Este artigo discute o paradigma City Information Modeling (CIM a partir de uma abordagem ampla, considerando um viés teórico e conceitual deste e de outros termos relacionados. O CIM tem sido apontado por alguns autores como uma extensão do conceito de BIM para o espaço urbano. Contudo, face às características da cidade em relação à edificação isolada e à profusão de conceitos ora em uso, algumas questões precisam ser aprofundadas. Estes conceitos estão intimamente relacionados, apresentando algum tipo de sobreposição, e talvez por isto, sejam confundidos. Assim, pretende-se ampliar a discussão sobre esses conceitos, contribuindo para a utilização dos mesmos e avançando no estabelecimento de uma conceituação e terminologias que facilitem o desenvolvimento das aplicações e a adoção das tecnologias nas práticas relativas ao planejamento, à gestão e ao monitoramento da cidade. Não e tem a pretensão de esgotar o tema, seja pela vastidão das questões envolvidas, seja ainda pelo reduzido espaço a para discussão das mesmas, mas principalmente, porque estas questões estão “em aberto”, sendo objeto de discussões e controvérsias.
José Fernando Bitencourt Lomônaco
Full Text Available Este trabalho visou a avaliar a concepção de responsabilidade social de gestores e empregados de algumas empresas que participam da Política Nacional de Integração da Pessoa com Deficiência. A amostra foi constituída por 57 sujeitos, divididos em dois grupos: gestores e empregados. O grupo de gestores foi formado por 19 profissionais de recursos humanos, e o grupo de empregados, por 38 profissionais com deficiência. Os sujeitos foram solicitados a escrever as associações evocadas pelas palavras responsabilidade social em um período de 90 segundos. A partir dos dados coletados, as respostas dos sujeitos foram agrupadas em oito categorias: preocupação com o ambiente, inclusão social, solidariedade, respeito, compromisso social, sentimentos e atitudes positivos, coletividade e outras respostas. A análise estatística do Qui-quadrado permitiu rejeitar a hipótese nula com um alto grau de probabilidade. Verificou-se que o maior número de respostas associadas ao conceito de responsabilidade social concentrou-se nas categorias inclusão social, sentimentos/atitudes positivos e preocupação com o meio ambiente que, em conjunto, englobaram pouco mais da metade (52% do total das respostas. A fim de avaliar o grau de associação entre as respostas dos gestores e dos empregados, foi calculado o coeficiente de correlação posto-ordem de Spearman. Os resultados permitiram identificar uma rede de conceitos associados ao conceito de responsabilidade social, tal como previsto por uma das teorias sobre formação de conceitos: a visão teórica.
Marília Luz David
Full Text Available http://dx.doi.org/10.5007/1806-5023.2011v8n1p30 O presente artigo discute as contribuições de Anthony Giddens e Niklas Luhmann para uma melhor definição do conceito de risco, tendo em vista o rigor teórico de ambos os autores. Inicialmente é feita uma breve exposição sobre como o conceito de risco passou a ser utilizado na Modernidade e recebeu a atenção de autores das Ciências Sociais, principalmente a partir da abordagem cultura proposta por Mary Douglas. Em seguida, as definições e correspondentes argumentos sobre o conceito de risco em Luhmann e Giddens são apresentados respectivamente. Finalmente, alguns pontos de distanciamento entre os autores são discutidos e de que maneira cada um contribuiu para o debate sobre os riscos na teoria social e para o diagnóstico da Modernidade.
Rosinda Martins Oliveira
Full Text Available O interesse no Executivo Central (EC cresce a cada dia em vista da observação de disfunção executiva em patologias como o transtorno do déficit de atenção. Entretanto, embora existam referências a esse conceito na literatura nacional, não há nenhum estudo dedicado a um detalhamento teórico a seu respeito. Este trabalho apresenta o conceito de Executivo Central e suas origens teóricas. O EC se caracteriza como um coordenador das operações mentais. A concepção desse sistema remonta à dicotomia entre processos controlados e automáticos. O EC foi explorado na Psicologia soviética e, no contexto da teoria do processamento da informação, seu funcionamento foi explicitado no modelo composto por um Sistema Atencional Supervisor e um organizador pré-programado. Conhecer as origens do conceito de Executivo Central pode trazer novas idéias sobre o seu desenvolvimento normal ou patológico.
Yang, Yang; Jia, Chan-Wei; Ma, Yan-Min; Zhou, Li-Ying; Wang, Shu-Yu
Human papillomavirus (HPV) is one of the most common sexually transmitted diseases which comprises a group of small DNA viruses that infect both cutaneous and mucous squamous epithelia. Liquid bead microarray technology (LBMA) were used to evaluate 24 HPV genotypes in confirmed fertile and infertile males of North China so that the effects of HPV infection on semen parameters and relationship with male infertility could be discussed. A total of 1138 subjects were recruited in this study; 142 were HPV-positive (12.48%). Among 523 confirmed fertile males, only 35 were HPV-positive (6.70%), and two of them had multiple infections. Among 615 infertile males, 107 were HPV-positive (17.4%), and 29 of them had multiple infections. Infertile males had a relatively high HPV infection rate compared with confirmed fertile males. Sperm progressive motility (PR) and the normal morphology rate were significantly decreased in HPV-positive subjects. HPV-45, HPV-52, HPV-18, HPV-59 and HPV-16 infections were more frequently in infertile males. Hence, HPV infection is closely related to male infertility which will decrease sperm PR and morphology. HPV-45, HPV-52, HPV-18, HPV-59 and HPV-16 infection seems to be major risk factors.
... Cancer Home How Many Cancers Are Linked with HPV Each Year? Language: English Español (Spanish) Recommend on ... about 31,500 of these cancers. Number of HPV-Associated Cancer Cases per Year An HPV-associated ...
Infection with human papillomavirus (HPV) types targeted by the quadrivalent HPV vaccine has declined by nearly two-thirds among teenage girls since HPV vaccination was recommended in the United States.
Smith, Elaine M; Parker, Michael A; Rubenstein, Linda M; Haugen, Thomas H; Hamsikova, Eva; Turek, Lubomir P
Few large studies have evaluated concordance based on a broad spectrum of human papillomavirus (HPV) types in oral and genital specimens of mothers and their recently born infants. This information is important in determining whether HPV vaccines administered prior to pregnancy may be useful for preventing vertical transmission. HPV DNA was positive in 30% of mothers and 1.5% of newborns. Maternal/newborn concordance (HPV+/+ or HPV-/-) was 71%. Among HPV DNA+ mothers, only 3% of their infants were DNA+ and only 1 pair had the same HPV type. Among HPV- women, 0.8% of infants were HPV+. HPV DNA detected in hospitalized newborns reflects current infection transmitted to infants during pregnancy or delivery. None of the mother/baby HPV DNA+ concordance pairs detected viral types found in HPV vaccines suggesting that vaccination prior to pregnancy is unlikely to be efficacious in preventing vertical transmission.
... in its entirety from the CDC HPV (Human Papillomavirus) Vaccine Information Statement (VIS): www.cdc.gov/vaccines/ ... hpv.html . CDC review information for HPV (Human Papillomavirus) VIS: Page last reviewed: December 2, 2016 Page ...
Gennadiy T. Sukhikh; Tatyana A. Demura; Nafisa M. Fayzullina; Evgeniya A. Kogan
... chronic cervicitis (HPV-CC). Methods and Results: The cytology and biopsy materials from 223 patients with HPV-CC were subjected to molecular testing for HPV DNA by Real-Time Polymerase Chain Reaction (Real-Time PCR...
Cates, Joan R.; Brewer, Noel T.; Fazekas, Karah I.; Mitchell, Cicely E.; Smith, Jennifer S.
Context: Because cervical cancer mortality in the United States is twice as high among black women as white women and higher in rural areas, providing human papillomavirus (HPV) vaccine to rural black adolescents is a high priority. Purpose: To identify racial differences in knowledge and attitudes about HPV, cervical cancer, and the HPV vaccine…
Matlung, Sanne Evelien; van Kempen, Pauline Maria Wilhelmina; Bovenschen, Niels; van Baarle, Debbie; Willems, Stefan Martin
Recent studies have suggested that immune cells as part of tumor's microenvironment could partly explain the better outcome in HPV-associated oropharyngeal carcinoma. We performed a systematic review of the literature focused on differences in immune-infiltrate in HPV+ versus HPV- oropharyngeal
Ohri, Linda K
There has been substantial media coverage of the quadrivalent human papillomavirus (HPV) vaccine since the Food and Drug Administration approved Gardasil (Merck & Co., Inc.) on June 8, 2006. The most vocal complaints maintain that its use will promote promiscuity among teenagers, and condemn proposed mandated use for school entry. Some also question evidence for the vaccine's safety. There have been concerns raised by both providers and patients regarding financial barriers to access. Still others argue that additional populations could benefit who have not been included in current recommendations. Clarification of these issues is essential to advance optimal use of this important new vaccine. There is strong evidence to support HPV vaccine as an effective, safe, and efficient public health measure. School mandates are valuable tools to reduce disparities in availability of immunizations. The time has come to consider universal funding as a means to improve access to all recommended vaccines.
Cervical cancer is the third most common cancer in women worldwide and often affects women under 40 years with young families. Vaccination against the human papillomavirus (HPV) is a major advance, since it offers primary prevention against the infectious agent that is the main cause of the disease. Two prophylactic vaccines have shown great promise in clinical trials. One of these (Gardasil(®)) contains all four HPV types, offering protection against genital warts (types 6 and 11) as well as cervical cancer (types 16 and 18). The other (Cervarix(®)) contains types 16 and 18, targeting cervical cancer alone, but also has a degree of cross-protection against types 31 and 45, which could significantly increase the level of protection. Adolescent girls remain the primary target of vaccination programmes, but the issues of vaccinating boys and older women are increasingly debated.
Safaeian, Mahboobeh; Kemp, Troy J; Pan, David Yuanji; Porras, Carolina; Rodriguez, Ana Cecilia; Schiffman, Mark; Cortes, Bernal; Katki, Hormuzd; Wacholder, Sholom; Schiller, John T; Gonzalez, Paula; Penrose, Kerri; Lowy, Douglas R; Quint, Wim; van Doorn, Leen-Jan; Herrero, Rolando; Hildesheim, Allan; Pinto, Ligia A
We investigated the role of antibody responses as potential mechanism for the cross-protective vaccine-efficacies (VE) observed from randomized clinical trials of the HPV16/18 bivalent vaccine. Results HPV31 cases had lower HPV16 antibody levels than controls (OR 4th quartile compared with 1st quartile = 0.63; 95%CI: 0.36-1.08; p-trend = 0.03). HPV31 cases were also less likely to have detectable HPV31 neutralization, and HPV16 avidity than controls. No statistically significant differences by HPV18 antibody or HPV45 neutralization were observed among HPV45 cases and controls. Protection against HPV58 was not associated with any of the markers, confirming the specificity of our findings. Samples are from three-dose HPV vaccine recipients from the Costa Rica HPV16/18 vaccine trial. Women with a new HPV31, HPV45, or HPV58 infections over four years of follow-up were compared with randomly selected control women--with no new infection with HPV31/45/58--with respect to HPV16 and HPV18 antibody, HPV31, HPV45, and HPV58 neutralization, and HPV16 avidity. High HPV16 levels and avidity, and the ability to neutralize HPV31 were associated with protection against newly detected HPV31 infections, suggesting that the partial VE demonstrated for HPV31 is likely to be mediated at least in part through antibodies induced by HPV16/18 vaccination.
Gerend, Mary A.; Shepherd, Janet E.
Until recently, awareness of the sexually transmitted infection human papillomavirus (HPV)—the virus that causes cervical cancer—was relatively low. The purpose of this study was to identify factors associated with HPV knowledge now that HPV vaccines have become widely available. Young adult women (n = 739; aged 18-26 years) attending Florida State University who had not yet initiated HPV vaccination completed a survey between March-August 2009. The survey assessed HPV awareness, HPV knowledg...
Danielle N Poole
Full Text Available Despite a high prevalence of oncogenic human papilloma virus (HPV infection and cervical cancer mortality, HPV vaccination is not currently available in Mali. Knowledge of HPV and cervical cancer in Mali, and thereby vaccine readiness, may be limited. Research staff visited homes in a radial pattern from a central location to recruit adolescent females and males aged 12-17 years and men and women aged ≥ 18 years (N = 51 in a peri-urban village of Bamako, Mali. Participants took part in structured interviews assessing knowledge, attitudes, and practices related to HPV, cervical cancer, and HPV vaccination. We found low levels of HPV and cervical cancer knowledge. While only 2.0% of respondents knew that HPV is a sexually transmitted infection (STI, 100% said they would be willing to receive HPV vaccination and would like the HPV vaccine to be available in Mali. Moreover, 74.5% said they would vaccinate their child(ren against HPV. Men were found to have significantly greater autonomy in the decision to vaccinate themselves than women and adolescents (p = 0.005, a potential barrier to be addressed by immunization campaigns. HPV vaccination would be highly acceptable if the vaccine became widely available in Bamako, Mali. This study demonstrates the need for a significant investment in health education if truly informed consent is to be obtained for HPV vaccination. Potential HPV vaccination campaigns should provide more information about HPV and the vaccine. Barriers to vaccination, including the significantly lower ability of the majority of the target population to autonomously decide to get vaccinated, must also be addressed in future HPV vaccine campaigns.
Golob, Barbara; Poljak, Mario; Verdenik, Ivan; Kolbezen Simoniti, Mojca; Vrtačnik Bokal, Eda; Zorn, Branko
... papillomaviruses (HPV) are the most common sexually transmitted viruses. More than three quarters of the sexually active human population will acquire an HPV infection during their lifetime, alth...
Leeson, Simon C
Current cytology-based screening has a moderate sensitivity to detect cervical intraepithelial neoplasia grade 3 (CIN 3) and cervical cancer even in those states providing rigorous quality control of their cervical screening programs. The impact of vaccination against human papillomavirus (HPV) types 16 and 18 as well as the incorporation of HPV testing on the detection of CIN 3 and cancer is discussed. HPV testing used as a triage for atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions, test of cure after treatment, and HPV-based primary screening may improve current cervical screening programs.HPV testing as a triage test for ASCUS seems to offer an improved sensitivity, with a similar specificity as compared to repeat cytology for diagnosing high-grade CIN and has been recommended throughout most EU states. HPV testing as a triage test for low-grade squamous intraepithelial lesions has a low specificity and is not recommended in most member states. HPV test of cure offers an improved sensitivity compared to cytology for women with persistent cervical precancer after treatment. HPV-based cervical cancer screening is more effective than screening with cytology. The effects of HPV-based screening depend on the organization of the program and on adherence to algorithms for screening triage. Otherwise, it is likely that HPV-based screening will increase the referral rate to colposcopy including more women with no detectable cervical lesion. HPV vaccination will require many years to evaluate any beneficial effects on cervical cancer incidence and mortality.
Clark, Sarah J; Cowan, Anne E; Filipp, Stephanie L; Fisher, Allison M; Stokley, Shannon
In 2013, approximately one-third of US adolescent males age 13-17 y had received ≥1 doses of HPV vaccines and only 14% had received ≥3 doses. This study used a nationally representative, online survey to explore experiences and attitudes related to HPV vaccination among parents with adolescent sons. Analyses compared the perspective of parents who do not intend to initiate HPV vaccine for ≥1 adolescent son to that of parents who are likely to initiate or continue HPV vaccination. Of 809 parents of sons age 11-17 years, half were classified as Unlikely to Initiate HPV vaccination and 39% as Likely to Vaccinate. A higher proportion of the Likely to Vaccinate group felt their son's doctor was knowledgeable about HPV vaccine, did a good job explaining its purpose, and spent more time discussing HPV vaccine; in contrast, over half of the Unlikely to Initiate group had never discussed HPV vaccine with their child's doctor. The majority of parents in both groups showed favorable attitudes to adolescent vaccination in general, with lower levels of support for HPV vaccine-specific statements. Physician-parent communication around HPV vaccine for adolescent males should build on positive attitude toward vaccines in general, while addressing parents' HPV vaccine-specific concerns.
Pitisuttithum, Punnee; Velicer, Christine; Luxembourg, Alain
Human papillomavirus (HPV) is the causative agent of nearly all cervical cancer cases as well as a substantial proportion of anal, vulvar, vaginal, penile and oropharyngeal cancers, making it responsible for approximately 5% of the global cancer burden. The first-generation HPV vaccines that is, quadrivalent HPV type 6/11/16/18 vaccine and bivalent HPV type 16/18 vaccine were licensed in 2006 and 2007, respectively. A second-generation 9-valent HPV type 6/11/16/18/31/33/45/52/58 vaccine with broader cancer coverage was initiated even before the first vaccines were approved. By preventing HPV infection and disease due to HPV31/33/45/52/58, the 9vHPV vaccine has the potential to increase prevention of cervical cancer from 70 to 90%. In addition, the 9vHPV vaccine has the potential to prevent 85-95% of HPV-related vulvar, vaginal and anal cancers. Overall, the 9vHPV vaccine addresses a significant unmet medical need, although further health economics and implementation research is needed.
Vidal, Joao Paulo C B; Felix, Shayany Pinto; Chaves, Cláudia B P; Patury, Patrícia; Franco, Vanessa F; de Morais, Evaneide A; de Carvalho, Neile A; Carvalho, Aurenice C L; Almeida Neto, Olimpio F; Vieira, Lina Maria T M; Correa, Flavia Miranda; Martins, Luís Felipe Leite; Negrão, Antonio; de Almeida, Liz Maria; Moreira, Miguel Angelo Martins
Cervical cancer is the fourth most common cancer among women, and ∼70-80% of these cancers are associated with two human papillomavirus types: HPV16 and HPV18. Several studies have reported that intra-type diversity is associated with the progression of infection to invasive cancer. Herein, we report the genetic diversity of HPV16 and HPV18 in a cohort of 594 Brazilian women with invasive cervical cancer and describe the prevalence of lineages and intra-type diversity prior to the implementation of the public immunization program in Brazil. HPV detection and genotyping were performed using PCR, PGMY/GP primers, and DNA extracted from fresh tumors. The HPV16 (378 women) and HPV18 (80 women) lineages were identified by PCR and sequencing of the LCR and E6 fragments, followed by SNV comparison and phylogenetic analysis. In our cohort, was found a higher frequency of the lineage A (in 217 women), followed by lineage D (in 97 women) and lineages B and C (in 10 women each) for HPV16; and a higher frequency of lineage A (in 56 women) followed by lineage B (in 15 women) in HPV18. The genetic diversity of HPV16 indicated a recent expansion of specific variants or a selective advantage that is associated with invasive cancer; this pattern was not observed for HPV18. © 2016 Wiley Periodicals, Inc.
Bautista, Oliver M; Luxembourg, Alain
Human papillomavirus (HPV) vaccines were licensed by demonstrating prevention of anogenital disease caused by specific HPV types in clinical studies. Measuring the impact of HPV vaccination on the overall burden of anogenital disease (irrespective of HPV) is an important public health question which is ideally addressed in post-licensure epidemiological studies. Attempts were made to use clinical trial data for that purpose. However, the interpretation of vaccine efficacy on the endpoint of disease irrespective of HPV is not widely understood. We used the 9-valent HPV vaccine clinical program as a case study to determine the value of measuring vaccine efficacy in such endpoint. This assessment was rigorously performed by heuristic reasoning and through probability calculations. The measure of vaccine efficacy in the irrespective of HPV endpoint is driven simultaneously in opposite directions by the high estimate of prophylactic efficacy and a numerically negative estimate of risk reduction that is also a reflection of high prophylactic efficacy and no cross-protection. The vaccine efficacy estimate in the irrespective of HPV endpoint is ambiguous and difficult to interpret. Comparing this estimate across different HPV vaccine studies requires an understanding of the contributions of vaccine HPV type efficacy and the incidence of disease not related to vaccine HPV types for each study. Without such understanding, comparing studies and drawing conclusions from such comparison are highly misleading. Approaches are proposed to divide this endpoint in components that are easier to interpret. Copyright © 2016. Published by Elsevier Inc.
Cláudia da Silva Pereira
Full Text Available A proposta do presente trabalho é avaliar de que forma a publicidade vem construindo um conceito de “juventude”. Pela análise de anúncios publicados entre 1989 e 2009 na revista Veja e pela reflexão sobre as representações sociais da juventude, percebe-se que um conjunto de valores quea constituem – modernidade, felicidade, sociabilidade e liberdade – passa a ser hegemônico nas ações de comunicação de produtos e marcas dirigidas a todas as idades.
Flávia Maria de Paula Soares
Full Text Available É pertinente falarmos de um conceito psicanalítico de velhice? Este artigo pretende responder a essa questão analisando a concepção de velhice dada pela gerontologia – essa ótica multidisciplinar calcada nas ciências positivistas –, passando pela metapsicologia psicanalítica basicamente atemporal, até chegar à possibilidade oferecida pela psicopatologia fundamental, que talvez seja a única que faculte a abordagem da velhice sustentada na psicanálise pelo viés do phatos.
ZUIN ANTÔNIO ÁLVARO SOARES
Full Text Available Este texto objetiva argumentar que a essência do conceito de Indústria Cultural não só permanece atual, como também é relevante para a crítica das condições sociais que fundamentam a universalização da semiformação (Halbbildung. Conclui-se que uma concepção educacional crítica, balizada nos escritos de Theodor W. Adorno, poderia oferecer subsídios iniciais para uma práxis de resistência a esse processo de debilitação da individualidade.
Carvalho, Graça Simões de
Neste capítulo aborda-se o conceito de literacia científica, referindo-se a sua origem e dando ênfase a cinco dimensões que a caracterizam. São estas: os grupos de interesse nesta temática, as inúmeras concepções de literacia científica, os níveis de literacia, os objectivos e benefícios, e ainda a avaliação da literacia científica de populações, em particular de crianças e jovens em idade escolar.
Márcia Cristina Teixeira Martins; Marle dos Santos Alvarenga; Sílvia Viviane Alves Vargas; Karen Sayuri Cabral de Jesus Sato; Fernanda Baeza Scagliusi
Ortorexia nervosa é o termo descrito para o comportamento obsessivo patológico caracterizado pela fixação por saúde alimentar. O quadro ainda não foi oficialmente reconhecido como um transtorno alimentar, mas discute-se o conceito, suas características, interações e sintomas. No presente trabalho foi realizada uma revisão dos vinte e um artigos publicados desde 1997, quando o comportamento da ortorexia nervosa foi inicialmente descrito. Foram apontadas semelhanças e diferenças entre o comport...
Full Text Available ... school health clinical trials disclosing to kids estate planning find a doctor find health information helpful articles ... sq how to do kids infect kids links & resources M.O.V.E. parents for prevention ... go to GETVAXED.ORG cme Immunizations HPV (Human Papillomavirus) One family's struggles with HPV We provide ...
Bishop, Justin A; Andreasen, Simon; Hang, Jen-Fan
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC), originally known as HPV-related carcinoma with adenoid cystic carcinoma-like features, is a peculiar neoplasm that is restricted to the sinonasal tract, exhibits features of both a surface-derived and salivary gland ca...
The latter is significant as the incidence of genital cancer in ... Table I. Summary of clinical details (age and site of lesion), HPV typing with NISH and peR confirmation of the presence of the virus. Case No. Age (yrs). Site. NISH HPV type. PCR. 1. < 12'. Vulva. 11 ... 33-positive cervical biopsies (paraffin sections) were used as.
Golob, Barbara; Poljak, Mario; Verdenik, Ivan; Kolbezen Simoniti, Mojca; Vrtačnik Bokal, Eda; Zorn, Branko
Human papillomaviruses (HPV) are the most frequently sexually transmitted viruses and etiological agents of several human cancers. Controversial results of the role of HPV in infertile population on sperm parameters have been published. The aim of this study was to estimate the type-specific prevalence of HPV DNA infection of the external genitalia and semen in 340 Slovenian men from infertile couples and to establish the relationship between seminal HPV DNA infection and abnormal sperm parameters. Self-taken swabs of the entire penile surface and semen samples were collected, and HPV detection and genotyping were performed. HPV DNA was detected in 37.12% of external genitalia and in 13.61% of semen samples with high HPV type concordance of both sampling sites. The most prevalent HPV types in the male external genitalia were HPV-CP6108 and HPV-84. The most prevalent HPV types in semen were HPV-53 and HPV-CP6108. The prevalence of HPV infection between normozoospermic men and men with abnormal sperm parameters did not differ significantly. Sperm quality did not differ significantly between men with seminal HPV infection and uninfected men. In conclusion, the men from infertile couples are equally susceptible to HPV infection regardless of their fertile potential; seminal HPV infection does not impair sperm quality.
Full Text Available Human papillomaviruses (HPV are the most frequently sexually transmitted viruses and etiological agents of several human cancers. Controversial results of the role of HPV in infertile population on sperm parameters have been published. The aim of this study was to estimate the type-specific prevalence of HPV DNA infection of the external genitalia and semen in 340 Slovenian men from infertile couples and to establish the relationship between seminal HPV DNA infection and abnormal sperm parameters. Self-taken swabs of the entire penile surface and semen samples were collected, and HPV detection and genotyping were performed. HPV DNA was detected in 37.12% of external genitalia and in 13.61% of semen samples with high HPV type concordance of both sampling sites. The most prevalent HPV types in the male external genitalia were HPV-CP6108 and HPV-84. The most prevalent HPV types in semen were HPV-53 and HPV-CP6108. The prevalence of HPV infection between normozoospermic men and men with abnormal sperm parameters did not differ significantly. Sperm quality did not differ significantly between men with seminal HPV infection and uninfected men. In conclusion, the men from infertile couples are equally susceptible to HPV infection regardless of their fertile potential; seminal HPV infection does not impair sperm quality.
Halec, Gordana; Dondog, Bolormaa; Pawlita, Michael; Schmitt, Markus
HPV types with high viral load are associated with cervical abnormalities. However, viral load measurements and concordance of HPV loads and viral mRNA have not been demonstrated for all high-risk/possibly high-risk (HR-/pHR-)HPV types in cervical cancer (CxCa). Especially, the biological role of co-infecting HR-/pHR-HPV types with low viral load has not been thoroughly investigated. Using BSGP5+/6+-PCR/MPG genotyping, we analyzed viral loads for all currently defined 51 mucosal HPV types in 74 cervical smears from patients with CxCa and compared this data with HPV DNA and mRNA status in these patients' corresponding CxCa tissues. All cervical smear/tissue pairs were HPV DNA+. Overall HPV type agreement within pairs was 99% (complete agreement in 50%, partial agreement in 49%, and complete disagreement in 1% of cases). The proportion of multiple HPV types was significantly higher in smears compared to tissues (pHPV infections (>1 copy/cell) were found in 88% of HPV DNA+ smears, and were significantly associated with the presence of respective HPV DNA (kappa=0.685, CI: 0.567-0.803), and HPV mRNA (kappa=0.693, CI: 0.566-0.820) in CxCa tissues. In total, 93% (67/72) of high load HR-/pHR-HPV infections identified in smears were also present in corresponding CxCa tissues, and 93% (62/67) of these were HPV mRNA+. On the other hand, 78% (42/54) of low load HR-/pHR-HPV infections identified in smears were not detectable in tissues, including 11 out of 15 low load HPV16 infections. This data demonstrates that the presence of high HPV loads in CxCa smears predicts biologically active HR-/pHR-HPV types in tumor tissues.
M. Caetano de Barros
Full Text Available Apenas do ponto de vista estritamente anatômico o lobo occipital pode ser delimitado com relativa facilidade. Aparentemente constitui uma unidade morfológica, séde de estruturas basicamente relacionados com a percepção visual, aí entendidos também certos mecanismos integrativos óculo-motores que, em última análise, não são senão componentes dêste complexo fenômeno perceptivo. Depois de revistos alguns detalhes da anatomia convencional do lobo occipital (limites, área cortical estriada, peri-estriada e para-estriada é feita uma tentativa, à base de estudo da literatura, no sentido de indicar as principais conexões destas áreas (radiações ópticas, feixes de associação, fibras de projeção e fibras comissurais com diferentes estruturas do sistema nervoso central. A vascularização do lobo occipital é revisada com o auxílio de preparações anátomo-radiológicas seriadas e seletivas de diferentes troncos arteriais, nas quais se constatam intercomunicações entre os setores "terminais" dos sistemas das artérias cerebral posterior, média e anterior. Algumas variações morfológicas dos cornos occipitais são também postas em evidência com recursos de técnicas anátomo-radiológicas. Todavia, dados puramente anatômicos não são suficientes para compreensão das funções psico-fisiológicas do lobo occipital que pode ser conceituado como parte de um sistema perceptivo — o sistema óptico — altamente complexo, funcionando integradamente com múltiplos sectores do sistema nervoso e envolvendo diferentes mecanismos. Muito provàvelmente êste sistema, à maneira de muitos outros sistemas biológicos, está composto de vários circuitos mutuamente conjugados agindo sob o princípio de servo-mecanismos, devendo sua ação ser encaixada dentro do conceito das "totalidades" (Gestalten, cuja funcionalidade não deriva da soma dos seus componentes, mas da relação funcional que estes mantém entre sí para a atua
Wang, Chia-ching J.; Sparano, Joseph; Palefsky, Joel M.
SYNOPSIS Anal cancer is an increasingly common non-AIDS-defining cancer among HIV-infected individuals. It is associated with human papillomavirus (HPV), the most common sexually transmitted infectious agent. The 14 oncogenic types of HPV are causally associated with 5–10% of all cancers, notably anogenital cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The HPV types detected in anal cancer are included in the 9-valent vaccine. HPV vaccines have demonstrated efficacy in reducing anal precancerous lesions in HIV-infected individuals. The standard treatment for anal cancer has been fluorouracil (5-FU) and mitomycin (or cisplatin) as chemotherapy agents plus radiation, which can also be effectively used for the HIV-infected patients. Continued studies will be needed to test new treatment strategies in HIV-infected patients with anal cancer to determine which treatment protocols provide the best therapeutic index. PMID:27889034
van Zwol, Ulla Bonde; Joergensen, J. S.; Lamont, R. F.
Millions of doses of HPV vaccine have been administered globally. Inadvertent administration of HPV vaccine during pregnancy occurs given that the main recipients of the vaccine are fertile young women, who might be unaware of their pregnancy at the time of their vaccination. To investigate...... the subject of HPV vaccine and pregnancy , the databases of PubMed and Embase were searched to find the relevant literature published in English within the last 10 y. Most of the evidence pertaining to fetal adverse events following HPV vaccination relates to spontaneous miscarriage. None of the relevant...... studies found any significantly increased rate of spontaneous abortion in the overall analyses. There was no indication of other HPV vaccine-associated adverse events in pregnancy or immediately post-conception. © 2016 Taylor & Francis....
Baloch, Zulqarnain; Yasmeen, Nafeesa; Li, Yuanyue; Zhang, Wenhui; Lu, Hongyu; Wu, Xiaomei; Xia, Xueshan; Yang, Shihua
BACKGROUND It is important to understand the knowledge that various groups of a population have about cervical cancer and human papillomavirus (HPV) and their attitudes toward HPV vaccination, as it will ultimately influence their decision-making for or against the acceptability of vaccines and other preventive methods. This study was designed to determine the level of knowledge and awareness about cervical cancer, HPV, and the HPV vaccine among Chinese women in Yunnan province. MATERIAL AND METHODS A survey was conducted in Yunnan province by the Laboratory of Molecular Virology in collaboration with the Yunnan First People's Hospital in Feb 2015. A total of 388 women were recruited and asked to participate in a questionnaire-based interview that collected information related to their awareness and knowledge about: (1) cervical cancer, (2) HPV and HPV vaccine and willingness to have their children receive vaccination, and (3) demographic characteristics. RESULTS A total of 388 HPV-positive women were included; 300/388 (73.3%) were Han, and 88/388 (22.7%) were other ethnicities. Overall, 204/388 (52.6%) of the women were aware of cervical cancer, with a significant difference between Han women and women of other ethnic groups (168/388, 56.0% and 36/88, 40.9%; P=0.015). Overall, 26.5% of the women were aware of the role of HPV in cervical cancer; 29.0% of the Han women and 18.2% of women of other ethnic groups were aware of this role of HPV (P=0.05). The knowledge that HPV infection leads to cervical cancer was higher among Han women (29.0%) compared to women of other ethnicities (18.2%). Knowledge about the HPV vaccine was very low in all ethnic groups, but the Han women were more willing to allow their children to be vaccinated before they become sexually active. A similar difference has also been found in women from various regions. CONCLUSIONS Although level of awareness and knowledge about cervical cancer was moderate, knowledge and awareness of HPV and the HPV
Alyssa M. Cornall
Full Text Available Purpose: To compare human papillomavirus genotype-specific performance of two genotyping assays, Anyplex II HPV28 (Seegene and EuroArray HPV (EuroImmun, with Linear Array HPV (Roche. Methods: DNA extracted from clinican-collected cervical brush specimens in PreservCyt medium (Hologic, from 403 women undergoing management for detected cytological abnormalities, was tested on the three assays. Genotype-specific agreement were assessed by Cohen's kappa statistic and Fisher's z-test of significance between proportions. Results: Agreement between Linear Array and the other 2 assays was substantial to almost perfect (Îº = 0.60 â 1.00 for most genotypes, and was almost perfect (Îº = 0.81 â 0.98 for almost all high-risk genotypes. Linear Array overall detected most genotypes more frequently, however this was only statistically significant for HPV51 (EuroArray; p = 0.0497, HPV52 (Anyplex II; p = 0.039 and HPV61 (Anyplex II; p=0.047. EuroArray detected signficantly more HPV26 (p = 0.002 and Anyplex II detected more HPV42 (p = 0.035 than Linear Array. Each assay performed differently for HPV68 detection: EuroArray and LA were in moderate to substantial agreement with Anyplex II (Îº = 0.46 and 0.62, respectively, but were in poor disagreement with each other (Îº = â0.01. Conclusions: EuroArray and Anyplex II had similar sensitivity to Linear Array for most high-risk genotypes, with slightly lower sensitivity for HPV 51 or 52. Keywords: Human papillomavirus, Genotyping, Linear Array, Anyplex II, EuroArray, Cervix
Carlos Alberto Steil
Full Text Available Este artigo delimita o conceito de epistemologias ecológicas, entendido como uma postura compreensiva que se pauta pelo reconhecimento da alteridade e da agência dos processos naturais, dos objetos e dos materiais. Autores contemporâneos de diferentes trajetórias disciplinares têm empreendido reflexões nesta direção e sugerem a emergência de um novo realismo ou ainda de um novo materialismo. É neste movimento que buscamos situar o conceito de epistemologias ecológicas. O adjetivo ecológico nos parece plausível na medida em que ele remete ao reposicionamento do humano numa rede de relações simétricas e reciprocamente determinadas. Neste sentido, as epistemologias ecológicas dão voz ao mundo, considerando a autonomia das coisas e da natureza em sua relação com o humano, sem recair nos determinismos culturalistas ou biológicos. Este artigo contextualiza as interfaces dos novos materialismos, que emergem na antropologia, na filosofia e nos estudos da ciência, com o campo ambiental. Este nos parece um caminho oportuno para compreender nosso lugar no mundo e o lugar do mundo em nós desde uma perspectiva ecológica, no sentido de uma ecologia do pensamento, da ação e do conhecimento.
Édivo de Almeira Oliveira
Full Text Available Mesmo constituindo-se um dos pilares de funcionamento do sistema capitalista, é bem verdade que o conceito de mercado não é consensual entre as distintas abordagens do pensamento econômico, dado as diferentes premissas e axiomas que fundamentam suas análises. Isto posto, o presente trabalho objetiva fornecer uma concepção holística e mais pragmática do mercado a partir dos conceitos de ordem espontânea, taxas naturais e expectativas racionais articulados com a Teoria do Caos. Com base nesses fundamentos teóricos conclui-se que o mercado é uma ordem espontânea evolutiva, repleta de relações não-lineares e formada por agentes autointeressados que, mediante processo de aprendizagem social, complexificam e aprimoram os padrões institucionais, culturais e técnicos que configuram o próprio mercado no transcorrer de um tempo dinâmico.
Full Text Available O artigo procura descrever o conceito de religiosidade na psicologia junguiana, conectando-o aos conceitos que embasam e se relacionam com sua especificidade, contextualizando-o de forma breve no panorama científico atual e relacionando-o à prática psicoterapêutica. Para tanto, utiliza as obras de Jung e de autores relacionados com a temática abordada. O estudo suscitou questionamentos em relação à importância dada à consideração e ao estudo do fator religiosidade em psicologia e na prática clínica. Conclui-se que a religiosidade é fator de suma importância no entendimento do humano e conseqüêntemente na prática clínica, sendo que a teoria de Jung fornece elementos que possibilitam um estudo e uma compreensão em profundidade desse fator
Significant association of HPV with non-vegetarian diet ( < 0.05) and rural residential areas ( < 0.01) were observed. High prevalence of HPV-16 in asymptomatic women of this population, a frequency comparable to invasive cervical cancers, highlights an urgent need for a therapeutic HPV vaccine covering HPV-16 and ...
In this 30 second public service announcement, a mother talks about the importance of protecting 11-12 year-old boys and girls with HPV vaccination. (Una madre habla sobre la importancia de proteger a los niÃ±os y las niÃ±as de 11 a 12 aÃ±os con la vacuna contra el VPH.). Created: 1/15/2014 by National Center for Immunizations and Respiratory Diseases (NCIRD). Date Released: 1/15/2014.
In this 30 second public service announcement, a mother talks about the importance of protecting 11-12 year-old boys and girls with HPV vaccination. (Una madre habla sobre la importancia de proteger a los niÃ±os y las niÃ±as de 11 a 12 aÃ±os con la vacuna contra el VPH.). Created: 1/15/2014 by National Center for Immunizations and Respiratory Diseases (NCIRD). Date Released: 1/15/2014.
Lehtinen, Tuomas; Söderlund-Strand, Anna; Petäjä, Tiina; Eriksson, Tiina; Jokiranta, Sakari; Natunen, Kari; Dillner, Joakim; Lehtinen, Matti
We assessed human papillomavirus (HPV) prevalence among HPV-16/18-vaccinated and unvaccinated Finnish male adolescents participating in chlamydia screening 4 years after vaccination with AS04-adjuvanted HPV-16/18 vaccine in 2007-2009. Previously vaccinated (n = 395) or unvaccinated (n = 149) male adolescents were enrolled in 12 municipalities. First-void urine samples were tested for HPV types 6, 11, 16, 18, 31, 33, 35, 45, 51, 52, 56, 58, 59, 66, and 68, and prevalence rates for HPV-16/18, and HPV-11/16/18/31/33/45 were reduced profoundly (0% vs 2.1% [P = .02] and 0.8% vs 5.3 [P = .002], respectively). Overall HPV DNA prevalence was also significantly reduced among HPV-16/18-vaccinated (4.1%) compared with unvaccinated subjects (10.1%) (P = .01). In this post hoc study, a highly significant reduction in HPV prevalence 4 years after vaccination suggests that the bivalent HPV-16/18 vaccine has protective efficacy in men. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: email@example.com.
Dinc, Bedia; Rota, Seyyal; Onan, Anil; Bozdayi, Gulendam; Taskiran, Cagatay; Biri, Aydan; Güner, Haldun
this study was planned to evaluate the prevalence of HPV (excepting type 16) and HPV 16 by real-time PCR in colposcopy patients and to interprete the results with age, age of first sexual intercourse (FSI), parity and Pap smear results. one hundred and two colposcopy patients (50 and 52 of the patients were classified as colposcopy positive and negative, respectively) applying to Gynecology clinic were included. HPV (excepting type 16) and HPV 16 were detected by realtime PCR using the L1 region. Real-time nested amplifications of MY09/11 products were done by GP5+/GP6+ primers and Cyanine-5 labeled HPV and HPV 16 DNA specific probe after HPV DNA extraction by phenol chloroform isoamylalcohol. HPV (excepting type 16) and HPV 16 were positive in 12% and 18% of the colposcopy positive patients respectively. HPV (excepting type 16) and HPV 16 were positive in 5.7% and 3.8% of the colposcopy negative patients, respectively. there was a statistically significant difference between colposcopy positive and colposcopy negative patients comparing HPV 16 with total HPV positivity (p = 0.021 for type 16 and p = 0.010 for total HPV) but there was not a statistically significant difference between colposcopy positive and colposcopy negative patients when we compared HPV (excepting type 16) positivity (p = 0.314). In conclusion, HPV detection and typing may be helpful for cervical cancer screening and prevention.
Full Text Available PURPOSE: this study was planned to evaluate the prevalence of HPV (excepting type 16 and HPV 16 by real-time PCR in colposcopy patients and to interprete the results with age, age of first sexual intercourse (FSI, parity and Pap smear results. METHODS: one hundred and two colposcopy patients (50 and 52 of the patients were classified as colposcopy positive and negative, respectively applying to Gynecology clinic were included. HPV (excepting type 16 and HPV 16 were detected by realtime PCR using the L1 region. Real-time nested amplifications of MY09/11 products were done by GP5+/GP6+ primers and Cyanine-5 labeled HPV and HPV 16 DNA specific probe after HPV DNA extraction by phenol chloroform isoamylalcohol. RESULTS: HPV (excepting type 16 and HPV 16 were positive in 12% and 18% of the colposcopy positive patients respectively. HPV (excepting type 16 and HPV 16 were positive in 5.7% and 3.8% of the colposcopy negative patients, respectively. CONCLUSION: there was a statistically significant difference between colposcopy positive and colposcopy negative patients comparing HPV 16 with total HPV positivity (p = 0.021 for type 16 and p = 0.010 for total HPV but there was not a statistically significant difference between colposcopy positive and colposcopy negative patients when we compared HPV (excepting type 16 positivity (p = 0.314. In conclusion, HPV detection and typing may be helpful for cervical cancer screening and prevention.
Carvalho,Tatiana Oliveira de; Marinho-Araujo,Claisy Maria
Discute-se o cenário atual da Psicologia Escolar no Maranhão, tendo como parâmetro as transformações ocorridas nas últimas décadas em âmbito nacional. Foi realizado um estudo bibliográfico sobre o tema, a partir do qual se levantaram reflexões sobre o histórico e as tendências atuais no âmbito da formação e atuação do psicólogo escolar no estado. Considera-se que no Maranhão necessita-se da contribuição de psicólogos escolares que, seguros de seu papel e intencionalidade, construam uma identi...
v anglickém jazyce The thesis is dedicated to the awareness of students about the possibilities of graduation classes have HPV viruses. Introduction is devoted to the description of the theoretical and empirical chapters and a brief explanation of the issue of HPV viruses. In the beginning of the theoretical part presents brief characteristics of HPV viruses along with the history of HPV research, the incidence of disease caused due to HPV infection and disease transmission. In other chapters...
A solid tumor related to viral infection is a rare and challenging condition to the medical community raising the possibility to fight and prevent this cancer by vaccine. Cervical cancer, caused by human papillomavirus (HPV), is a major health problem worldwide. The two HPV vaccines approved lately could lead to more than a 70% reduction in cases of cervical cancer and a similar reduction in deaths from the cancer. Pap smear screening significantly (80%) reduced disease incidence and is still useful and needed. In addition to early detection, vaccination will prevent the development of precancerous and cancerous lesion and reduce morbidity, mortality and psychological and social stress as well as stressful and expensive follow-ups in women with suspicious lesions. The vaccinations described will bring to a significant reduction in genital warts incidence, a serious social and psychological burden to the infected population. Practical social and psychological issues are still to be addressed, some of them are: time and frequency of administration, use of vaccination in men, public acceptance and behavior, appropriate populations to be vaccinated, etc. Most unresolved questions will be answered over time. The new vaccines embody a big promise to humanity, although we still have to overcome the financial burden and possible late side effects of the vaccine.
Kroupis, Christos; Vourlidis, Nikolaos
Human Papilloma Virus (HPV) is becoming a menace worldwide, especially to the developing world, due to its involvement in a variety of malignancies, with cervical cancer being the most important and prevalent. There are many HPV types; HPV 16/18 are the most carcinogenic but few others are also characterized as high-risk (HR). They can cause a variety of low- or high-grade cellular abnormalities, most frequently detected in a routine Pap test. Most infections clear within 2 years, however, a minority persists and potentially could progress to cervical cancer. Molecular tests detecting HPV DNA, RNA or proteins are now being available either commercially or in-house developed. DNA detection is nowadays an established tool for diagnosis and monitoring of HPV-related disease, however, there is lack of a reference method and standardization with reference materials. The various available test formats create confusion on which molecular test to choose and what are its limitations. Therefore, the need for lab accreditation and participation in proficiency testing has to be stressed. Novel HPV biomarkers (RNA, protein etc.) are now intensively examined for their inclusion as adjunct tools. Recently, developed prophylactic vaccines for HPV 16/18 have already proven safe and efficient and raise high expectations for the complete eradication of these types in the future.
Lee, Won-Chul; Lee, Sae-Young; Koo, Yu Jin; Kim, Tae-Jin; Hur, Soo Young; Hong, Sung Ran; Kim, Sung Soon; Kee, Mee-Kyung; Rhee, Jee Eun; Lee, Joo Shil; Choi, Ho Sun; Cho, Chi Heum; Kim, Ki Tae
We have designed a five-year multicentre prospective cohort study in women who are both human papillomavirus (HPV)-positive with either atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) of cervix. This study aimed to analyze the risk of developing a high-grade squamous intraepithelial lesion (HSIL) from either ASCUS or LSIL in HPV-positive women, so called 'progression' rate, to investigate differences in the progression rates according to HPV type-specific infection, and to evaluate the various factors associated with the persistence or clearance of HPV infection in the Korean population. At present, the study protocol composed of cervical cytology, HPV DNA testing, and questionnaire have been conducted actively since the first participant was enrolled in 2010. This study is the first nationwide Korea HPV cohort study. Our data will provide valuable information about not only the ambiguous cytology results of ASCUS and LSIL but also the effect of the specific HPV type and other various factors on the progression to HSIL. Finally, the results of our study will be helpful and applicable to determine the primary cervical cancer prevention strategies. PMID:23346315
Mariani, Luciano; Igidbashian, Sarah; Sandri, Maria Teresa; Vici, Patrizia; Landoni, Fabio
To evaluate, from a gynecology perspective, the transition from cytology-based HPV screening to primary HPV screening. Studies examining switching from cytology-based screening to primary HPV-DNA testing with triaging of patients with positive test results were retrieved and reviewed, with a particular focus on screening in an Italian setting. The increased complexity of patient-management decisions when implementing HPV-based screening was a critical issue discussed in the literature. The change in strategy represents a paradigm shift in moving from a medical perspective of identifying the disease in individual patients, to a public-healthcare perspective of excluding HPV from the healthy population and identifying a small sub-group of individuals at increased risk of HPV. With knowledge about HPV screening evolving rapidly, new programs and related algorithms need to be sufficiently flexible to be adjusted according to ongoing research and the validation of new assays. The establishment of a national working group (including epidemiologists, gynecologists, pathologists, and healthcare providers) will be necessary to properly implement and govern this important technical and cultural transition. © 2016 International Federation of Gynecology and Obstetrics.
Full Text Available Ao invés de produzirem um conceito analiticamente robusto de "gueto", as Ciências Sociais utilizam o termo de maneira descritiva, não raro lhes conferindo significados do senso comum emprestados das sociedades em que o fenômeno é identificado. A partir da produção historiográfica sobre a diáspora judaica na Europa renascentista, da Sociologia da experiência negra na metrópole fordista dos EUA e da Antropologia da marginalidade étnica na Ásia Oriental, este artigo constrói um conceito relacional de gueto como um instrumento bifacetado [Janus faced] de cercamento e controle etno-racial. Por meio desse procedimento, o gueto revela-se como um dispositivo sócio-organizador composto de quatro elementos (estigma, limite, confinamento espacial e encapsulamento institucional que emprega o espaço para reconciliar seus dois propósitos contraditórios: exploração econômica e ostracismo social. O gueto não é uma "área natural", produto da "história da migração" (como Louis Wirth defendia, mas sim uma forma especial de violência coletiva concretizada no espaço urbano. A articulação do conceito de gueto possibilita o desvelamento da relação entre "guetização", pobreza urbana e segregação, assim como o esclarecimento das diferenças estruturais e funcionais entre guetos e aglomerações étnicas. Esse proceder também possibilita que realcemos o papel do gueto como matriz e incubador simbólico da produção de uma identidade maculada, indicando que seu estudo seja feito por analogia a outras instituições voltadas para o confinamento forçado de grupos despossuídos e desonrados como o campo de refugiados, a reserva e a prisão.
Clark, Sarah J; Cowan, Anne E; Filipp, Stephanie L; Fisher, Allison M; Stokley, Shannon
Efforts to increase human papillomavirus (HPV) vaccine coverage rates in adolescents include finding ways to improve discussions between clinicians and parents. One potentially important piece of information for these discussions is the HPV vaccination status of older siblings. A nationally representative online panel was used to conduct a cross-sectional survey of parents of children aged 9 to 17 years in October 2012. Overall, 768 adolescents (35%) had ≥1 older sister aged 10 to 26 years. Male and female adolescents with an older sister who had received no HPV vaccine doses demonstrated higher rates of having no doses themselves, compared with those who had no older sister or those who had an older sister who had received ≥1 HPV vaccine dose. Discussing the HPV vaccination status of older sisters may be a useful strategy for providers to differentiate HPV vaccine messages to parents of unvaccinated younger siblings. © Copyright 2015 by the American Board of Family Medicine.
Colón-López, Vivian; Toro-Mejías, Lizbeth M; Conde-Toro, Alexandra; Serra-Rivera, Michelle J; Martínez, Tania M; Rodríguez, Verónica; Ríos, Ana M; Berdiel, Luis; Villanueva, Héctor
The purpose of this study was to understand through a quantitative assessment, the views of HPV and HPV vaccination among parents of sons from a FQHC in PR. A self-administered questionnaire was given to a convenience sample of 200 parents of sons 9-17 years old. Nearly 30% of the parents reported that their sons had initiated the HPV vaccine regimen. Health care provider recommendation was significantly associated with vaccine initiation. Among parents of unvaccinated sons, the main reason for not getting the HPV vaccine was they did not know that boys were allowed to get the vaccine. Future efforts should focus on multilevel interventions aimed to increase knowledge as well as other modified behavioral determinants in parents of young males about HPV and the vaccine. Capacity building efforts should be targeted also to increase health providers' education and communication skills to promote HPV vaccination effectively.
Full Text Available O presente artigo ilumina o específico do conceito de reflexão de Hegel em cinco momentos. Em um primeiro momento, delineia-se um esboço do conceito de reflexão na lógica da essência de Hegel. Em um segundo momento, o conceito de reflexão de Hegel é apresentado como estrutura lógica objetiva em contraste com a reflexão subjetiva da consciência e do entendimento, com a qual, ao mesmo tempo, o conceito de essência ontológica independente da reflexão é submetido a uma crítica. Do novo conceito de reflexão de Hegel resulta, em terceiro lugar, uma adaptação radical do círculo vicioso na teoria tradicional da reflexão da autoconsciência. Num quarto momento, lança-se um olhar sobre o conceito de reflexão anterior de Hegel como pensar do entendimento que separa, do qual o conceito de reflexão posterior se distingue. Por fim, apresenta-se, em quinto lugar, a lógica da reflexão de Hegel como crítica à fundação ontológica da reflexão em Schelling. O conceito de reflexão de Hegel se mostra, com isto, como crítica da metafísica ontológica tradicional e como fundação de uma metafísica da relacionalidade absoluta que supera a relatividade do pensar moderno do entendimento.
Pils, Sophie; Gensthaler, Lisa; Alemany, Laia; Horvat, Reinhard; de Sanjosé, Silvia; Joura, Elmar A
Even if vulvar cancer is not common, over one hundred women are affected in Austria per year. There is strong evidence that basaloid and warty variants are associated with types of human papillomavirus (HPV). The aim of this study is to analyze the types of HPV in vulvar cancer in Austria. This cross-sectional period-prevalence international collaborative study on archival specimens was performed in cooperation with the Institut Catalan di Oncologia in Barcelona, Spain. A total of 177 consecutive samples of Austrian women were analyzed to detect the presence of various HPV types using the SPF10 PCR/DEIA/LiPA25 system. Furthermore, the expression of the tumor suppressor protein p16(INK4a) was analyzed by immunohistochemistry (CINtec histology kit, ROCHE). A tumor was considered HPV-driven if an overexpression of p16(INK4a) was detected. In all, 41 cases of vulvar cancer tested positive for HPV DNA (23%) and 32 (18%) were p16 positive. Patients with warty and basaloid squamous cell cancer were significantly younger than those with keratinizing squamous cell cancer (63.3 years vs. 71.0 years, p = 0.021). In addition, 77.4% of all cases suffering from warty or basaloid squamous cell cancer tested positive for HPV, compared to 9.5% of the keratinizing squamous cell cancer cases (p HPV strain was type 16, followed by 31 and 33. Infection with HPV type 16 appears to be strongly correlated to the development of warty or basaloid squamous cell cancer. Vaccination against HPV can be expected to prevent this type of vulvar cancer.
Yim, Eun-Kyoung; Park, Jong-Sup
Cervical cancer is one of the leading world causes of cancer morbidity and mortality in woman, with more than 98% related to a human papillomavirus (HPV) infection origin. Infection with specific subtypes of HPV has been strongly implicated in cervical carcinogenesis. The identification and functional verification of host proteins associated with HPV E6 and E7 oncoproteins may provide useful information in understanding cervical carcinogenesis and the development of cervical cancer-specific m...
Durante a última década, o desenvolvimento policêntrico tornou-se um conceito-chave no desenvolvimento territorial europeu. Em muitos aspectos, é um conceito difuso que significa diferentes coisas para diferentes pessoas em diferentes escalas espaciais. Neste artigo, analisamos as variadas
Full Text Available O que é um conceito no sentido de Hegel é, atualmente, algo praticamente desconhecido. Como exemplo de um conceito, a Filosofia Moderna da Linguagem apresenta aproximadamente o conceito de pílula anticoncepcional. Nenhuma mulher, nem mesmo uma admiradora da dialética, compreenderia, por exemplo, se, no médico passando a receita, o conceito de pílula anticoncepcional começasse a correr e no farmacêutico transmutasse no seu oposto. Ninguém admitiria que com os conceitos fundamentais de nossa vida joga-se de tal maneira (Wilhelm E. Essler. A crítica à doutrina hegeliana do juízo, que se tornou uma repreensão standard, reza que ele confundiria a cópula com a identidade: A parte da dialética de Hegel parece geralmente repousar no equívoco de dois significados da palavra é (Bertrand Russel. E, em relação à doutrina de Hegel do silogismo, o hegeliano Vittorio Hösle chega à seguinte averiguação fulminante: Em medida ainda mais alta do que a lógica do juízo de Hegel, sua lógica do silogismo tem que valer como ultrapassada. Este artigo objetiva iluminar o sentido racional e o conteúdo crítico da teoria de Hegel do conceito, do juízo e do silogismo.
Ngan, H Y; Stanley, M; Liu, S S; Ma, H K
Objective - To determine the prevalence of HPV 16 and 18 E6 by DNA detection and p53 abnormal protein expression in cervical cancers in Hong Kong. Materials and methods - Seventy-three squamous cell cervical cancer biopsy were analysed. Detection of HPV DNA was carried out by the polymerase chain reaction and Southern blotting (PCR/SB) technique using primers to the HPV16 and 18 E6 region and consensus primers to the L1 region. Abnormal expression of the p53 protein was detected by immunohist...
Maurício José d’Escragnolle Cardoso
Full Text Available Muitas vezes ignorada, a importância dada por Lacan à obra de Frege se mostra na verdade cada vez mais considerável. Citada pelo psicanalista desde os anos 1950, a importância dessa obra evolui na mesma medida que o ensino lacaniano. Este privilégio é devido não somente à crescente sofisticação da reflexão de Lacan, mas sobretudo a seu esforço em determinar uma questão bastante específica: como isolar a articulação existente entre a estrutura diferencial do significante e a economia pulsional? Este problema encontra sua formulação mais explícita na elaboração lacaniana do conceito de Um, que é justamente realizada através de um diálogo constante com o logicismo fregeano.
Full Text Available No presente trabalho abordamos algumas questões pertinentes ao pensamento de Guilherme de Ockham, por isso usamos como método uma compilação bibliográfica que foi permeada pelos seguintes objetivos; evidenciar o conceito de poder de Ockham. Com isso, percebeu-se que à sua maneira, as idéias de Guilherme de Ockham sobre a Igreja no mundo foram tão radicais quanto sua teologia. Ele sustentou o ideal franciscano de um clero pobre, negou o poder papal de comandar soberanos seculares e afirmou que a fonte suprema de autoridade religiosa era o povo, e não a hierarquia.
Anselmo Tadeu Ferreira
Resumo: Esta dissertação investiga o conceito de ciência elaborado por Guilherme de Ockham (ca. 1285-1349) em suas obras Exposítío ín VIII libras physícorum - prologus (prólogo do Comentário à Física de Aristóteles) e Scríptum ín librum prímum sententiarum - prologus (prólogo do Comentário ao Livro I das Sentenças de Pedra Lombardo). Nestas obras, o autor analisa os diversos sentidos possíveis da palavra scientia e as distinções em seu uso, procurando com isso conciliar a noção aristotélica d...
Full Text Available O presente artigo coloca em discussão a produção de paisagens como prática que pode envolver diferentes agentes e percepções, não sendo estreitamente vinculado a um único olhar dito objetivo. A partir de tal discussão, mapas e atlas, instrumentos cartográficos por demais usuais, são aqui transformados em conceitos para se pensar a paisagem e sua produção na contemporaneidade levando em conta diferentes recortes epistemológicos, pontos de vista, agentes e sujeitos. Usando o conceito de espasmos advindo da critica do filósofo francês Gilles Deleuze a respeito das pinturas Francis Bacon, tais operadores serão discutidos como espaços autônomos de produção de paisagens a despeito de qualquer imagem exterior existente a priori. Serão usadas duas obras que, por sua vez, apontarão para a definição destes mesmos operadores: o trabalho artístico participativo Alter Bahnhof Vídeo Walk dos artistas Janet Cardiff e George Miller apresentado na DOCUMENTA XIII de Kassel em 2012 e o site interativo We feel Fine. An Exploration of Human Emotion, in Six Movements feito pelos designers Jonathan Harris e Sep Kamvar. E na conclusão, pretende-se discutir o mapa e atlas não como instrumentos de leitura de um real, mas eles mesmos como um real narrativo.
João Marcos Mateus KOGAWA
Full Text Available O pensamento de M. Bakhtin e seu círculo traz indagações importantes para o campo linguístico e literário. Os conceitos que formam o universo teórico desse grupo russo permitem-nos investigar diferentes tipos de discursos. Analisamos a constituição do conceito de polifonia desenvolvido no texto Problernas da poética de Dostoiévski como uma categoria estética em relação com a filosofia linguística (natureza dialógica da linguagem de Bakhtin. Empreendemos breves reflexões sobre a canção "Geni e o Zepelim , de Chico Buarque, para entender esse discurso como monológico. O procedimento teórico e metodológico conduz-nos a relativizar algumas "máximas como: "a consciência é polifônica ou "todo discurso é polifônico . A polifonia não se caracteriza apenas pela coexistência de várias vozes. Mais que isso, é a forma de coexistência das vozes que permite a Bakhtin concluir que Dostoiévski é um autor polifônico. O romance polifônico é um espaço discursivo em que as personagens compõem um conjunto e vozes que dialogam igualmente. Não há sobreposição de uma voz sobre outra, apesar de o autor ser o centro organizador da relação entre as personagens.
João Marcos Mateus KOGAWA
Full Text Available O pensamento de M. Bakhtin e seu círculo traz indagações importantes para o campo linguístico e literário. Os conceitos que formam o universo teórico desse grupo russo permitem-nos investigar diferentes tipos de discursos. Analisamos a constituição do conceito de polifonia desenvolvido no texto Problernas da poética de Dostoiévski como uma categoria estética em relação com a filosofia linguística (natureza dialógica da linguagem de Bakhtin. Empreendemos breves reflexões sobre a canção "Geni e o Zepelim , de Chico Buarque, para entender esse discurso como monológico. O procedimento teórico e metodológico conduz-nos a relativizar algumas "máximas como: "a consciência é polifônica ou "todo discurso é polifônico . A polifonia não se caracteriza apenas pela coexistência de várias vozes. Mais que isso, é a forma de coexistência das vozes que permite a Bakhtin concluir que Dostoiévski é um autor polifônico. O romance polifônico é um espaço discursivo em que as personagens compõem um conjunto e vozes que dialogam igualmente. Não há sobreposição de uma voz sobre outra, apesar de o autor ser o centro organizador da relação entre as personagens.
Oriana Aparecida FÁVERO
Full Text Available Visando contribuir para o Plano de Gestão (Manejo da Floresta Nacional de Ipanema (FLONA, o presente trabalho objetivou espacializar sua vegetação natural potencial e realizar o mapeamento da vegetação e usos atuais das terras, oferecendo subsídios básicos para seu planejamento ambiental. Para tanto, foi elaborado um croqui, espacializando a vegetação potencial da FLONA, utilizando: as descrições da paisagem de viagens de naturalistas (Saint-Hilaire, Spix e Martius ao Brasil, no século XIX; estudos mais recentes sobre a vegetação da FLONA e a caracterização edáfica da área apresentada pela Carta de Solos da Fazenda Ipanema (escala 1:10.000. Com base na interpretação de fotos aéreas (escala 1:25.000 Terrafoto, 1972 e verificações de campo, organizou-se o mapa de Vegetação e Usos Atuais das Terras (na escala 1:35.000. Considerando-se os conceitos de clímax climático e clímaces edáficos concluiuse que a vegetação potencial da FLONA seria de Floresta Estacional Semidecidual com manchas das diversas fisionomias de cerrado, limitadas em seu desenvolvimento pela ação do fogo, que no passado teria causas naturais. The potential natural vegetation and current land use mapping of Ipanema National Forest, Iperó/SP: conservation and environmental management Abstract Aiming at contributing to the management plan of the Ipanema National Forest, the present research set out to make a map of the potential natural vegetation and land current usage, offering basic aid to environmental planning. Moreover, a sketch-map was prepared, the potential FLONA vegetation, by means of: details of naturalists trekking routes (Saint- Hilaire, Spix and Martius in Brazil, in the nineteenth century; more recent studies of the FLONA vegetation; and the edaphic characterization of the area presented by the Soil Chart of Ipanema Farm (scale 1:10.000. Data were collected based on the interpretation of aerial photos (scale 1:25.000 Terrafoto
Full Text Available O objeto deste artigo é a Teoria das Representações Sociais. Seu objetivo constitui também sua hipótese: a possibilidade de aliar a leitura psicossocial a uma leitura sociológica do conceito de Moscovici, articulando-o com os conceitos de ideologia e hegemonia de Althusser e Gramsci, e estabelecendo diálogo com o conceito de prática articulatória de Laclau e Mouffe. A problemática que envolve essa discussão se refere à restrição do conceito moscoviciano ao momento da interação e sua insuficiência para abranger o âmbito do conflito e das relações de poder. Aos conceitos de ideologia e hegemonia, por sua vez, faltaria espaço para o reconhecimento de que muitas idéias, valores e teorias implícitas no mundo vivido não estão necessariamente ligados a relações históricas de dominação, tampouco à luta de classes. A autora defende que tais conceitos podem ser eficientemente articulados, desde que o conceito de representação social seja ampliado em seu caráter cognitivo e psicossocial, e os conceitos de ideologia e hegemonia sejam revistos em seu essencialismo e determinismo. A ponte entre o conceito de representação social de Moscovici e os demais é feita através das noções de "ideologia geral" de Althusser, de "teorias do senso comum" de Gramsci e do resgaste do conceito gramsciano de hegemonia como prática discursiva na abordagem pós-estruturalista de Laclau e Mouffe.
Lau, Joseph T. F.; Wang, Zixin; Kim, Jean H.; Lau, Mason; Lai, Coco H. Y.; Mo, Phoenix K. H.
HPV vaccines are available to men but there are few studies investigating the acceptability of HPV vaccines among men who have sex with men (MSM), a high risk group. We assessed the intention to take up HPV vaccines among MSM in Hong Kong and the associated factors related to cognitions on HPV and HPV vaccines, basing on the Health Belief Model (n = 542). The acceptability of HPV vaccines was 20% (unconditional on efficacies and price), 29.2% (conditional on efficacies and market price), 51.7% (conditional on efficacies and discounted price) and 79.1% (conditional on efficacies and free price). Adjusting for background variables, composite scores of perceived susceptibility, perceived severity, perceived barriers and cue to actions were significantly associated with acceptability of HPV vaccines conditional on specific efficacies and the market price. Acceptability of HPV vaccines was highly price sensitive. Future studies need to use conditional measures. Implementation and translational researches are warranted. PMID:23451188
Kavanagh, K; Pollock, K G J; Potts, A; Love, J; Cuschieri, K; Cubie, H; Robertson, C; Donaghy, M
.... By linking individual vaccination, screening and HPV testing records, we aim to determine the impact of the immunisation programme on circulating type-specific HPV infection particularly for four outcomes...
Nadarzynski, Tom; Smith, Helen; Richardson, Daniel; Pollard, Alex; Llewellyn, Carrie
Men who have sex with men (MSM) are at risk of genital warts and anal cancer due to human papillomavirus (HPV) infection. This study explores MSMs' perceptions of HPV and HPV vaccination prior to the introduction of this programme. Focus groups and one-to-one interviews with self-identified MSM were conducted between November 2014 and March 2015 in Brighton, UK. Participants were recruited from community-based lesbian-gay-bisexual-transgender (LGBT) venues and organizations. Discussions were recorded, transcribed verbatim, and analysed using framework analysis. Thirty-three men took part (median age 25 years, IQR: 21-27), most of whom (n = 25) did not know about HPV, anal cancer (31), or HPV vaccination (26). While genital warts and anal cancer were perceived as severe, men did not perceive themselves at risk of HPV. All MSM would accept the HPV vaccine if offered by a health care professional. The challenges of accessing sexual health services or openly discussing same-sex experiences with health care professionals were perceived as barriers to accessing HPV vaccination. Two participants were concerned that selective HPV vaccination could increase stigma and prejudice against MSM, comparable to the AIDS epidemic. Ten MSM were unsure about the effectiveness of HPV vaccination for sexually active men and were in favour of vaccinating all adolescent boys at school. Most MSM have poor knowledge about HPV and associated anal cancer. Despite the lack of concern about HPV, most MSM expressed willingness to receive HPV vaccination. There is a need for health education about the risks of HPV and HPV-related diseases so that MSM can appraise the benefits of being vaccinated. Concerns about HPV vaccine effectiveness in sexually active men and possible stigmatization need to be addressed to optimize HPV vaccine acceptability. Statement of contribution What is already known on this subject? Men who have sex with men (MSM) have poor knowledge about HPV and HPV
Sabrina Soares da Silva
Full Text Available More attention has been paid to environmental matters in recent years, mainly due to the current scenario of accentuated environmental degradation. The economic valuation of nature goods can contribute to the decision-making process in environment management, generating a more comprehensive informational base. This paper aims to present, in a historic perspective, the different concepts attributed to nature goods and were related to the current predominant perspectives of nature analyses. For this purpose, this paper presents the different concepts attributed to value since the pre-classical period, when nature were viewed as inert and passive providers of goods and services, this view legitimized nature's exploration without concern over the preservation and conservation of nature. The capacity of nature to absorb the impact of human action appears to be reaching its limit, considering the irreversibility, the irreproducibility and the possibility of collapse. The appropriate method for valuing natural resources is not known, but more important than the method is to respect and incorporate the particular characteristics of the nature goods into this process. These characteristics must be valuated in order to arrive at a more consistence approach to nature value and promote sustainability.Nos últimos anos, mais atenção tem sido dada às questões ambientais, principalmente decorrente do atual cenário de acentuada degradação. A avaliação econômica dos recursos naturais pode contribuir com o processo de tomada de decisão na gestão ambiental, gerando uma importante base de informações. Neste artigo, buscou-se apresentar, em uma perspectiva histórica, os diferentes conceitos atribuídos ao valor dos recursos naturais e como eles se relacionam às perspectivas atuais de análise ambiental. Com essa finalidade, foram apresentados os conceitos atribuídos ao valor desde o período pré-clássico, quando a natureza era vista como
Sehnal, B; Vojáčková, N; Driák, D; Kmoníčková, E; Vaňousová, D; Maxová, K; Neumannová, H; Sláma, J
There is a considerable number of studies on the efficacy HPV (human papillomavirus) vaccination against different cancers but relevant information is scattered in diverse journals. This paper is a review summarizing current knowledge of the potential of HPV vaccination against all HPV related cancers. HPV infection is probably the most frequent sexually transmitted disease. At least 13 HPV genotypes are classified as carcinogenic or probably carcinogenic in respect to cervical cancer. Almost 100% of cervical cancers are linked to HPV infection. HPV 16 and HPV 18 are the most frequently involved genotypes and account together for approximately 70% of cervical cancer in the world. Persistent high risk HPV infection is responsible for a significant proportion of vulvar, vaginal, anal and penile carcinomas. The virus has also been implicated in oncogenesis of head and neck cancers, including oropharyngeal cancers. HPV infection can play an important role in cancerogenesis of lung, esophagus, breast, and colon and rectum. On the contrary, published results indicate that HPV infection is not associated with prostate oncogenesis. Strong predominance of HPV 16 has been reported for all HPV associated cancer sites. Generally, it is estimated that approximately 5.2% of all cancers are associated with oncogenic HPV infection. Currently, there are two vaccines on the market; quadrivalent Silgard® (Gardasil®) and bivalent CervarixTM. Large trials for both vaccines have shown efficacy against HPV related infection and disease. Efficacy has been very high in HPV naive subjects to vaccine related types. While HPV vaccination is currently approved for the prevention of cervical cancer, it also has the potential in the prevention of all HPV associated malignancies. The Czech republic belongs to countries that cover HPV vaccination of girls at the age of 13- 14 years by general health insurance. Overall impact of this vaccination remains to be evaluated. The new issues of the
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This page contains brief information about recombinant human papillomavirus (HPV) nonavalent vaccine and a collection of links to more information about the use of this vaccine, research results, and ongoing clinical trials.
This page contains brief information about recombinant human papillomavirus (HPV) quadrivalent vaccine and a collection of links to more information about the use of this vaccine, research results, and ongoing clinical trials.
An international randomized clinical trial has shown that the vaccine Gardasil can reduce the incidence of anogenital human papillomavirus (HPV) infections in young men 16 to 26 years of age at the time of vaccination.
This page contains brief information about recombinant human papillomavirus (HPV) bivalent vaccine and a collection of links to more information about the use of this vaccine, research results, and ongoing clinical trials.
Hübbers, Christian U; Akgül, Baki
Increased awareness of human papillomavirus (HPV) as an etiological cause of head and neck squamous cell carcinoma has increased the interest in analysis of distinct oral sub-sites. It is currently under debate, whether HPV plays a role in the development of squamous cell carcinoma of the oral cavity (OSCC). The weakness in most published studies is the lack of performing different HPV detection tests combined with analysis for biological activity of the virus. In addition, different sub-sites of the oral cavity had been combined to a single entity, which retrospectively leads to a highly heterogeneous basis of data. In this review we mainly discuss the unclear role of HPV in OSCC development.
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Human papillomavirus (HPV) is a sexually transmitted infection (STI) of global importance; it is the most prevalent STI in the United States, with strains causally linked to oropharyngeal and other cancers. Efforts to prevent HPV have been made to varying degrees by policies implemented by different state governments; however, HPV and associated oropharyngeal cancer continue to show increasing incidence rates in the US. A narrative review based on search on SciVerse, PubMed/Medline, Google Scholar, and EMBASE databases, as well as literature/documents from the World Health Organization, Centers for Disease Control and Prevention, American Cancer Society, National Conference of State legislatures, and the U.S. Department of Health and Human Services relevant to HPV and HPV vaccine policy in the US. Vaccination has proved to be a successful policy in the US, and an extant recommendation aimed at preventing HPV and associated cervical and other anogenital cancers is the routine use of HPV vaccines for males and females. However, HPV vaccines are presently not recommended for preventing oropharyngeal cancer, although they have been shown to be highly effective against the HPV strains that are most commonly found in the oropharynx. And while there is a history of successful vaccine mandate in the US with resulting decrease in occurrence of infectious diseases, implementing HPV vaccine mandate has proved to be very unpopular. With emerging evidence of the efficacy of the use of the HPV vaccine in preventing oral-HPV, more focus should be put on extending HPV vaccine to present oral HPV infection and oropharyngeal cancer. Also, implementing a broader HPV vaccine policy that include mandating HPV vaccines as a school-entry requirement for both sexes may increase vaccine use in the US for the greater good of the public. Copyright © 2013 Elsevier Ltd. All rights reserved.
Zizipho Z A Mbulawa
Full Text Available The objectives of the study were to investigate prevalence of cervical human papillomavirus (HPV genotypes to inform HPV vaccination strategy in South Africa and to study factors associated with HPV prevalence. Sexually active, HIV-negative women, aged 16-22 years recruited from Soweto (n = 143 and Cape Town (n = 148 were tested for cervical HPV and other genital infections. Overall HPV prevalence was 66.7% (194/291 in young women. Cape Town women were more likely to have multiple HPV infections than the Soweto women (48.0%, 71/148 versus 35.0%, 50/143 respectively, p = 0.033 and probable HR-HPV types (34.5%, 51/148 versus 21.7%, 31/143 respectively, p = 0.022. The most frequently detected HPV types were HPV-16 (11.7%, HPV-58 (10.3%, HPV-51 (8.9%, HPV-66 (8.6%, HPV-18 and HPV-81 (7.6% each. HPV types targeted by the bivalent HPV vaccine (HPV-16/18 were detected in 18.6% (54/291 of women, while those in the quadrivalent vaccine (HPV-6/11/16/18 were detected in 24.7% (72/291 of women; and those in the nonavalent vaccine (HPV-6/11/16/18/31/33/45/52/58 were detected in 38.5% (112/291 of women. In a multivariable analysis, bacterial vaginosis remained significantly associated with HPV infection (OR: 4.0, 95% CI: 1.4-12.6. Women were more likely to be HPV positive if they had received treatment for STI during the past 6-months (OR: 3.4, 95% CI: 1.1-12.4 or if they had ever been pregnant (OR: 2.3, 95% CI: 1.1-5.5. Compared to women who reported only one sexual partner, those with increased number of lifetime sex partners were more likely to have HPV (4-10 partners: OR: 2.9, 95% CI: 1.1-8.0. The high prevalence of HPV types targeted by the nonavalent HPV vaccine encourages the introduction of this vaccine and catch-up HPV vaccination campaigns in South Africa. The high burden of BV and concurrent STIs also highlights the need to improve the prevention and appropriate management of sexually-acquired and other genital tract infections in South African
Full Text Available HPV204 is the only newly identified Mupapillomavirus (Mu-PV type in more than a decade. To comprehensively characterize HPV204, we performed a detailed molecular analysis of the viral genome and evaluated its clinical relevance in comparison to the other Mu-PVs, HPV1 and HPV63. The 7,227-bp long genome of HPV204 exhibits typical genomic organization of Mu-PVs with eight open reading frames (ORFs (E6, E7, E1, E2, E8, E4, L2, and L1. We developed three type-specific quantitative real-time PCRs and used them to test a representative collection (n = 1,006 of various HPV-associated benign and malignant neoplasms, as well as samples of clinically normal cutaneous, mucosal, and mucocutaneous origins. HPV204, HPV1, and HPV63 were detected in 1.1%, 2.7%, and 1.9% of samples tested, respectively, and were present in skin and mucosa, suggesting dual tissue tropism of all Mu-PVs. To evaluate the etiological role of Mu-PVs in the development of HPV-associated neoplasms, Mu-PV viral loads per single cell were estimated. HPV1 and HPV63 were present in high viral copy numbers in 3/43 and 1/43 cutaneous warts, respectively, and were identified as the most likely causative agents of these warts. HPV204 viral load was extremely low in a single HPV204-positive cutaneous wart (7.4 × 10-7 viral copies/cell. Hence, etiological association between HPV204 and the development of cutaneous warts could not be established. To the best of our knowledge, this is the first study to evaluate the genetic variability of Mu-PVs by sequencing complete LCR genomic regions of HPV204, HPV1, and HPV63. We detected several nucleotide substitutions and deletions within the LCR genomic regions of Mu-PVs and identified two genetic variants of HPV204 and HPV63 and five genetic variants of HPV1.
Mário Martins dos Santos Motta
Full Text Available O edema macular é a principal causa de baixa visual em pacientes diabéticos. Seu mecanismo de formação é complexo e envolve alterações bioquímicas e estruturais. Os autores fazem uma revisão e atualização dos conceitos fisiopatológicos envolvidos na maculopatia diabética.Macular edema is the leading cause of poor vision in diabetic patients.The mechanism of edema formation is complex and involves biochemical and structural changes. The authors review and update the physiopathologic concepts related to diabetic maculopathy.
Human papillomavirus (HPV), the most common sexually transmitted virus in the world, is associated with almost all cases of cervical cancer. It is also related to vulvar, vaginal, penile, anal, and oropharyngeal cancer. HPV vaccination is recommended by the Centers for Disease Control and Prevention (CDC) for both boys and girls. Unfortunately,…
Balla, Bettina Claudia; Terebessy, András; Tóth, Emese; Balázs, Péter
(1) Background: Hungarys's estimated cervical cancer mortality was 6.9/100,000 in 2012, above the average of the EU27 countries (3.7/100,000) in the same year. Since 2014, the bivalent HPV vaccine has been offered to schoolgirls aged 12-13. (2) Methods: We conducted a cross-sectional study among 1022 high school seniors (492 girls, 530 boys) in 19 randomly selected schools in Budapest. Our anonymous questionnaire contained 54 items: basic socio-demographic data, knowledge about HPV infection/cervical cancer and HPV vaccination. (3) Results: 54.9% knew that HPV caused cervical cancer, and 52.1% identified HPV as an STD. Knowledge of risk factors such as promiscuity (46.9%) and early sexual activity (15.6%) was low, but higher than that of further HPV-induced diseases: genital warts (in females 9.9%, in males 9%), anal cancer (in females 2.2%, in males 1.9%), penile cancer (9.4%), and vulvar cancer (7.8%). A percentage of 14.6% feared getting infected, and 35.7% supported compulsory HPV vaccination. A percentage of 51.2% would have their future children vaccinated-significantly more girls than boys. (4) Conclusion: Our results support the findings of previous studies about young adults' HPV-related knowledge, which was poor, especially regarding pathologies in men. Despite the low level of awareness, the students' attitude was mostly positive when asked about vaccinating their future children.
Rietbergen, M.M.; Braakhuis, B.J.M.; Moukhtari, N.; Bloemena, E.; Brink, A.; Sie, D.; Ylstra, B.; Baatenburg de Jong, R.J.; Snijders, P.J.F.; Brakenhoff, R.H.; Leemans, C.R.
Background Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCCs) have a better prognosis than patients with HPV-negative OPSCCs. Important factors contributing to this better prognosis are relatively low numbers of local/regional recurrences (LRRs) and
S.M. Matthijsse (Suzette)
textabstractHuman papillomavirus (HPV) is a highly prevalent sexually transmitted virus, of which 150 types have been completely sequenced. Currently, about 14 HPV-types are considered ‘high risk’ for their potential to cause cervical cancer, the fourth most common cancer among women worldwide. In
Latsuzbaia, Ardashel; Tapp, Jessica; Nguyen, Trung; Fischer, Marc; Arbyn, Marc; Weyers, Steven; Mossong, Joël
Analytically accurate human papillomavirus (HPV) genotyping methods are required to assess the impact of HPV vaccination. The aim of this study was to evaluate the analytical performance of Anyplex II HPV28 (Seegene, Korea) and Euroarray HPV (Euroimmun, Germany) genotyping kits, for conducting a future HPV vaccine efficacy monitoring study in Luxembourg. A total number of 150 cervical swabs were collected from women with mean age 31.4 years. Agreements for detecting any HPV between Aptima/Anyplex (88.0%) and Aptima/Euroarray (90.7%) were similar. Agreement of Anyplex/EuroArray with Aptima was higher for Genotypes 16, 18 or 45 than for the other 11 HPVs. The average number of HPV genotypes detected per sample was similar with 2.6 and 2.5, for Anyplex and EuroArray, respectively. In conclusion, Anyplex and Euroarray showed high agreement in general and in particular for detecting genotypes contained in HPV vaccines. Copyright © 2016 Elsevier Inc. All rights reserved.
Jach, Robert; Galarowicz, Bartłomiej; Huras, Hubert; Pawlik, Dorota; Basta, Tomasz; Streb, Joanna; Wolski, Hubert; Ludwin, Artur; Ludwin, Inga
Human papillomavirus (HPV) is the most common sexually transmitted infection. Data reporting vertical transmission of HPV from the mother to the fetus are inconsistent and scant. Vertical transmission may occur by hematogenic route (transplacental), or by ascending contamination, or through the birth canal, which may result in the dreaded and rare laryngeal papillomatosis. Infected sperm at fertilization is a potential route of infection, too. The objective of the study was to evaluate the rate of vertical transmission of HPV in HPV-positive pregnant women to their newborn infants, as well as the risk factors of HPV vertical transmission. The clinical material was provided by 136 pregnant women, aged 18-45 years. Out of this group, 30 (22.05%) women with abnormal Pap test and positive DNA HPV test were prospectively observed Neonatal status, i.e. DNA HPV from the nasopharyngeal smear was recorded in all infants during the perinatal period. The conventional Pap test was performed with the cervix brush in all women. The Bethesda 2011 classification system was applied. An average C Reactive Protein (CRP) concentration in the studied pregnant women was 711.6083 (Std Dev--12.93). The most frequent cytological findings in the cervical smears from the examined women were ASCUS, n = 13 (43.3%), then--LSIL, n = 10 (33.3%), HSIL--n = 5 (16.7%) and AGC--n = 2 (6.7%). In the neonates, the presence of LR HPV DNA was detected in 9 cases (30.0%) and HR HPV DNA in 7 cases (23.3%). Fourteen neonates (46.7%) tested HPV DNA negative in the perinatal period. HPV infection (incidental or chronic) is observed in approximately 22% of pregnant women from the Matopolska province. Neonatal HPV infection in HPV-positive women was observed in 53.3% of the subjects. CRP concentration > 10 mg/dl in the serum of pregnant women statistically significantly (p 0.001) reduces the risk of vertical transmission of HPV from the mother to the fetus.
Nørregaard, Cecilie; Grønhøj, Christian; Jensen, David
; 1.00 year), secondary malignancies (n = 131; 2.37 years), cardiovascular and pulmonary causes (n = 58; 3.48 years), and unspecified causes (n = 102; 3.42 years). HPV/p16 status was the strongest predictor of improved survival across all causes of death. The only cause of death to decrease...... in incidence over the 2 years after treatment was death from OPSCC. HPV/p16 positivity was an independent factor for improved survival across all causes of death in patients with OPSCC. In addition, both HPV-positive and HPV-negative OPSCC patients faced high 5- and 10-year mortality rates. Implementing......Identifying the causes of death in head and neck cancer patients can optimize follow-up and therapeutic strategies, but studies in oropharyngeal squamous cell carcinoma (OPSCC) patients stratified by HPV status are lacking. We report cause-specific mortality in a population-based cohort of patients...
Lee, Sung-Jong; Lee, Ah-Won; Kang, Chang-Suk; Park, Jong-Sup; Park, Dong-Choon; Ki, Eun-Young; Lee, Keun-Ho; Yoon, Joo-Hee; Hur, Soo-Young; Kim, Tae-Jung
The objective of this study was to investigate the expression of human papilloma virus (HPV) L1 capsid protein in abnormal cervical cytology with HPV16 infection and analyze its association with cervical histopathology in Korean women. We performed immunocytochemistry for HPV L1 in 475 abnormal cervical cytology samples from patients with HPV16 infections using the Cytoactiv(®) HPV L1 screening set. We investigated the expression of HPV L1 in cervical cytology samples and compared it with the results of histopathological examination of surgical specimens. Of a total of 475 cases, 188 (39.6%) were immunocytochemically positive and 287 (60.4%) negative for HPV L1. The immunocytochemical expression rates of HPV L1 in atypical squamous cells of unknown significance (ASCUS), low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), and cancer were 21.8%, 59.7%, 19.1%, and 0.0%, respectively. LSIL exhibited the highest rate of HPV L1 positivity. Of a total of 475 cases, the multiple-type HPV infection rate, including HPV16, in HPV L1-negative cytology samples was 27.5%, which was significantly higher than that in HPV L1-positive cytology samples (p = 0.037). The absence of HPV L1 expression in ASCUS and LSIL was significantly associated with high-grade (≥ cervical intraepithelial neoplasia [CIN] 2) than low-grade (≤ CIN1) histopathology diagnoses (p HPV16 single and multiple-type HPV infections (p > 0.05). On the other hand, among 188 HPV L1-positive cases, 30.6% of multiple-type HPV infections showed high-grade histopathology diagnoses (≥ CIN3), significantly higher than the percentage of HPV16 single infections (8.6%) (p = 0.0004) CONCLUSIONS: Our study demonstrates that the expression of HPV L1 is low in advanced dysplasia. Furthermore, the absence of HPV L1 in HPV16-positive low-grade cytology (i.e., ASCUS and LSIL) is strongly associated with high-grade histopathology diagnoses. The multiplicity of HPV infections
Godi, Anna; Bissett, Sara L; Miller, Elizabeth; Beddows, Simon
Human papillomavirus (HPV) vaccines confer protection against the oncogenic genotypes HPV16 and HPV18 through the generation of type-specific neutralizing antibodies raised against virus-like particles (VLP) representing these genotypes. The vaccines also confer a degree of cross-protection against HPV31 and HPV45, which are genetically-related to the vaccine types HPV16 and HPV18, respectively, although the mechanism is less certain. There are a number of humoral immune measures that have been examined in relation to the HPV vaccines, including VLP binding, pseudovirus neutralization and the enumeration of memory B cells. While the specificity of responses generated against the vaccine genotypes are fairly well studied, the relationship between these measures in relation to non-vaccine genotypes is less certain. We carried out a comparative study of these immune measures against vaccine and non-vaccine genotypes using samples collected from 12-15 year old girls following immunization with three doses of either Cervarix® or Gardasil® HPV vaccine. The relationship between neutralizing and binding antibody titers and HPV-specific memory B cell levels for the vaccine genotypes, HPV16 and HPV18, were very good. The proportion of responders approached 100% for both vaccines while the magnitude of these responses induced by Cervarix® were generally higher than those following Gardasil® immunization. A similar pattern was found for the non-vaccine genotype HPV31, albeit at a lower magnitude compared to its genetically-related vaccine genotype, HPV16. However, both the enumeration of memory B cells and VLP binding responses against HPV45 were poorly related to its neutralizing antibody responses. Purified IgG derived from memory B cells demonstrated specificities similar to those found in the serum, including the capacity to neutralize HPV pseudoviruses. These data suggest that pseudovirus neutralization should be used as the preferred humoral immune measure for
José Carlos Teixeira da Silva
Este trabalho discute conceitos e dimensões do termo "tecnologia", no campo da gestão da tecnologia em empresas de manufatura. Considerando a tecnologia embutida em produtos/processos, e a capabilidade tecnológica nas organizações, foi possível desdobrar o "conteúdo da tecnologia", criando os conceitos de "macrotecnologia" e "microtecnologia". Enquanto a macrotecnologia é referente ao conceito sistêmico dentro da organização, a microtecnologia envolve a tecnologia embutida em um produto/proce...
Reis Alberto Olavo Advincula
Full Text Available São discutidas as origens do conceito de adolescência procurando explicar aspectos críticos do conceito, como a presença hegemônica do pensamento bio-naturalista e a presença de um androcentrismo nocional na sua formulação. Destaca-se a pertinência dessa discussão no sentido de contribuir para uma assistência mais adequada aos adolescentes, além de colaborar para expansão do conceito de adolescência no campo da Saúde Pública.
Alberto Olavo Advincula Reis
Full Text Available São discutidas as origens do conceito de adolescência procurando explicar aspectos críticos do conceito, como a presença hegemônica do pensamento bio-naturalista e a presença de um androcentrismo nocional na sua formulação. Destaca-se a pertinência dessa discussão no sentido de contribuir para uma assistência mais adequada aos adolescentes, além de colaborar para expansão do conceito de adolescência no campo da Saúde Pública.
Rosiris Sindeaux de Alencar Pires de Oliveira
Este trabalho teve por objetivos: levantar conceitos alternativos sobre radicais livres na mídia impressa e em livros de Bioquímica; examinar os conceitos alternativos prevalentes em pós-graduandos e em professores de Química e Biologia do Ensino Médio; e, planejar e aplicar intervenção para reduzir a influência destes conceitos. Para o levantamento na mídia impressa, foi selecionada a revista Veja, período de 01/01/2000 a 31/07/2014, e foram criadas as seguintes categorias para classificar o...
Audisio, Riccardo A; Icardi, Giancarlo; Isidori, Andrea M; Liverani, Carlo A; Lombardi, Alberto; Mariani, Luciano; Mennini, Francesco Saverio; Mitchell, David A; Peracino, Andrea; Pecorelli, Sergio; Rezza, Giovanni; Signorelli, Carlo; Rosati, Giovanni Vitali; Zuccotti, Gian Vincenzo
The story of Human Papillomavirus vaccination demands reflection not only for its public health impact on the prophylactic management of HPV disease, but also for its relevant economic and social outcomes. Greater than ever data confirm the efficacy and support the urge for effective vaccination plans for both genders before sexual debut. A review of previous experience in gender-restricted vaccination programs has demonstrated a lower effectiveness. Limiting vaccination to women might increase the psychological burden on women by confirming a perceived inequality between genders; and even if all women were immunized, the HPV chain of transmission would still be maintained through men. The cost-effectiveness of including boys into HPV vaccination programs should be re-assessed in view of the progressive drop of the economic burden of HPV-related diseases in men and women due to universal vaccination. The cost of the remarkable increase in anal and oropharyngeal HPV driven cancers in both sexes has been grossly underestimated or ignored. Steps must be taken by relevant bodies to achieve the target of universal vaccination. The analysis of HPV vaccination's clinical effectiveness vs. economic efficacy are supportive of the economic sustainability of vaccination programs both in women and men. In Europe, these achievements demand urgent attention to the social equity for both genders in healthcare. There is sufficient ethical, scientific, strategic and economic evidence to urge the European Community to develop and implement a coordinated and comprehensive strategy aimed at both genders and geographically balanced, to eradicate cervical cancer and other diseases caused by HPV in Europe. Policymakers must take into consideration effective vaccination programs in the prevention of cancers. Copyright © 2015. Published by Elsevier Ireland Ltd.
Wanda de Aguiar Horta
Full Text Available Desenvolve-se uma teoria que procura explicar a natureza da enfermagem, seu campo especifico e sua metodologia de trabalho. Fundamenta-se na teoria de Maslow para explicar ser a enfermagem um serviço prestado ao Homem visando assisti-lo no atendimento de suas necessidades básicas e desta maneira contribuir para mantê-lo em equilíbrio no tempo e espaço, seja prevenindo desequilíbrios, ou revertendo estes em equilíbrio. Da teoria proposta inferem-se os conceitos de enfermagem, assistir, assistência e cuidados em enfermagem. Algumas proposições e principios também são expostos. Tendo a Teoria das Necessidades Humanas Básicas por fundamento, estabelece-se a metodologia ou Processo de Enfermagem em 6 fases: histórico, diagnóstico, plano assistencial, plano de cuidados, evolução e prognóstico. Salienta-se a importância do desenvolvimento de habilidades denominadas instrumentos básicos, para a execução do Processo de Enfermagem
Matheus Mesquita Pontes
Full Text Available Em 1966 Zygmunt Bauman publicou Kultura i spoleczénstwo. Preliminaria(Cultura e sociedade. Preliminares como professor da Universidade de Varsóvia na Polônia. Foi sua última produção bibliográfica no leste europeu sobre o “socialismo real” e a primeira voltada especificamente à relação entre cultura e sociedade. De 1968 a 1971 Bauman transitou por instituições de ensino superior na Austrália, Canadá, Estados Unidos e, por último, fixou-se na Inglaterra, na Universidade de Leeds. Sua migração contribuiu para a consolidação de um campo de experiência frente às trocas culturais, contatos com intelectuais de língua anglo-saxônica, apuramento das interpretações sobre os conceitos de cultura, comunidade, identidade, xenofobia, que marcariam o conteúdo de suas obras no final do século XX e início do século XXI.
Vinícios Eduardo Ferrari
Full Text Available O intento primordial deste artigo consiste na análise das concepções de Nicos Poulantzas a respeito do Estado Capitalista presentes nas obras Poder Político e Classes Sociais, e O Estado, O Poder, o Socialismo. O primeiro livro foi fortemente influenciado pelo estruturalismo althusseriano. O Estado é concebido como uma estrutura regional do Modo Capitalista de Produção destinada a constituir o fator de coesão dos diversos níveis de uma formação social. Nas obras subsequentes, Poulantzas rompe com o marxismo estruturalista. Em O Estado, O Poder, o Socialismo, o Estado é descrito como a condensação material de uma relação de forças entre as classes e frações da sociedade, portanto, a cristalização de uma relação social. É possível observar nesta segunda obra uma tentativa de aproximação em relação ao pensamento gramsciano. Poulantzas passa a reconhecer a necessidade de concessões materiais estatais a favor das classes dominadas. Estas concessões são consideradas fundamentais para a construção do consenso popular, elemento, por sua vez, crucial para a instauração da hegemonia de uma classe social.PALAVRAS CHAVES: Poulantzas. O Poder, Conceito de Hegemonia.
Eduardo de Assis Duarte
Full Text Available O presente artigo discute os conceitos de literatura negra e literatura afro-brasileira a partir das reflexões existentes em nossa história e crítica literárias, tomando como referência a produção de autores afrodescendentes dos séculos XIX e XX. Em seguida, busca estabelecer um conjunto de elementos que, uma vez reunidos, possam estabelecer parâmetros de distinção que estabeleçam a especificidade da literatura afro-brasileira frente à literatura brasileira tout court.Abstract: The present article debates the concepts of black literature and afro-brazilian literature from the existent debates in our history and literary critics. Taking as a reference the production of afro-descendent authors from the XIX and XX centuries. Also, tries to estabilish a group of elements that, once reunited, may present references of distinction that provides the especificity of the afro-brazilian literature along with the brazilian “tout court” literature.Keywords: Literature; ethnicity; Afro-Brasilian-MindEduardo de Assis Duarte é professor Colaborador do Programa de Pós-graduação em Letras (Estudos Literários da UFMG.
Tatiana Oliveira de Carvalho
Full Text Available Discute-se o cenário atual da Psicologia Escolar no Maranhão, tendo como parâmetro as transformações ocorridas nas últimas décadas em âmbito nacional. Foi realizado um estudo bibliográfico sobre o tema, a partir do qual se levantaram reflexões sobre o histórico e as tendências atuais no âmbito da formação e atuação do psicólogo escolar no estado. Considera-se que no Maranhão necessita-se da contribuição de psicólogos escolares que, seguros de seu papel e intencionalidade, construam uma identidade profissional comprometida com as transformações sociais do contexto local, o que começa a se efetivar através do aprimoramento da formação na área.
Alder, Susanna; Gustafsson, Sofia; Perinetti, Claudia; Mints, Miriam; Sundström, Karin; Andersson, Sonia
Cervical cancer is the second most common cancer among women in Argentina and the mortality rate is not declining despite opportunistic screening. Free-of-charge human papillomavirus (HPV) vaccination of 11-year-old girls was introduced in 2011. Parental acceptance of HPV vaccination is considered to be of great importance for HPV vaccine uptake. However, little is known regarding this factor in Argentina. The aim of the present study was to explore maternal HPV vaccination acceptance, willingness to pay for HPV vaccination and correlates of this willingness, awareness of HPV and HPV-associated disease and behaviors and attitudes associated with HPV vaccination acceptance. A total of 180 mothers of girls aged 9-15 years comprised this quantitative, cross-sectional, survey-based study, conducted at two hospitals in the Mendoza Province. Correlates of willingness to pay for HPV vaccination were obtained using multivariable logistic regression models. Maternal HPV vaccination acceptance was 90%, and 60% of mothers were willing to pay for HPV vaccination. Mothers who were gainfully employed and had a higher disposable household income were significantly more willing to pay for HPV vaccination [odds ratio (OR)=2.54, 95% confidence interval (CI) 1.01-6.38; OR=3.28, 95% CI 1.36-7.94, respectively], as were mothers who were aware of cervical cancer prior to the study (OR=3.22, 95% CI 1.02-10.14). Only one in 10 mothers were informed that HPV vaccination does not offer complete protection against cervical cancer. In conclusion, the present study showed high maternal HPV vaccination acceptance, although acceptance decreased when vaccination was not free-of-charge. Continuous public education campaigns are needed to improve knowledge of HPV, HPV vaccines and HPV-associated disease.
Goldstone, Stephen E; Jessen, Heiko; Palefsky, Joel M; Giuliano, Anna R; Moreira, Edson D; Vardas, Eftyhia; Aranda, Carlos; Hillman, Richard J; Ferris, Daron G; Coutlee, Francois; Marshall, J Brooke; Vuocolo, Scott; Haupt, Richard M; Guris, Dalya; Garner, Elizabeth
A small number of HPV types are related to a majority of HPV-related neoplastic lesions in humans. High-risk types such as HPV 16 and 18 are most often implicated, although other oncogenic and non-oncogenic HPV types can cause disease in men. The efficacy of the quadrivalent HPV vaccine (qHPV) against external genital lesions and intra-anal disease related to HPV in men has been demonstrated. This report examines the vaccine's efficacy against disease due to 10 additional non-vaccine HPV types, as well as efficacy regardless of HPV detection. The data presented suggest that vaccinating males against HPV 6, 11, 16 and 18 protects them against most vaccine HPV-type related anogenital disease. However, significant efficacy against disease due to non-vaccine HPV types was not seen. In addition, the data do not provide any evidence that vaccination with qHPV vaccine will increase the likelihood of disease caused by non-vaccine types in the short term. Copyright © 2013 Elsevier Ltd. All rights reserved.
Thomsen, Louise T; Nygård, Mari; Stensen, Signe
Using a large, population-based survey, we assessed the levels and correlates of human papillomavirus (HPV) awareness among Scandinavian women after introduction of HPV vaccination. In 2011-2012, a random sample of women aged between 18 and 45 years from Denmark, Sweden and Norway received a ques......: OR=0.86, 95% CI: 0.80-0.92). HPV awareness in Scandinavia has increased since the introduction of HPV vaccination. However, 24-38% of Scandinavian women still have never heard of HPV. Future information efforts should target groups with low HPV awareness.......Using a large, population-based survey, we assessed the levels and correlates of human papillomavirus (HPV) awareness among Scandinavian women after introduction of HPV vaccination. In 2011-2012, a random sample of women aged between 18 and 45 years from Denmark, Sweden and Norway received...
... person to person through direct contact during vaginal, anal, or oral sex. Many different types of HPV can cause infections in the throat or genital area in both men and women. In most cases, HPV infections go away on ...
... gov/news/fullstory_165905.html 2 Doses of HPV Shot Enough to Prevent Genital Warts: Study Findings ... rather than three, doses of the human papillomavirus (HPV) vaccine to protect against genital warts in preteens ...
... page: https://medlineplus.gov/news/fullstory_165705.html HPV Vaccine May Also Prevent Cancers Affecting Men Study ... being linked to cervical cancer, the human papillomavirus (HPV) can cause cancers in the back of the ...
Researchers have found that antibodies against the human papillomavirus (HPV) may help identify individuals who are at greatly increased risk of HPV-related cancer of the oropharynx, which is a portion of the throat that contains the tonsils.
Fernández, María E.; Allen, Jennifer D.; Mistry, Ritesh; Kahn, Jessica A.
Infection with genital human papillomavirus (HPV) may cause anogenital cancers, oropharyngeal cancers, anogenital warts, and respiratory papillomas. Two prophylactic vaccines (a bivalent and a quadrivalent vaccine) are now licensed and currently in use in a number of countries. Both vaccines prevent infection with HPV-16 and HPV-18, which together cause approximately 70% of cervical cancers, and clinical trials have demonstrated 90%-100% efficacy in preventing precancerous cervical lesions attributable to HPV-16 and HPV-18. One vaccine also prevents HPV-6 and HPV-11, which cause 90% of genital warts. A growing literature describes associations between psychosocial, interpersonal, organizational, and societal factors that influence HPV vaccination acceptability. This paper summarizes the current literature and presents an integrated perspective, taking into account these diverse influences. The resulting integrated model can be used as a heuristic tool for organizing factors at multiple levels to guide intervention development and future research. PMID:20001821
Wigfall, L T; Bynum, S A; Brandt, H M; Hébert, J R
Cervical cancer risk is increased among women living with HIV (WLH). Human papillomavirus (HPV) vaccination has been shown to be safe and immunogenic among WLH. We examined HPV vaccine awareness and HPV knowledge among WLH. This cross-sectional study collected data from 145 WLH between March 2011 and April 2012. An interviewer-administered survey assessed HPV vaccine awareness and knowledge. Stata/IC 13 was used to perform chi-square tests and multivariate logistic regression analyses. Our sample was 90 % non-Hispanic black and 64 % earned awareness was ten times higher among WLH who knew HPV caused cervical cancer (OR = 10.17; 95 % CI 3.82-27.06). HPV vaccine awareness is low among WLH. Cancer prevention efforts aimed at raising awareness about the HPV vaccine and increasing knowledge about HPV are necessary first steps in reducing cervical cancer disparities among WLH.
Golovina, D A; Ermilova, V D; Zavalishina, L E; Andreeva, Yu Yu; Matveev, V B; Frank, G A; Volgareva, G M
Medical histories of 101 urothelial bladder cancer patients were compared with the results of morphological analysis and biomolecular detection of human papilloma viruses (HPV) in the tumor specimens. DNA of HPV16 (the major type of virus responsible for appearance of cervical carcinoma) was detected in 38 specimens, while mRNA of E6 and E7 oncogenes and E7 oncoprotein of HPV16 were observed in 13 specimens. HPV-positive bladder cancer was characterized by higher degree of cell anaplasia than HPV-negative cancer; in the primary bladder tumor, HPV was detected more often than in recurrent bladder cancer. These data attest to involvement of HPV16 in the genesis of bladder cancer. No correlations of HPV status of bladder tumor with patient's sex, age, and invasion into the muscle layer were revealed.
Baron, Mira; Levin, Myron J; Chatterjee, Archana; Fox, Bradley; Scholar, Sofia; Rosen, Jeffrey; Chakhtoura, Nahida; Meric, Dorothée; Dessy, Francis J; Datta, Sanjoy K; Descamps, Dominique; Dubin, Gary
In this observer-blind study (NCT00423046), women (N = 1,106), stratified by age (18–26, 27–35, 36–45 y), were randomized (1:1) to receive the HPV-16/18 vaccine (Cervarix®, GlaxoSmithKline Biologicals, Months 0, 1, 6) or the HPV-6/11/16/18 vaccine (Gardasil® Merck and Co., Inc., Months 0, 2, 6). Month 7 results were previously reported; we now report Month 24 results. In the according-to-protocol cohort for immunogenicity (seronegative and DNA-negative at baseline for HPV type analyzed), seropositivity rates of neutralizing antibodies (nAbs) [pseudovirion-based neutralization assay] were, across all age strata, 100% (HPV-16/18 vaccine) and 97.5–100% (HPV-6/11/16/18 vaccine) for HPV-16, and 99.0–100% (HPV-16/18 vaccine) and 72.3–84.4% (HPV-6/11/16/18 vaccine) for HPV-18. Corresponding geometric mean titers (GMTs) were 2.4–5.8-fold higher for HPV-16 and 7.7–9.4-fold higher for HPV-18 with the HPV-16/18 vaccine vs. the HPV-6/11/16/18 vaccine; HPV-16 and HPV-18 GMTs were significantly higher with the HPV-16/18 vaccine than the HPV-6/11/16/18 vaccine (p vaccinated cohort (received ≥1 vaccine dose, irrespective of baseline sero/DNA-status). Similar results were obtained using enzyme-linked immunosorbent assay (ELISA ). Positivity rates and GMTs of antigen-specific IgG antibodies in cervicovaginal secretions (ELISA) were not significantly different between vaccines. At Month 24, CD4+ T-cell responses for HPV-16 and HPV-18 were higher with the HPV-16/18 vaccine; memory B-cell response was higher for HPV-18 with the HPV-16/18 vaccine and similar between vaccines for HPV-16. Both vaccines were generally well tolerated. Although an immunological correlate of protection has not been defined, differences in the magnitude of immune response between vaccines may represent determinants of duration of protection. PMID:22048173
Objective Infection with high-risk genotypes of human papillomavirus (HR-HPV) is the major cause of invasive cervical cancers. HPV-16 and HPV-18 are known to be responsible for two-thirds of all invasive cervical carcinomas, followed by HPV-45, -31, and -33. Current guidelines only differentiate HPV-16/18 (+) by recommending direct colposcopy for treatment. We tried to evaluate whether there are differences in risk among 12 non-16/18 HR-HPV genotypes in this study. Methods The pathology archive database records of 1,102 consecutive gynecologic patients, who had results for cervical cytology and histology and for HPV testing, as determined by HPV 9G DNA chip, were reviewed. Results Among the 1,102 patients, 346 were non-16/18 HR-HPV (+) and 231 were HPV-16/18 (+). We calculated the odds ratios for ≥cervical intraepithelial neoplasia 2 (CIN 2) of 14 groups of each HR-HPV genotype compared with a group of HR-HPV (–) patients. Based on the odds ratio of each genotype, we divided patients with non-16/18 HR-HPV genotypes (+) into two groups: HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+). The age-adjusted odds ratios for ≥CIN 2 of the HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+) groups compared with a HR-HPV (–) group were 11.9 (95% CI, 7.6 to 18.8; pHPV-16/18 (+) group was 18.1 (95% CI, 11.6 to 28.3; p=0.003). Conclusion The 12 non-16/18 HR-HPV genotypes can be further categorized (HPV-31/33/35/45/52/58 vs. HPV-39/51/56/59/66/68) by risk stratification. The HPV-31/33/35/45/52/58 genotypes might need more aggressive action. Large scale clinical trials or cohort studies are necessary to confirm our suggestion. PMID:27550402
Maria Angelica Ehara Watanabe
proteínas como a p53 e a pRB, importantes na apoptose e na parada do ciclo celular. As vacinas atuais geram imunidade contra os sorotipos 6, 11, 16 e 18. A vacina pode ser tetravalente (quatro sorotipos: 6, 11, 16 e 18 ou bivalente (16 e 18. Ambas apresentam proteção cruzada contra a infecção por sorotipos não inclusos nas vacinas, porém não possuem caráter terapêutico. O presente trabalho teve como proposta revisar os avanços sobre a infecção pelo HPV, os aspectos imunológicos e as vacinas profiláticas disponíveis.
Elaine de Azevedo
Full Text Available Este ensaio objetiva delinear duas temáticas sociológicas atuais, o risco e a reflexividade, partindo de uma discussão que envolve a ciência e o conceito de alimentação saudável, ressaltando os diferentes aspectos envolvidos na definição deste termo. A partir da mobilização de teóricos das áreas de Nutrição, Sociologia Ambiental e Sociologia do Conhecimento Científico, tal ensaio sinaliza a necessidade de considerar o contexto político da pesquisa em Nutrição e a inserção de diferentes atores, além dos especialistas, de forma a revitalizar o processo de construção dos conceitos de alimentação saudável e riscos alimentares.This article aims to delineate two current sociological themes, risk and reflexivity, starting from a discussion that involves science and the concept of healthy eating, pointing out the different aspects involved in the definition of this term. Experts from the areas of Nutrition, Environmental Sociology and Sociology of Scientific Knowledge have collaborated to this essay which points out the need to consider the political context of nutrition research and the participation of different actors, besides specialists, to revitalize the process of building healthy eating and risky eating concepts.
Crosignani, P.; Stefani, A; G.M. Fara; Isidori, A. M.; A. Lenzi; Liverani, C.A.; Lombardi, A.; Mennini, F.S.; Palu, G.; Pecorelli, S; Peracino, A.P.; Signorelli, C.; G.V. Zuccotti
Background The Human Papillomavirus (HPV) is generally recognized to be the direct cause of cervical cancer. The development of effective anti-HPV vaccines, included in the portfolio of recommended vaccinations for any given community, led to the consolidation in many countries of immunization programs to prevent HPV-related cervical cancers. In recent years, increasing evidence in epidemiology and molecular biology have supported the oncogenic role of HPV in the development of other neoplasm...
Marlow, Laura A V; Wardle, Jane; Waller, Jo; Grant, Nina
Background With the introduction of human papillomavirus (HPV) testing and vaccination in the UK, health professionals will start to receive questions about the virus from their patients. This study aimed to identify the key questions about HPV that British women will ask when considering having an HPV test or vaccination. Methods Face-to-face interviews were carried out with 21 women to discover what they wanted to know about HPV. A thematic framework approach was used to analyse the data an...
Marlow, L. A. V.; Wardle, J.; Grant, N.; Waller, J.
Background With the introduction of human papillomavirus (HPV) testing and vaccination in the UK, health professionals will start to receive questions about the virus from their patients. This study aimed to identify the key questions about HPV that British women will ask when considering having an HPV test or vaccination.Methods Face-to-face interviews were carried out with 21 women to discover what they wanted to know about HPV. A thematic framework approach was used to analyse the data and...
Kirschner, Benny; Junge, Jette; Holl, Katsiaryna
Human papillomavirus (HPV) genotype distribution in invasive cervical cancers may differ by geographic region. The primary objective of this study was to estimate HPV-genotype distribution in Danish women with a diagnosis of invasive cervical cancer.......Human papillomavirus (HPV) genotype distribution in invasive cervical cancers may differ by geographic region. The primary objective of this study was to estimate HPV-genotype distribution in Danish women with a diagnosis of invasive cervical cancer....
Kalinowski, Paweł; Grządziel, Anna
Secondary prophylaxis of cervical cancer consisting in cytology screening tests, despite its effectiveness, does not achieve the desired results. For several years, primary prophylaxis has been available in the form of protective vaccinations. At present, two vaccine preparations are available on the market, and studies conducted on these preparations confirm their almost 100% effectiveness in the prevention of types of HPV present in the vaccine. Analysis of the programmes of protective vaccinations against HPV carried out during the period 2008-2013 in the Lublin Region. The material used in the study was data obtained from the relevant organs of the territorial self-government concerning programmes of vaccinations against HPV, demographic data pertaining to girls aged 10-18 living in the Lublin Region, as well as data published by the National Institute of Public Health - National Institute of Hygiene (NIZP-PZH). The method applied in the study was analysis of records. During the period 2008-2013, in the Lublin Region a total of 5,496 girls were vaccinated within the health programmes. The mean immunization coverage in Lublin is 50%, and in Radzyń Podlaski 59%. The percentage contribution of vaccinations guaranteed free by the local authorities, with relation to the total number of vaccinations performed in the Lublin Region, was from 60 to 77%. The units of territorial self-government allocated the amount of PLN 5,125,359 for the performance of projects associated with execution of free vaccinations. Among the total number of girls vaccinated against HPV, a considerable percentage were those vaccinated within the prophylactic programmes carried out by the units of territorial self-government. The programmes of free protective vaccinations against HPV began in 4 cities in the Lublin Region, and are continued only in two (Lublin and Radzyń Podlaski). Long-term observation of girls subjected to vaccinations from the aspect of maintenance of the immune response
Stanley Margaret A
Full Text Available Abstract Background Human papillomaviruses (HPV are the aetiological agents of certain benign and malignant tumours of skin and mucosae; the most important of which is cervical cancer. Also, the incidence of ano-genital warts, HPV-anal cancer and oropharyngeal cancers are rising. To help ascertain a useful PCR detection protocol for oropharyngeal cancers, we directly compared three commonly used primer sets in detection of HPV from different clinical samples. Methods We compared PGMY09/11, MY09/11 and GP5+/6+ primers sets in PCRs of 34 clinically diagnosed samples of genital warts, cervical brushings (with associated histological diagnosis and vulval biopsies. All negative samples were subsequently tested using the previously reported PGMY/GP PCR method and amplicons directly sequenced for confirmation and typing. An optimised PCR protocol was then compared to a line blot assay for detection of HPV in 15 oropharyngeal cancer samples. Results PGMY09/11 primers detected HPV presence in more cervical brushing (100% and genital wart (92.9% samples compared to MY09/11 (90% and 64.3% and GP5+/6+ (80% and 64.3% primer sets, respectively. From vulval biopsies, HPV detection rates were: MY09/11 (63.6%, GP5+/6+ (54.5% and PGMY09/11 (54.5%. PGMY/GP nested PCR demonstrated that HPV was present, and direct sequencing confirmed genotypes. This nested PCR protocol showed detection of HPV in 10/15 (66.7% of oropharyngeal cancer samples. Conclusions PGMY09/11 primers are the preferred primer set among these three for primary PCR screening with different clinical samples. MY09/11 and GP5+/6+ may be used (particularly for cervical samples but demonstrate lower detection rates. A nested PCR approach (i.e. a PGMY-GP system may be required to confirm negativity or to detect low levels of HPV, undetectable using current primary PCR methods, as demonstrated using oropharyngeal cancer samples.
Full Text Available Abstract HPV infection in the genital tract is common in young sexually active individuals, the majority of whom clear the infection without overt clinical disease. However most of those who develop benign lesions eventually mount an effective cell mediated immune (CMI response and the lesions regress. Failure to develop effective CMI to clear or control infection results in persistent infection and, in the case of the oncogenic HPVs, an increased probability of progression to CIN3 and invasive carcinoma. The prolonged duration of infection associated with HPV seems to be associated with effective evasion of innate immunity thus delaying the activation of adaptive immunity. Natural infections in animals show that neutralising antibody to the virus coat protein L1 is protective suggesting that this would be an effective prophylactic vaccine strategy. The current prophylactic HPV VLP vaccines are delivered i.m. circumventing the intra-epithelial immune evasion strategies. These vaccines generate high levels of antibody and both serological and B cell memory as evidenced by persistence of antibody and robust recall responses. However there is no immune correlate - no antibody level that correlates with protection. Recent data on how HPV infects basal epithelial cells and how antibody can prevent this provides a mechanistic explanation for the effectiveness of HPV VLP vaccines.
Neil D. Christensen
Full Text Available Human papillomaviruses (HPVs represent a large collection of viral types associated with significant clinical disease of cutaneous and mucosal epithelium. HPV-associated cancers are found in anogenital and oral mucosa, and at various cutaneous sites. Papillomaviruses are highly species and tissue restricted, and these viruses display both mucosotropic, cutaneotropic or dual tropism for epithelial tissues. A subset of HPV types, predominantly mucosal, are also oncogenic and cancers with these HPV types account for more than 200,000 deaths world-wide. Host control of HPV infections requires both innate and adaptive immunity, but the viruses have developed strategies to escape immune detection. Viral proteins can disrupt both innate pathogen-sensing pathways and T-cell based recognition and subsequent destruction of infected tissues. Current treatments to manage HPV infections include mostly ablative strategies in which recurrences are common and only active disease is treated. Although much is known about the papillomavirus life cycle, viral protein functions, and immune responsiveness, we still lack knowledge in a number of key areas of PV biology including tissue tropism, site-specific cancer progression, codon usage profiles, and what are the best strategies to mount an effective immune response to the carcinogenic stages of PV disease. In this review, disease transmission, protection and control are discussed together with questions related to areas in PV biology that will continue to provide productive opportunities of discovery and to further our understanding of this diverse set of human viral pathogens.
Beachler, Daniel C.; Waterboer, Tim; Campbell, Christine M. Pierce; Ingles, Donna J.; Kuhs, Krystle A. Lang; Nyitray, Alan G.; Hildesheim, Allan; Pawlita, Michael; Kreimer, Aimée R.; Giuliano, Anna R.
Antibodies against the Human papillomavirus 16 (HPV16) E6 oncoprotein appear years prior to clinical diagnosis of anal and oropharyngeal cancer, but whether they develop around the time of HPV infection is unclear. Serum samples from 173 cancer-free men from the Human Papillomavirus Infection in Men (HIM) Study were tested for HPV antibodies and DNA. HPV16 E6 seropositivity was low among men with oral HPV16-infection (1/28; 3.6%, 95%CI=0.0%-18.4%), anal HPV16-infection (1/61; 1.6%, 95%CI=0.0%-8.8%), and 24-month persistent genital HPV16-infection (1/84; 1.2%, 0.0-6.5%). This suggests E6 seroconversion may not occur around the time of oral, anal, or genital HPV16 acquisition. PMID:28239675
Beachler, Daniel C; Waterboer, Tim; Pierce Campbell, Christine M; Ingles, Donna J; Kuhs, Krystle A Lang; Nyitray, Alan G; Hildesheim, Allan; Pawlita, Michael; Kreimer, Aimée R; Giuliano, Anna R
Antibodies against the Human papillomavirus 16 (HPV16) E6 oncoprotein appear years prior to clinical diagnosis of anal and oropharyngeal cancer, but whether they develop around the time of HPV infection is unclear. Serum samples from 173 cancer-free men from the Human Papillomavirus Infection in Men (HIM) Study were tested for HPV antibodies and DNA. HPV16 E6 seropositivity was low among men with oral HPV16-infection (1/28; 3.6%, 95%CI=0.0%-18.4%), anal HPV16-infection (1/61; 1.6%, 95%CI=0.0%-8.8%), and 24-month persistent genital HPV16-infection (1/84; 1.2%, 0.0-6.5%). This suggests E6 seroconversion may not occur around the time of oral, anal, or genital HPV16 acquisition.
Nan, Xiaoli; Dahlstrom, Michael F; Richards, Adam; Rangarajan, Sarani
This research examines the influence of evidence type (statistical, narrative, or hybrid) and narrative type (first-person or third-person) on risk perception about human papillomavirus (HPV) and behavioral intention to get the HPV vaccine. In total, 174 college students who had not received the HPV vaccine participated in a controlled experiment. Results show that the hybrid message containing both statistical and narrative descriptions of HPV resulted in greater perceived risk of getting HPV than either of the messages containing just one type of evidence--statistical or narrative. Moreover, the first-person narrative message led to greater risk perception about HPV than the third-person narrative message. Both evidence type and narrative type had an indirect effect on intention to get the HPV vaccine free of cost through HPV risk perception. Implications of the findings for vaccine risk communication are discussed.
Lockwood-Rayermann, Suzy; McIntyre, Susan J.
Oncogenic human papillomavirus (HPV) causes 99.7% of all cervical cancers. HPV Types 16 and 18 are responsible for approximately 77% of cases, and peak prevalence occurs in females younger than 25 years of age. The recent implementation of HPV vaccination provides females with the opportunity to prevent infection. School nurses are advocates of…
AJRH Managing Editor
Technology for Health (PATH) to evaluate different HPV vaccine delivery strategies. A school-based HPV vaccine delivery strategy was adopted in Ibanda targeting girls enrolled in primary grade five (P5). In Nakasongola, the HPV vaccine was delivered during the routine Child. Days Plus (CDP) program, targeting girls of at.
Beder Ribeiro, Camila Maria; Ferrer, Iracema; Santos de Farias, Andreza Barkokebas; Fonseca, Débora Diniz; Morais Silva, Igor Henrique; Monteiro Gueiros, Luiz Alcino; Carvalho, Alessandra Tavares; Porter, Stephen Ross; Leao, Jair Carneiro
The aim of this study was to verify human papillomavirus (HPV) transmission and genotype concordance among heterosexual couples. Thirty-one married couples were evaluated. All male subjects presented with clinically diagnosed HPV-related malignant or potentially malignant lesions and underwent peniscopy and penile swab. Their female counterparts underwent swabs of the uterine cervix and oral mucosa. HPV-DNA detection was performed by polymerase chain reaction and restriction fragment length polymorphism. HPV-DNA was detected in the penis, vagina/cervix, and oral cavity of 16 couples (51.61%). Of these, HPV-DNA concordance was observed in 14 couples (87.5%). HPV-DNA was amplified in penile and oral sites of 14 couples. Of these, 13 couples reported fellatio (92.85%), most of them (10 couples, 76.9%) without condom use. HPV-DNA concordance was observed in 7/10 of these couples (70%). The three couples (100%) who reported use of condom during fellatio were HPV-DNA discordant (p = 0.025). Lifetime number of female sexual partners and detection of HPV-DNA in the penile mucosa are surrogate markers of exposure to HPV during marriage. Consistent use of condoms may reduce the risk of HPV transmission. Oral acquisition of HPV from oro-genital contact is influenced by lack of condom use and previous sexual behavior of the male partner. In addition, oral transmission of the virus due to fellatio is as common as genital transmission.
Prue, G; Lawler, M; Baker, P; Warnakulasuriya, S
Human papillomavirus (HPV) contributes to the most common sexually transmitted infections, with repeated and persistent infection with particular types causing disease in both men and women. Infection with low-risk HPV types can lead to genital warts and benign lesions of the oral cavity, while high-risk types can cause various HPV-related malignancies. The incidence of head and neck cancers has been rising in the past number of decades mostly due to oropharyngeal cancer linked to HPV infection. HPV vaccination has been shown to be effective for cervical and other anogenital HPV-related cancers, and there is significant potential for HPV vaccination to prevent oropharyngeal cancers, given that the HPV types implicated in this disease can be protected against by the HPV vaccine. Few countries have implemented a universal HPV vaccination programme for males and females, with many countries arguing that female-only vaccination programmes protect males via herd immunity and that men who have sex with men will be protected via targeted vaccination programmes. We argue these may be limited in their effectiveness. We propose that the most effective, practical, ethical and potentially cost-effective solution is universal HPV vaccination that might lead to control of HPV-related diseases in men and women alike. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
This dissertation describes the epidemiology of human papillomavirus (HPV) and the social-psychological aspects of HPV vaccination acceptability in two different minority populations. Both populations are at higher risk of developing HPV induced disease (notably cervical, penile, anal, and head and
Full Text Available Purpose: The aim of this study was to identify the knowledge and awareness about human papilloma virus (HPV and human papilloma virus (HPV vaccine of women in reproductive age. Material and Methods: The study covered 294 women aged between 15 and 49. A questionnaire was prepared by the researchers based on the literature review. Results: The mean age of the participants was 30.5+/-8.9 years. Only 24.5% had heard about HPV infection and 28.2% had heard HPV vaccine. Of the participants, 188 (63.9% got zero point from the knowledge questions. Conclusion: This study indicates that the women who apply primary care units have low knowledge levels; it is apperent that personal and social education is needed. Paying importance to patient education on HPV and cervical cancer in primary care health politics will increase knowledge and awareness for HPV infection and HPV vaccination. [Cukurova Med J 2015; 40(3.000: 517-524
Zhang, Li-dong; Zhang, Hui-min; Pei, Jing; He, Gui-rong; Sun, Xiao-fang; Li, Bing
High risk human papilomavirus (HPV) infection is often related to cervical cancer. This study investigated the infection of high risk HPV in cervical epithelia among infertile patients. Relative quantification and absolute quantification were applied for determination of "real" HPV viral load in the clinical setting. Adopting multi-channels real time PCR to genotype and quantify eight high risk HPV (HPV16, 18, 45, 31; intermediate risk types: HPV33, 52, 58, 67) DNA in cervical epithelia of the 130 infertile patients and the 150 controls. This study applied housekeeping gene (beta-globin) for the DNA quantification on secretions samples for clinical diagnosis. The infection rate of the infertility group was 25.38 percent (33/130) and that of the control group was 11.33 percent (17/150), the difference was statistically significant. Among the 33 positive cases in the infertility group, 24 cases showed a viral load no less than 106; in 9 of them, the viral load was less than 106. Among the 17 positive cases in the control group, 4 cases had a viral load no less than 106; in 13 of them, the viral load was less than 106. There is a statistically significant difference in viral load between the infertility group and the control group. The HPV infection rate of the infertility group was higher than that of the control group.
Lee, Hee Yun; Lust, Katherine; Vang, Suzanne; Desai, Jay
Despite the availability of the human papillomavirus (HPV) vaccine for males, uptake of the vaccine has been low, particularly among young adult males. This study aimed to investigate the levels of HPV vaccination and predictors of HPV vaccine completion in college men ages 18-26. We analyzed data from the 2015 College Student Health Survey, which was administered at 17 post-secondary institutions in Midwest areas. We included only responses from male participants who were ages 18-26 years old, resulting in a sample size of 2516. We used Andersen's Behavioral Model of Health Services Utilization to guide our study design. Multivariate logistic regression was used to examine predictors of HPV vaccine receipt. College-aged males in our sample had a HPV vaccine completion rate of 50.0%. Male students who were younger, had at least one parent who held a graduate degree, had initiated sex, and were enrolled at a private 4-year institution were more likely to have been vaccinated. These findings suggest that HPV vaccination in college-aged men are low. Efforts are needed to increase HPV vaccination in male students who are older, from lower socioeconomic statuses, have not initiated sex, and enrolled at public institutions. Findings also indicate important gender disparities in vaccine uptake that must be addressed in order to achieve optimal vaccine uptake in college-aged males.
Serour, Y; Bendahmane, M; Abbou Baker, F; Medles, M; Moueddene, B; Kraiba, R
Persistent high-risk HPV (HR-HPV) infection is associated with a greater risk of cervical cancer. Statistical data on the prevalence of HR-HPV infections in the Algerian population is lacking. We conducted a prospective study of 300 women aged between 25 and 50 years, screened for cervical cancer from 2012 to 2015 in Sidi Bel Abbès, a western region of Algeria. We aimed to assess the reliability of the repeated use of the HC II test (three longitudinal HPV tests 9 months apart from each other) in diagnosing the persistence of HR-HPV infection. The prevalence of HR-HPV infection was 7.33% and infected women were aged 37.9±3years. For 90.9% of HR-HPV-positive patients, the infection persisted for a mean of 18.5months [95% CI: 16.9-22.1months]. Among these patients, 55.55% developed CIN1 and 11.11% developed CIN2. The sensitivity of the HC II test was 81.74% [95% CI: 71.3-89.6] and its positive predictive value associated with abnormal cervical biopsy was 27.49% [95% CI: 16.0-33.33]. Repeating the HC II test is a good predictor for identifying women at high risk of cervical cancer. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Cates, Joan R; Brewer, Noel T; Fazekas, Karah I; Mitchell, Cicely E; Smith, Jennifer S
Because cervical cancer mortality in the United States is twice as high among black women as white women and higher in rural areas, providing human papillomavirus (HPV) vaccine to rural black adolescents is a high priority. To identify racial differences in knowledge and attitudes about HPV, cervical cancer, and the HPV vaccine that may influence uptake of the vaccine. We interviewed women (91 black and 47 white) living in a rural area of the Southern United States in 2006. Analyses controlled for socioeconomic status, age, and recruitment location. More white respondents had heard of HPV than had black respondents (57% vs 24%, P < .001), and whites had higher HPV knowledge (42% vs 29% correct responses, P < .05). Blacks were less likely than whites to think that cervical cancer would be a serious threat to their daughters' health (75% vs 96%, P < .001). More blacks than whites thought the ideal age to receive the vaccine was 17 years or older (63% vs 40%, P < .05). Blacks reported lower intentions to vaccinate their daughters than whites (M = 4.14 vs 4.55, P < .05 in unadjusted analyses, but not statistically significant in adjusted analyses). Black and white respondents had different awareness, knowledge, and beliefs related to the HPV vaccine. Communication-based interventions to maximize uptake of the HPV vaccine in the rural, Southern United States may need different messages for black parents of adolescent girls.
Full Text Available Destinado ao volume 2 do Diccionario político y social del mundo iberoamericano, dirigido por Fernández Sebastián (2011, este artigo segue a chamada história dos conceitos de Koselleck e colaboradores, a fim de examinar o conceito de ordem em Portugal, desde a concepção herdada da sociedade de antigo regime, passando pelas vicissitudes do liberalismo oitocentista, até os primeiros sinais das ideias socialistas.
Ratanasiripong, Nop T; Cheng, An-Lin; Enriquez, Maithe
This cross-sectional study, guided by Ajzen's Theory of Planned Behavior, aimed to identify factors that influence the decision to obtain an HPV vaccine among college women and to examine the relationships among these factors. An electronic self-administered survey was utilized to collect data. An email invitation was sent to 3074 college women attending a large, public university in southern California, aged between 18 and 26 years. The email directed the recipient to click on a link to a web-based survey if she wanted to participate in the study. Participants in this study were college women (n=384; 175 HPV non-vaccinees and 209 HPV vaccinees). Women in this study knew that a Pap test is still needed after HPV vaccination and that the HPV vaccine does not protect against other Sexually Transmitted Infections. Both non-vaccinees and vaccinees had positive attitudes about mandating HPV vaccine. Knowledge and attitudes toward the vaccine were not directly linked to the outcome predictors - intention to obtain the vaccine and vaccine uptake. Attitude about receiving HPV vaccine, subjective norms (complying with the expectations of others), and perceived behavioral control were correlated with the outcome predictors. Subjective norms consistently predicted intention to obtain HPV vaccine and vaccine uptake. A proposal to mandate the HPV vaccine among young girls/women was acceptable to this population. Vaccination promotion strategies to increase the vaccine uptake rate among the catch-up group (aged 13-26) should include attention to college women's subjective norms. Health care provider's recommendation and encouragement from significant others (i.e., mother and peers) are critical in order for the college women to obtain the vaccine. Copyright © 2013 Elsevier Ltd. All rights reserved.
Löwhagen, G B; Bolmstedt, A; Ryd, W; Voog, E
OBJECTIVE--To evaluate the prevalence of "high-risk" human papilloma virus (HPV) types in penile condyloma-like lesions and to correlate HPV types with clinical and histological features. DESIGN--The study included 94 male patients with signs of penile HPV infection. From acuminate, papular and macular lesions, specimens were collected for HPV DNA hybridisation, using the dot blot and Southern blot techniques. Biopsy specimens from 51 cases were examined by light microscopy for signs of koilo...
Dinc,Bedia; Rota, Seyyal; Onan, Anil; Bozdayi,Gulendam; Taskiran,Cagatay; Biri,Aydan; Güner,Haldun
PURPOSE: this study was planned to evaluate the prevalence of HPV (excepting type 16) and HPV 16 by real-time PCR in colposcopy patients and to interprete the results with age, age of first sexual intercourse (FSI), parity and Pap smear results. METHODS: one hundred and two colposcopy patients (50 and 52 of the patients were classified as colposcopy positive and negative, respectively) applying to Gynecology clinic were included. HPV (excepting type 16) and HPV 16 were detected by realtime PC...
Muller Clemma J
Full Text Available Abstract Background High-risk strains of human papillomavirus (HPV cause cervical cancer. American Indian (AI women in the Northern Plains of the U.S. have significantly higher incidence and mortality rates for cervical cancer than White women in the same geographical area. We compared HPV prevalence, patterns of HPV types, and infection with multiple HPV types in AI and White women living in South Dakota, U.S. Methods We analyzed the HPV status of cervical samples collected in 2006-2008 from women aged 18-65 years who attended two rural AI reservation clinics (n = 235 or an urban clinic in the same area serving mostly White women (n = 246. Data collection occurred before HPV vaccination was available to study participants. HPV DNA was amplified by using the L1 consensus primer system and an HPV Linear Array detection assay to identify HPV types. We used chi-square tests to compare HPV variables, with percentages standardized by age and lifetime number of sexual partners. Results Compared to White women, AI women were younger (p = 0.01 and reported more sexual partners (p p p = 0.001. Infections among AI women showed a wider variety and very different pattern of HPV types, including a higher prevalence of mixed HPV infections (19% [95% CI = 26-38] vs. 7% [95% CI = 4-11]; p = 0.001. AI women had a higher percentage of HPV infections that were not preventable by HPV vaccination (32% [95% CI = 26-38] vs. 15% [95% CI = 11-21]; p Conclusions A higher HPV burden and a different HPV genotyping profile may contribute to the high rate of cervical cancer among AI women.
Barbara Golob; Mario Poljak; Ivan Verdenik; Mojca Kolbezen Simoniti; Eda Vrtačnik Bokal; Branko Zorn
Human papillomaviruses (HPV) are the most frequently sexually transmitted viruses and etiological agents of several human cancers. Controversial results of the role of HPV in infertile population on sperm parameters have been published. The aim of this study was to estimate the type-specific prevalence of HPV DNA infection of the external genitalia and semen in 340 Slovenian men from infertile couples and to establish the relationship between seminal HPV DNA infection and abnormal sperm param...
Liz Abad MAXIMIANO
Full Text Available A noção de paisagem acompanha a existência humana desde o início, uma vez que a sobrevivência dos seres humanos sempre dependeu de sua relação com o meio. Entretanto, a formulação de um conceito de paisagem ocorreu ao longo de muito tempo, começando a se manifestar mais claramente a partir das observações de pintores, artistas e poetas, tanto do Oriente quanto no Ocidente. Na Antigüidade o ambiente fora do controle humano era olhado com desconfiança e entendido como elemento hostil, daí serem construídos jardins fechados para lazer, contemplação ou plantio de algumas espécies. No Ocidente, a partir de Humboldt, iniciam estudos mais sistemáticos que levariam à compreensão de paisagem como resultante de um complexo de interações entre elementos naturais e humanos. Contudo, ainda haveria discussões sobre o conceito e o método de abordagem da paisagem, passando por ênfases nos aspectos geomorfológicos, biológico ou ocupação humana de um espaço. Em meio a tendências à especialização da década de 60, Bertrand, geógrafo francês, descartou que paisagem fosse uma simples junção de elementos geográficos; antes definiu-a como combinação dinâmica, instável, dos elementos físicos, biológicos e antrópicos. Na Geografia ocidental contemporânea paisagem é entendida como produto visual de interações entre elementos naturais e sociais que, por ocupar um espaço, pode ser cartografada em escala macro ou de detalhe, e classificada de acordo com um método ou elemento que a compõe. Paisagem não é o mesmo que espaço, mas parte dele; algo como um parâmetro ou medida multidimensional de análise espacial. Considerations about landscape concept Abstract Conceptions about landscape come together in human life, since mankinds existence has always depended on his relationship with nature. However, the expression of a landscape concept took some time, and its first concrete manifestation came through arts, both
Saraiya, Mona; Unger, Elizabeth R; Thompson, Trevor D; Lynch, Charles F; Hernandez, Brenda Y; Lyu, Christopher W; Steinau, Martin; Watson, Meg; Wilkinson, Edward J; Hopenhayn, Claudia; Copeland, Glenn; Cozen, Wendy; Peters, Edward S; Huang, Youjie; Saber, Maria Sibug; Altekruse, Sean; Goodman, Marc T
This study sought to determine the prevaccine type-specific prevalence of human papillomavirus (HPV)-associated cancers in the United States to evaluate the potential impact of the HPV types in the current and newly approved 9-valent HPV vaccines. The Centers for Disease Control and Prevention partnered with seven US population-based cancer registries to obtain archival tissue for cancers diagnosed from 1993 to 2005. HPV testing was performed on 2670 case patients that were fairly representative of all participating cancer registry cases by age and sex. Demographic and clinical data were evaluated by anatomic site and HPV status. Current US cancer registry data and the detection of HPV types were used to estimate the number of cancers potentially preventable through vaccination. HPV DNA was detected in 90.6% of cervical, 91.1% of anal, 75.0% of vaginal, 70.1% of oropharyngeal, 68.8% of vulvar, 63.3% of penile, 32.0% of oral cavity, and 20.9% of laryngeal cancers, as well as in 98.8% of cervical cancer in situ (CCIS). A vaccine targeting HPV 16/18 potentially prevents the majority of invasive cervical (66.2%), anal (79.4%), oropharyngeal (60.2%), and vaginal (55.1%) cancers, as well as many penile (47.9%), vulvar (48.6%) cancers: 24 858 cases annually. The 9-valent vaccine also targeting HPV 31/33/45/52/58 may prevent an additional 4.2% to 18.3% of cancers: 3944 cases annually. For most cancers, younger age at diagnosis was associated with higher HPV 16/18 prevalence. With the exception of oropharyngeal cancers and CCIS, HPV 16/18 prevalence was similar across racial/ethnic groups. In the United States, current vaccines will reduce most HPV-associated cancers; a smaller additional reduction would be contributed by the new 9-valent vaccine. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Maximiliano Valerio López
Full Text Available O conceito de experiência se apresenta, na obra de Foucault, como uma constelação integrada por três problemáticas intimamente vinculadas entre si: os jogos de verdade, as relações de poder e as formas de subjetividade às quais estes jogos dão lugar. Estes elementos são veiculados a través de dispositivos heterogêneos (proposições científicas, procedimentos administrativos, estruturas arquitetônicas, etc. que abarcam tanto o âmbito do dito como do não dito. Tais dispositivos configuram uma “experiência histórica” singular, na qual o ser (o sujeito se pensa a si próprio e se toma como objeto de ação moral. No entanto, toda a obra do autor está perpassada por uma tensão entre a possibilidade de, por meio de minuciosos estudos históricos, estabelecer os limites dessa experiência histórica, e um exercício propriamente filosófico a través do qual se tenta fazer experiência do próprio limite, quer dizer, realizar uma experiência trágica capaz de colocar em entredito a própria experiência e as formas de subjetividade à qual ela está ligada. Palavras chaves: Experiência histórica, experiência trágica, poder, saber, subjetividade, dispositivo.
Full Text Available A noção de mal radical aparece em Kant no contexto da discussão da religião nos limites da simples razão e busca dar conta da complexa relação entre o respeito pela lei moral e o amor-próprio na definição do móbil para a ação. Na busca por identificar o fundamento da propensão para o mal no homem, Kant se vê diante da dificuldade de ter de articular natureza e liberdade, e ainda que a noção de mal radical possa conservar algumas ambigüidades, permite conceber uma noção de responsabilidade compatível com uma inata propensão para o mal. Neste texto busco explicitar alguns passos fundamentais na construção do conceito por Kant.The concept of radical evil appears in Kant's theory when he discusses the religion in the limits of the mere reason and aims explain the complex relationship between respect for the moral law and the self-love, for establish the motive of the action. By aiming identify the basis of human inclination to evil, Kant is faced with the trouble of have to put nature and freedom in connection. Despite of the concept of radical evil retain some ambiguity, it allows conceive a notion of responsibility suitable to an inherent inclination to evil. In this paper is my purpose to explain some basic moments of Kantian formulation of that notion.
Jones, Georden; Perez, Samara; Huta, Veronika; Rosberger, Zeev; Lebel, Sophie
Objective: The goals of the present study are (1) to identify sociodemographic and psychosocial predictors of human papillomavirus (HPV)-related stigma and (2) to examine the relationship between HPV-related stigma in predicting HPV vaccine decision-making among college males. Participants: Six hundred and eighty college males aged 18--26 from 3…
Herrera-Ortiz, Antonia; Conde-Glez, Carlos Jesús; Olamendi-Portugal, Ma Leonidez; García-Cisneros, Santa; Plett-Torres, Tanya; Sánchez-Alemán, Miguel A
HPV is the sexually transmitted agent most common among young people, like college students. The aim of study was to associate sexual behavior characteristics of women with HPV, detected in genital samples taken before the introduction of the HPV vaccine. Female students during 2001-2005 donated genital samples and the samples were re-analyzed in 2013 for HPV genotyping by RT-PCR. The frozen storage of the students' genital samples allowed the detection of HPV DNA and its genotyping after years of sample collection. HPV prevalence was 22%, HPV16 3.9%, and HPV18 1.1%. Age, multiple sexual partners and the partner's age at first sexual intercourse were significantly associated to HPV. Students with ≥ 3 sexual partners and who did not use condom had 12.8 higher odds of being HPV positive. These results made possible the analysis of HPV prevalence changes, before HPV vaccine introduction. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Ortiz, M.; Torres, M.; Muñoz, L.; Fernández-García, E.; Canals, J.; Cabornero, A. I.; Aguilar, E.; Ballesteros, J.; del Amo, J.; García-Sáiz, A.
The aim of this study is to determine oncogenic human papillomavirus (HPV) types and HPV type 16 (HPV16) variant distribution in two Spanish population groups, commercial sex workers and imprisoned women (CSW/IPW) and the general population. A multicenter cross-sectional study of 1,889 women from five clinical settings in two Spanish cities was conducted from May to November 2004. Oncogenic HPV infection was tested by an Hybrid Capture II (HC2) test, and positive samples were genotyped by direct sequencing using three different primer sets in L1 (MY09/11 and GP5+/GP6+) and E6/E7. HPV16 variants were identified by sequencing the E6, E2, and L1 regions. Four hundred twenty-five samples were positive for the HC2 test, 31.5% from CSW/IPW and 10.7% from the general population. HPV16 was the most frequent type. Distinct profiles of oncogenic HPV type prevalence were observed across the two populations. In order of decreasing frequency, HPV types 16, 31, 58, 66, 56, and 18 were most frequent in CSW/IPW women, and types 16, 31, 52, 68, 51, and 53 were most frequent in the general population. We analyzed HPV16 intratype variants, and a large majority (78.7%) belonged to the European lineage. AA variants were detected in 16.0% of cases. African variants belonging to classes Af1 (4.0%) and Af2 (1.3%) were detected. Different HPV types and HPV16 intratype variants are involved in oncogenic HPV infections in our population. These results suggest that HPV type distribution differs in CSW/IPW women and in the general population, although further analysis is necessary. PMID:16597872
Kavanagh, K; Pollock, K G J; Potts, A; Love, J; Cuschieri, K; Cubie, H; Robertson, C; Donaghy, M
In 2008, a national human papillomavirus (HPV) immunisation programme began in Scotland for 12-13 year old females with a three-year catch-up campaign for those under the age of 18. Since 2008, three-dose uptake of bivalent vaccine in the routine cohort aged 12-13 has exceeded 90% annually, while in the catch-up cohort overall uptake is 66%. To monitor the impact of HPV immunisation, a programme of national surveillance was established (pre and post introduction) which included yearly sampling and HPV genotyping of women attending for cervical screening at age 20. By linking individual vaccination, screening and HPV testing records, we aim to determine the impact of the immunisation programme on circulating type-specific HPV infection particularly for four outcomes: (i) the vaccine types HPV 16 or 18 (ii) types considered to be associated with cross-protection: HPV 31, 33 or 45; (iii) all other high-risk types and (iv) any HPV. From a total of 4679 samples tested, we demonstrate that three doses (n=1100) of bivalent vaccine are associated with a significant reduction in prevalence of HPV 16 and 18 from 29.8% (95% confidence interval 28.3, 31.3%) to 13.6% (95% confidence interval 11.7, 15.8%). The data also suggest cross-protection against HPV 31, 33 and 45. HPV 51 and 56 emerged as the most prevalent (10.5% and 9.6%, respectively) non-vaccine high-risk types in those vaccinated, but at lower rates than HPV 16 (25.9%) in those unvaccinated. This data demonstrate the positive impact of bivalent vaccination on the prevalence of HPV 16, 18, 31, 33 and 45 in the target population and is encouraging for countries which have achieved high-vaccine uptake.
Lavina Madeira Ribeiro
Full Text Available RESUMO Este é um ensaio teórico sobre a relevância do conceito de massa utilizado no contexto dos estudos de Comunicação. Há o reconhecimento da importância da mídia na formação de identidades, comportamentos e sociabilidades, a dinâmica vivida na esfera pública promovida por ela e nas relações entre diferentes práticas culturais. Nestes termos, o conceito de massa está completamente superado. Já deveria ter sido superado pouco depois de ter sido inventado. Logo após as primeiras pesquisas de Lasswell sobre as intenções de voto dos norte-americanos, descobriu-se uma teia complexa de fatores, em que eles votavam influenciados por inúmeras variáveis e, portanto, não eram uma massa homogênea, sem identidade, sem rosto. O fato é que, do ponto de vista científico, o conceito de massa, em termos analíticos, é completamente inoperável, é um muro opaco que esconde atributos fundamentais do público receptor das mensagens midiáticas e impede a compreensão dos complexos processos interativos que ocorrem entre eles. PALAVRAS-CHAVE: Massa; meios de comunicação de massa; sociedade de massa; indivíduo. ABSTRACT This is a theoretical essay regarding the relevance of the concept of mass used in the context of Communication studies. There is the recognition of the importance of the media in the formation of identities, behaviors and sociability; the dynamics experienced in public space promoted by the media and in the relations between different cultural practices. Therefore, the concept of mass is completely overcome. It should have been overcome shortly after it was invented. In the very first research of Lasswell regarding the intentions of vote of Americans, it was discovered that they voted influenced by countless variables and, therefore, they were not a homogeneous mass without identity or faceless. The fact is that, from a scientific point of view, in analytical terms, the concept of mass is completely
Stenmark, Matthew H., E-mail: firstname.lastname@example.org [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); McHugh, Jonathan B. [Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Schipper, Matthew [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Department of Biostatistics, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Walline, Heather M.; Komarck, Christine [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Worden, Francis P. [Department of Medical Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Wolf, Gregory T.; Chepeha, Douglas B.; Prince, Mark E.; Bradford, Carol R. [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Mukherji, Suresh K. [Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Eisbruch, Avraham [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Carey, Thomas E. [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States)
Purpose: To investigate the relationship between human papillomavirus (HPV) and Epstein-Barr virus (EBV) in nonendemic nasopharyngeal carcinoma (NPC) and assess the prognostic implications of viral status. Methods and Materials: Paraffin-embedded tumor specimens from 62 patients with primary NPC diagnosed between 1985 and 2011 were analyzed for EBV and high-risk HPV. EBV status was determined by the use of in situ hybridization for EBV encoded RNA. HPV status was assessed with p16 immunohistochemistry and multiplex polymerase chain reaction MassArray for determination of HPV type. Proportional hazards models were used to compare the risk of death among patients as stratified by viral status. Results: Of 61 evaluable tumors, 26 (43%) were EBV-positive/HPV-negative, 18 (30%) were HPV-positive/EBV-negative, and 17 (28%) were EBV/HPV-negative. EBV and HPV infection was mutually exclusive. HPV positivity was significantly correlated with World Health Organization grade 2 tumors, older age, and smoking (all P<.001). The racial distribution of the study population was 74% white, 15% African American, and 11% Asian/Middle Eastern. Among HPV-positive patients, 94% were white. At a median follow-up time of 7 years, HPV-positive and EBV/HPV-negative tumors exhibited worse outcomes than did EBV-positive tumors, including decreased overall survival (hazard ratio [HR] 2.98, P=.01; and HR 3.89, P=.002), progression-free survival (HR 2.55, P=.02; and HR 4.04, P<.001), and locoregional control (HR 4.01, P=.03; and HR 6.87, P=.001). Conclusion: In our Midwestern population, high-risk HPV infection may play an etiologic role in the development of nonendemic, EBV-negative NPC. Compared with EBV-positive NPC, HPV-positive and EBV/HPV-negative NPC are associated with worse outcomes. A larger confirmatory study is needed to validate these findings.
Full Text Available Testicular cancer represents the more frequent solid tumour affecting males aged 15-35 years.In the last decades, its incidence showed a progressive increased probably due to genetic and environmental factors. Despite exposure to some viruses such as HIV, HCV, EBV and HPV is frequently related to cancer development, there are no studies aimed to evaluate the possible implication of viral infections in the pathogenesis of testicular cancer. In this study we analyzed sperm parameters and prevalence of HPV on sperm in 155 testicular cancer patients at diagnosis (T-1, after orchiectomy (T0 and after 12 months from surgery or from the end of adjuvant treatments (T12. All patients showed a significantly higher prevalence of semen infection than controls (9.5% and 2.4% respectively and altered sperm parameters both at T-1 and T0. Considering sperm parameters, at T-1 we observed a reduction of progressive motility, and after orchiectomy patients showed a reduction of sperm concentration and count and a further worsening of motility. Thereafter, patients were assigned to three groups on the basis of medical option after surgery: S = surveillance, R = radiotherapy and C = chemotherapy +/- radiotherapy. At T12, untreated patients had an improvement of sperm parameters while R group and even more C group had a strong decrease of sperm number (p<0.01 both vs T0 and S group. Moreover, patients who received radio and/or chemotherapy had a very high prevalence of HPV semen infection (S: 7.7%, R: 30.8% and C: 61.5%. In conclusion, patients with testicular cancer had frequently altered sperm parameters and higher prevalence of HPV semen infection that were worsened after radio and chemotherapy. Because HPV infection is a risk factor for cancer development and it may further reduce fertility, we suggest screening for HPV in testicular cancer patients at diagnosis and particularly after adjuvant treatments.
Garolla, Andrea; Pizzol, Damiano; Bertoldo, Alessandro; Ghezzi, Marco; Carraro, Umberto; Ferlin, Alberto; Foresta, Carlo
Testicular cancer represents the more frequent solid tumor affecting males aged 15-35 years. In the last decades, its incidence showed a progressive increased probably due to genetic and environmental factors. Despite exposure to some viruses such as HIV, HCV, EBV, and HPV is frequently related to cancer development, there are no studies aimed to evaluate the possible implication of viral infections in the pathogenesis of testicular cancer. In this study, we analyzed sperm parameters and prevalence of HPV on sperm in 155 testicular cancer patients at diagnosis (T-1), after orchiectomy (T0) and after 12 months from surgery or from the end of adjuvant treatments (T12). All patients showed a significantly higher prevalence of semen infection than controls (9.5% and 2.4% respectively,) and altered sperm parameters both at T-1 and T0. Considering sperm parameters, at T-1 we observed a reduction of progressive motility, and after orchiectomy patients showed a reduction of sperm concentration and count and a further worsening of motility. Thereafter, patients were assigned to three groups on the basis of medical option after surgery: S = surveillance, R = radiotherapy, and C = chemotherapy +/- radiotherapy. At T12, untreated patients had an improvement of sperm parameters while R group and even more C group had a strong decrease of sperm number (p HPV semen infection (S = 7.7%, R = 30.8%, and C = 61.5%). In conclusion, patients with testicular cancer had frequently altered sperm parameters and higher prevalence of HPV semen infection that were worsened after radio and chemotherapy. Because HPV infection is a risk factor for cancer development and it may further reduce fertility, we suggest screening for HPV in testicular cancer patients at diagnosis and particularly after adjuvant treatments.
Lucian Borges de Oliveira
Full Text Available Este trabalho toma como fundamento a Psicologia Social da Libertação e pretende constituir-se com um estudo piloto ao propor a reflexão sobre os conceitos de crise e situação-limite discutidos, respectivamente, por Leonardo Boff e Ignacio Martín- Baró. Para isso, propomos a leitura de textos de cada um destes autores: Crise – oportunidade de crescimento de Leonardo Boff e Guerra y Trauma Psicosocial Del Niño Salvadoreño e Guerra y Salud Mental de Ignacio Martín - Baró. O confronto entre estas leituras tem o objetivo de explicitar as semelhanças e as divergências entre os conceitos de situação-limite e de crise a partir do paradigma da Libertação. Assim, propõe-se uma ampliação do conceito de situação-limite tratado por Martín-Baró para, com isso, sinalizar um avanço no sentido dos conceitos que surgem no interior desta concepção teórica para a Psicologia.
Chesson, Harrell W.; Markowitz, Lauri E.; Hariri, Susan; Ekwueme, Donatus U.; Saraiya, Mona
Introduction: The objective of this study was to assess the incremental costs and benefits of the 9-valent HPV vaccine (9vHPV) compared with the quadrivalent HPV vaccine (4vHPV). Like 4vHPV, 9vHPV protects against HPV types 6, 11, 16, and 18. 9vHPV also protects against 5 additional HPV types 31, 33, 45, 52, and 58. Methods: We adapted a previously published model of the impact and cost-effectiveness of 4vHPV to include the 5 additional HPV types in 9vHPV. The vaccine strategies we examined w...
Schabath, Matthew B; Villa, Luisa L; Lin, Hui-Yi; Fulp, William J; Akogbe, Gabriel O; Abrahamsen, Martha E; Papenfuss, Mary R; Lazcano-Ponce, Eduardo; Salmerón, Jorge; Quiterio, Manuel; Giuliano, Anna R
This analysis assessed the acquisition (incidence) and persistence (clearance) of human papilloma virus (HPV) infection by self-reported race among men in The HPV in Men (HIM) Study, a multinational prospective study of the natural history of genital HPV infections. Self-reported race was categorized as White, Black, Asian/Pacific Islander (PI), or multiple and mixed race. Genital samples were combined for HPV DNA testing and categorized by any, oncogenic, and non-oncogenic HPV infections. Asian/PI race had significantly the lowest incidence of any, oncogenic, and non-oncogenic HPV infection (P HPV infection (HR = 0.61; 95% CI, 0.40-0.93) when compared to Whites. No significant associations were evident for Asian/PI race for clearance. Multiple and mixed race was significantly associated with lower probability of acquiring non-oncogenic HPV infection (HR = 0.83; 95% CI, 0.69-0.99) and borderline significant associations were observed for any HPV (HR = 0.91) and oncogenic infections (HR = 0.92). Multiple and mixed race was associated with a lower probability of clearing any (HR = 0.92; 95% CI, 0.84-1.00) and oncogenic HPV infections (HR = 0.85; 95% CI, 0.75-0.95). Asian/PI race had the lowest incidence of HPV and exhibited a lower probability of acquiring new HPV infections. Multiple and mixed race had the second lowest incidence of infection and was associated with a lower probability of acquiring and clearing an HPV infection. Race-specific differences in HPV infection could be due to behavior, innate genetic differences, or circulating intratypic HPV variants.
Oscarsson, Marie G; Hannerfors, Anna-Karin; Tydén, Tanja
To explore young women's decision-making process for HPV vaccination and to identify their beliefs about HPV vaccination. This study employs a qualitative design. Data was collected by audio-taped interviews with 16 HPV vaccinated Swedish women, 17-26 years old. The data was analysed using latent content analysis. Three themes emerged from the data: "Fear of cancer", "Reliance on vaccination" and "Mother--the main motivational factor". One of the major reasons for taking the decision to be HPV vaccinated was fear of cancer: vaccination was seen as a way to protect oneself against this. The young women's decision-making surrounding HPV vaccination was based on reliance on vaccination and trust in health care. Support from the mothers of the young women and mothers' sponsorship of costs initiated HPV vaccination. Other motivational factors were advertisements and friends. Despite having been vaccinated, the young women were unaware of the relation between cervical cancer, sexual behaviour and HPV. These HPV vaccinated young women had limited knowledge about HPV. Therefore it is important that health professionals provide comprehensible information about HPV vaccination in attaining informed consent. In order to avoid misunderstandings, health care professionals in youth clinics and schools need to initiate discussion with young women, clarifying the relation between cervical cancer, HPV and sexual transmission. Copyright © 2012 Elsevier B.V. All rights reserved.
Fuller, Kelli M; Hinyard, Leslie
Human papilloma virus (HPV) affects both men and women; however, recommendations for HPV vaccination among men were not issued in the United States until 2011. The purpose of this study was to describe and compare characteristics of men who did and did not report receiving at least one dose of the HPV vaccine. Data from the ten states that completed the HPV vaccination module in the 2013 Behavioral Risk Factor Surveillance System (BRFSS) were included in the study. Young men ages 18-26 were included (N = 1624). Categorical variables were compared between those who did and did not receive the HPV vaccine using Chi square. Logistic regression was used to examine the odds of HPV vaccination by the above factors. Only 16.5% of men reported at least one dose of HPV vaccine. Having health insurance, having a primary doctor, and receiving an HIV test were predictive of HPV vaccination. Men in Texas were more likely to report HPV vaccination than all other states. Overall, HPV vaccination is low in men. Targeted interventions for improving HPV vaccination rates in men are warranted, especially for those without health insurance or a routine source of care.
Lajer, C B; Garnæs, E; Friis-Hansen, L; Norrild, B; Therkildsen, M H; Glud, M; Rossing, M; Lajer, H; Svane, D; Skotte, L; Specht, L; Buchwald, C; Nielsen, F C
Although the role of human papilloma virus (HPV) in cervical squamous cell carcinoma (CSCC) is well established, the role in head and neck SCC (HNSCC) is less clear. MicroRNAs (miRNAs) have a role in the cancer development, and HPV status may affect the miRNA expression pattern in HNSCC. To explore the influence of HPV in HNSCC, we made a comparative miRNA profile of HPV-positive (HPV+) and HPV-negative (HPV-) HNSCC against CSCC. Fresh frozen and laser microdissected-paraffin-embedded samples obtained from patients with HPV+/HPV- HNSCC, CSCC and controls were used for microarray analysis. Differentially expressed miRNAs in the HPV+ and HPV- HNSCC samples were compared with the differentially expressed miRNAs in the CSCC samples. Human papilloma virus positive (+) HNSCC had a distinct miRNA profile compared with HPV- HNSCC. Significantly more similarity was seen between HPV+ HNSCC and CSCC than HPV- and CSCC. A set of HPV core miRNAs were identified. Of these especially the miR-15a/miR-16/miR195/miR-497 family, miR-143/miR-145 and the miR-106-363 cluster appear to be important within the known HPV pathogenesis. This study adds new knowledge to the known pathogenic pathways of HPV and substantiates the oncogenic role of HPV in subsets of HNSCCs.
Bettina Claudia Balla
Full Text Available (1 Background: Hungarys’s estimated cervical cancer mortality was 6.9/100,000 in 2012, above the average of the EU27 countries (3.7/100,000 in the same year. Since 2014, the bivalent HPV vaccine has been offered to schoolgirls aged 12–13. (2 Methods: We conducted a cross-sectional study among 1022 high school seniors (492 girls, 530 boys in 19 randomly selected schools in Budapest. Our anonymous questionnaire contained 54 items: basic socio-demographic data, knowledge about HPV infection/cervical cancer and HPV vaccination. (3 Results: 54.9% knew that HPV caused cervical cancer, and 52.1% identified HPV as an STD. Knowledge of risk factors such as promiscuity (46.9% and early sexual activity (15.6% was low, but higher than that of further HPV-induced diseases: genital warts (in females 9.9%, in males 9%, anal cancer (in females 2.2%, in males 1.9%, penile cancer (9.4%, and vulvar cancer (7.8%. A percentage of 14.6% feared getting infected, and 35.7% supported compulsory HPV vaccination. A percentage of 51.2% would have their future children vaccinated—significantly more girls than boys. (4 Conclusion: Our results support the findings of previous studies about young adults’ HPV-related knowledge, which was poor, especially regarding pathologies in men. Despite the low level of awareness, the students’ attitude was mostly positive when asked about vaccinating their future children.
González-Losa,María del R; Puerto-Solis,Marylin; Tenorio Ruiz,Juan; Rosado-López,Ariel I; Hau-Aviles,Oscar; Ayora-Talavera,Guadalupe; Cisneros-Cutz,Isidro; Conde-Ferráez,Laura
Integration of human papillomavirus (HPV) DNA into human cells accompanied by the disruption of the viral genome has been described as a prerequisite for cancer development. This study aimed to investigate E2 gene integrity of HPV16 and HPV58 viruses isolated from infected women with cervical lesions. Forty-two HPV16- and 31 HPV58-positive samples were analysed. E2 integrity was assumed when all fragments covering the E2 gene were amplified with specific polymerase chain reaction primers. Ove...
Full Text Available Human Papillomavirus type 16 (HPV16 causes over half of all cervical cancer and some HPV16 variants are more oncogenic than others. The genetic basis for the extraordinary oncogenic properties of HPV16 compared to other HPVs is unknown. In addition, we neither know which nucleotides vary across and within HPV types and lineages, nor which of the single nucleotide polymorphisms (SNPs determine oncogenicity.A reference set of 62 HPV16 complete genome sequences was established and used to examine patterns of evolutionary relatedness amongst variants using a pairwise identity heatmap and HPV16 phylogeny. A BLAST-based algorithm was developed to impute complete genome data from partial sequence information using the reference database. To interrogate the oncogenic risk of determined and imputed HPV16 SNPs, odds-ratios for each SNP were calculated in a case-control viral genome-wide association study (VWAS using biopsy confirmed high-grade cervix neoplasia and self-limited HPV16 infections from Guanacaste, Costa Rica.HPV16 variants display evolutionarily stable lineages that contain conserved diagnostic SNPs. The imputation algorithm indicated that an average of 97.5±1.03% of SNPs could be accurately imputed. The VWAS revealed specific HPV16 viral SNPs associated with variant lineages and elevated odds ratios; however, individual causal SNPs could not be distinguished with certainty due to the nature of HPV evolution.Conserved and lineage-specific SNPs can be imputed with a high degree of accuracy from limited viral polymorphic data due to the lack of recombination and the stochastic mechanism of variation accumulation in the HPV genome. However, to determine the role of novel variants or non-lineage-specific SNPs by VWAS will require direct sequence analysis. The investigation of patterns of genetic variation and the identification of diagnostic SNPs for lineages of HPV16 variants provides a valuable resource for future studies of HPV16
Full Text Available Abstract Background Human Papillomavirus-32 (HPV-32 has traditionally been associated with focal-epithelial-hyperplasia (FEH. It is also present in 58% of oral warts of HIV-positive individuals whose prevalence is increasing. Current methods for the detection of HPV-32 are labor-intensive and insensitive so the goal of this work was to develop a highly sensitive and easy to use specific polymerase chain reaction (PCR assay. Materials and methods An HPV-32 L1 specific PCR assay was developed and optimized. The sensitivity and specificity was compared to previous assays utilized for detection (PGMY and MY09/11 PCR with dot blot hybridization using cloned HPV-32 L1, the closely related HPV-42 L1 as well as clinical samples (oral swabs and fluids from 89 HIV-positive subjects. Results The HPV-32 specific PCR assay showed improved sensitivity to 5 copies of HPV-32 as compared to the PGMY PCR, MY09/11 PCR and dot blot which had a limit of detection of approximately 3,000 copies. Using the HPV-32 dot blot hybridization assay as the gold standard, the HPV-32 specific PCR assay has a sensitivity of 95.8% and 88.9% by sample and subject, respectively, and specificity was 87.8% and 58.8% by sample and subject, respectively. The low sensitivity is due to the HPV-32 specific PCR assays ability to detect more HPV-32 positive samples and may be the new gold standard. Conclusion Due to the ease, sensitivity, and specificity the HPV-32 specific PCR assay is superior to previous assays and is ideal for detection of HPV-32 in large cohorts. This assay provides an excellent tool to study the natural history of HPV-32 infection and the development of oral warts.
Full Text Available Questiona-se a atual definição de saúde da Organização Mundial da Saúde: "situação de perfeito bem-estar físico, mental e social" da pessoa, considerada ultrapassada, primeiramente, por visar a uma perfeição inatingível, atentando-se as próprias características da personalidade. Menciona-se como principal sustentação dessa idéia, a renúncia necessária a parte da liberdade pulsional do homem, em troca da menor insegurança propiciada pelo convívio social. Discute-se a validade da distincão entre soma, psique e sociedade, esposando o conceito de homem "integrado", e registrando situações em que a interação entre os três aspectos citados é absolutamente cristalina. É revista a noção de qualidade de vida sob um vértice antipositivista. Essa priorização e proposta de resgate do subjetivismo, reverte a um questionamento da atual definição de saúde, toda ela embasada em avaliações externas, "objetivas", dessa situação.Objections to the present WHO (World Health Organization definition of HEALTH, as "the state of perfect physical, mental and social well-being", are expressed. It is considered to be anachronistic, first because it aims at perfection which is unaltainelle because of distict personality characteristics. As the main support for this idea, the necessary renunciation of part of man's drive to liberty in exchange for the lesser insecurity provided by social life (Freud, Castoriadis and Mc Dougall, is groted. The validity of distinguishing between "soma", "psyche" and "society" is questioned and the concept of the "integrated man", alluding to Pierre Marty and to Freud himself is adapted, and situations are recalled in which the interaction of the three aspects mentioned above is actually evident. Finally, the notion of the quality of life, in accordance with an antipositivistic taken from Bion, point of view, is discussed, and the concept that reality is that of each human being, is adapted. This
Daley, Ellen M; Vamos, Cheryl A; Thompson, Erika L; Zimet, Gregory D; Rosberger, Zeev; Merrell, Laura; Kline, Nolan S
Human papillomavirus (HPV) can cause a number of anogenital cancers (i.e., cervical, penile, anal, vaginal, vulvar) and genital warts. A decade ago, the HPV vaccine was approved, and has been shown to be a public health achievement that can reduce the morbidity and mortality for HPV-associated diseases. Yet, the mistaken over-identification of HPV as a female-specific disease has resulted in the feminization of HPV and HPV vaccines. In this critical review, we trace the evolution of the intersection of science, politics, economics and gender norms during the original HPV vaccine approval, marketing era, and implementation. Given the focus on cervical cancer screening, women were identified as bearing the burden of HPV infection and its related illnesses, and the group responsible for prevention. We also describe the consequences of the feminization of HPV, which has resulted primarily in reduced protection from HPV-related illnesses for males. We propose a multilevel approach to normalizing HPV vaccines as an important aspect of overall health for both genders. This process must engage multiple stakeholders, including providers, parents, patients, professional organizations, public health agencies, policymakers, researchers, and community-based organizations. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
María del R González-Losa
Full Text Available Integration of human papillomavirus (HPV DNA into human cells accompanied by the disruption of the viral genome has been described as a prerequisite for cancer development. This study aimed to investigate E2 gene integrity of HPV16 and HPV58 viruses isolated from infected women with cervical lesions. Forty-two HPV16- and 31 HPV58-positive samples were analysed. E2 integrity was assumed when all fragments covering the E2 gene were amplified with specific polymerase chain reaction primers. Overall, in 59% of the samples, at least one fragment was not amplified in HPV16- (57% and HPV58-positive samples (61%. Samples from high-grade squamous intraepithelial lesions had the highest frequency of E2 gene disruptions (73%, followed by samples from low-grade squamous intraepithelial lesions (63% and, finally, samples from invasive cervical cancer (35%. Association between the integrity status of the E2 gene, and lesion grade was assessed by the chi-squared test applied to the combined set of viruses (p = 0.6555 or to populations of the same virus type (HPV58, p = 0.3101; HPV16, p = 0.3024. In conclusion, in this study, no association was found between the presence of E2 gene disruptions and the grade of cervical lesions caused by HPV16 and HPV58.
González-Losa, María Del R; Puerto-Solis, Marylin; Tenorio Ruiz, Juan; Rosado-López, Ariel I; Hau-Aviles, Oscar; Ayora-Talavera, Guadalupe; Cisneros-Cutz, Isidro; Conde-Ferráez, Laura
Integration of human papillomavirus (HPV) DNA into human cells accompanied by the disruption of the viral genome has been described as a prerequisite for cancer development. This study aimed to investigate E2 gene integrity of HPV16 and HPV58 viruses isolated from infected women with cervical lesions. Forty-two HPV16- and 31 HPV58-positive samples were analysed. E2 integrity was assumed when all fragments covering the E2 gene were amplified with specific polymerase chain reaction primers. Overall, in 59% of the samples, at least one fragment was not amplified in HPV16- (57%) and HPV58-positive samples (61%). Samples from high-grade squamous intraepithelial lesions had the highest frequency of E2 gene disruptions (73%), followed by samples from low-grade squamous intraepithelial lesions (63%) and, finally, samples from invasive cervical cancer (35%). Association between the integrity status of the E2 gene, and lesion grade was assessed by the chi-squared test applied to the combined set of viruses (p = 0.6555) or to populations of the same virus type (HPV58, p = 0.3101; HPV16, p = 0.3024). In conclusion, in this study, no association was found between the presence of E2 gene disruptions and the grade of cervical lesions caused by HPV16 and HPV58.
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Tamara R. Litwin
Full Text Available High-risk human papilloma virus (HPV infections cause cancers in different organ sites, most commonly cervical and head and neck cancers. While carcinogenesis is initiated by two viral oncoproteins, E6 and E7, increasing evidence shows the importance of specific somatic events in host cells for malignant transformation. HPV-driven cancers share characteristic somatic changes, including apolipoprotein B mRNA editing catalytic polypeptide-like (APOBEC-driven mutations and genomic instability leading to copy number variations and large chromosomal rearrangements. HPV-associated cancers have recurrent somatic mutations in phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA and phosphatase and tensin homolog (PTEN, human leukocyte antigen A and B (HLA-A and HLA-B-A/B, and the transforming growth factor beta (TGFβ pathway, and rarely have mutations in the tumor protein p53 (TP53 and RB transcriptional corepressor 1 (RB1 tumor suppressor genes. There are some variations by tumor site, such as NOTCH1 mutations which are primarily found in head and neck cancers. Understanding the somatic events following HPV infection and persistence can aid the development of early detection biomarkers, particularly when mutations in precancers are characterized. Somatic mutations may also influence prognosis and treatment decisions.
Litwin, Tamara R; Clarke, Megan A; Dean, Michael; Wentzensen, Nicolas
High-risk human papilloma virus (HPV) infections cause cancers in different organ sites, most commonly cervical and head and neck cancers. While carcinogenesis is initiated by two viral oncoproteins, E6 and E7, increasing evidence shows the importance of specific somatic events in host cells for malignant transformation. HPV-driven cancers share characteristic somatic changes, including apolipoprotein B mRNA editing catalytic polypeptide-like (APOBEC)-driven mutations and genomic instability leading to copy number variations and large chromosomal rearrangements. HPV-associated cancers have recurrent somatic mutations in phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha ( PIK3CA ) and phosphatase and tensin homolog ( PTEN ), human leukocyte antigen A and B ( HLA-A and HLA-B ) -A/B , and the transforming growth factor beta (TGFβ) pathway, and rarely have mutations in the tumor protein p53 ( TP53 ) and RB transcriptional corepressor 1 ( RB1 ) tumor suppressor genes. There are some variations by tumor site, such as NOTCH1 mutations which are primarily found in head and neck cancers. Understanding the somatic events following HPV infection and persistence can aid the development of early detection biomarkers, particularly when mutations in precancers are characterized. Somatic mutations may also influence prognosis and treatment decisions.
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Rivera Z.,René; Aguilera T.,Jorge; Larraín H,Angélica
Se presenta una revisión de la epidemiología del Virus Papiloma Humano (HPV). Patogenia, prevalencia mundial, magnitud de la infección, factores de riesgo, algunas lesiones producidas según tipo específico y se describe el concepto de clearance y persistencia viral.
Sichero, Laura; Pierce Campbell, Christine M.; Ferreira, Silvaneide; Sobrinho, João S.; Baggio, Maria Luiza; Galan, Lenice; Silva, Roberto C.; Lazcano-Ponce, Eduardo; Giuliano, Anna R.; Villa, Luisa L.
The HPV infection in men (HIM) study examines the natural history of genital HPV infection in men. Genotyping methods used in this study identify 37 α-HPV types; however, the viral type could not be identified in approximately 22% of male genital specimens that were HPV PCR positive. Our aim was to genotype HPV-unclassified specimens by sequencing PGMY09/11, GP5+/6+ or FAP59/64 PCR products. Using this approach we were able to detect 86 unique HPV types among 508 of 931 specimens analyzed. We report for the first time the presence of a broad range of α-, β- and γ-HPV at the male genitals. PMID:23722104
Agorastos, Theodoros; Chatzistamatiou, Kimon; Katsamagkas, Taxiarchis; Koliopoulos, George; Daponte, Alexandros; Constantinidis, Theocharis; Constantinidis, Theodoros C
The objective of the present study is to assess the performance of a high-risk human papillomavirus (HR-HPV) DNA test with individual HPV-16/HPV-18 genotyping as a method for primary cervical cancer screening compared with liquid-based cytology (LBC) in a population of Greek women taking part in routine cervical cancer screening. The study, conducted by the "HEllenic Real life Multicentric cErvical Screening" (HERMES) study group, involved the recruitment of 4,009 women, aged 25-55, who took part in routine cervical screening at nine Gynecology Departments in Greece. At first visit cervical specimens were collected for LBC and HPV testing using the Roche Cobas 4800 system. Women found positive for either cytology or HPV were referred for colposcopy, whereas women negative for both tests will be retested after three years. The study is ongoing and the results of the first screening round are reported herein. Valid results for cytology and HPV testing were obtained for 3,993 women. The overall prevalence of HR-HPV was 12.7%, of HPV-16 2.7% and of HPV-18 1.4%. Of those referred for colposcopy, cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was detected in 41 women (1.07%). At the threshold of CIN2+, cytology [atypical squamous cells of undetermined significance (ASC-US) or worse] and HPV testing showed a sensitivity of 53.7% and 100% respectively, without change between age groups. Cytology and HPV testing showed specificity of 96.8% and 90.3% respectively, which was increased in older women (≥30) in comparison to younger ones (25-29). Genotyping for HPV16/18 had similar accuracy to cytology for the detection of CIN2+ (sensitivity: 58.5%; specificity 97.5%) as well as for triage to colposcopy (sensitivity: 58.5% vs 53.7% for cytology). HPV testing has much better sensitivity than cytology to identify high-grade cervical lesions with slightly lower specificity. HPV testing with individual HPV-16/HPV-18 genotyping could represent a more accurate
Constantinidis, Theocharis; Constantinidis, Theodoros C.
Objectives The objective of the present study is to assess the performance of a high-risk human papillomavirus (HR-HPV) DNA test with individual HPV-16/HPV-18 genotyping as a method for primary cervical cancer screening compared with liquid-based cytology (LBC) in a population of Greek women taking part in routine cervical cancer screening. Methods The study, conducted by the “HEllenic Real life Multicentric cErvical Screening” (HERMES) study group, involved the recruitment of 4,009 women, aged 25–55, who took part in routine cervical screening at nine Gynecology Departments in Greece. At first visit cervical specimens were collected for LBC and HPV testing using the Roche Cobas 4800 system. Women found positive for either cytology or HPV were referred for colposcopy, whereas women negative for both tests will be retested after three years. The study is ongoing and the results of the first screening round are reported herein. Results Valid results for cytology and HPV testing were obtained for 3,993 women. The overall prevalence of HR-HPV was 12.7%, of HPV-16 2.7% and of HPV-18 1.4%. Of those referred for colposcopy, cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was detected in 41 women (1.07%). At the threshold of CIN2+, cytology [atypical squamous cells of undetermined significance (ASC-US) or worse] and HPV testing showed a sensitivity of 53.7% and 100% respectively, without change between age groups. Cytology and HPV testing showed specificity of 96.8% and 90.3% respectively, which was increased in older women (≥30) in comparison to younger ones (25–29). Genotyping for HPV16/18 had similar accuracy to cytology for the detection of CIN2+ (sensitivity: 58.5%; specificity 97.5%) as well as for triage to colposcopy (sensitivity: 58.5% vs 53.7% for cytology). Conclusion HPV testing has much better sensitivity than cytology to identify high-grade cervical lesions with slightly lower specificity. HPV testing with individual HPV-16/HPV-18
Full Text Available PURPOSE: The aim of this study was to evaluate the comprehension and acceptance of HPV vaccination in parents of adolescent boys aged 11 to 15 years. METHODS: A cross-sectional survey was conducted by means of questionnaires sent directly to the homes of all families with young males aged between 11 and 15, residents of three municipalities of the Province of Brescia, Italy. The documentation also contained an informative leaflet summarizing the HPV-related disease characteristics, the burden of disease and the available strategies for prevention and treatment, illustrating the rationale of vaccination and describing the project and its phases. The questionnaire included questions on demographic data, acceptance and motivations for HPV vaccination. The collected data was analyzed using descriptive statistics. At the end of the study, parents who received the questionnaires were also offered the possibility of vaccinating their male sons for free. RESULTS: From a total of 1072 questionnaires sent, 161 where returned from the three selected municipalities (average response rate 15%; 97% of adolescent males involved in the study were Italian and 91% Catholic; 97% of parents declared themselves to be willing to vaccinate their sons: the principal motivation given (92% was prevention of the disease, cancerous or not, related to viral infection. Among the respondents not willing to vaccinate their sons, the motivation was lack of information about the vaccine and the disease. At the end of the study, around 71 boys were vaccinated. DISCUSSION: To our knowledge, this is the first survey in Italy exclusively conducted on parents of adolescent males about the acceptability and feasibility of vaccination against HPV: a very high percentage of respondents was favorable to accept the vaccination for their sons, the main motivation being the fact that parents considered protecting their sons from HPV-related diseases highly important. Of the 161 boys
Halfon, Philippe; Benmoura, Dominique; Agostini, Aubert; Khiri, Hacene; Penaranda, Guillaume; Martineau, Agnes; Blanc, Bernard
Abbott RealTime (RT) High-Risk (HR) HPV assay is a new qualitative real-time polymerase chain reaction (PCR) based assay for the detection of 14 HR HPV DNA. The assay can differentiate between the infection by HPV 16, HPV 18 and non-HPV 16/18 types through the distinct fluorescent labels on the type specific probes. To evaluate the clinical performance of the Abbott RT HR HPV test, in comparison with biopsy, Hybrid Capture II (HCII), and Linear Array (LA), for detection of high-grade disease (CIN2+). The study population consisted of 143 women who were included in three referral gynecology clinics in Marseilles (France) between March 2007 and June 2008. The clinical performance of the RT HR HPV assay, performed on the fully automated m2000 system, was compared with HCII and LA. HR HPV positivity rate was similar for all tests (Abbott RT HR HPV and HCII, 62%, and LA 63%). All tests had high sensitivities and negative predictive values for CIN2+ detection (>90%). The agreement between HCII and Abbott RT HR HPV, and between HCII and LA were 93% (k=0.85) and 96% (k=0.91) respectively. As expected, HPV16 or HPV18 positivity was greater in advanced grades of disease, especially in CIN2+ patients: 85% in CIN2+ vs. 33% in Abbott RT HR HPV assay is good and closely correlated with the two other assays. The automation and ability to identify type 16 and 18 make this a very attractive option for HPV testing in laboratories and potentially provides improved patient management. Copyright 2010. Published by Elsevier B.V.
Lamech M. Mwapagha
Full Text Available Although high-risk human papillomaviruses (HPVs are the major risk factors for cervical cancer they have been associated with several other cancers, such as head and neck and oral cancers. Since integration of low-risk HPV11 DNA has been demonstrated in esophageal tumor genomes, this study compared the effects of low-risk HPV11E6 and high-risk HPV18E6 on cellular gene expression. The HPV11E6 and HPV18E6 genes were cloned into an adenoviral vector and expressed in human keratinocytes (HaCaT in order to investigate early events and to eliminate possible artifacts introduced by selective survival of fast growing cells in stable transfection experiments. HPV11E6 had very little effect on p21 and p53 gene expression, while HPV18E6 resulted in a marked reduction in both these proteins. Both HPV11E6 and HPV18E6 enabled growth of colonies in soft agar, but the level of colony formation was higher in HPV18E6 infected cells. DNA microarray analysis identified significantly differentially regulated genes involved in the cellular transformation signaling pathways. These findings suggest that HPV11E6 and HPV18E6 are important in initiating cellular transformation via deregulation of signaling pathways such as PI3K/AKT and pathways that are directly involved in DNA damage repair, cell survival, and cell proliferation. This study shows that the low-risk HPV11E6 may have similar effects as the high-risk HPV18E6 during the initial stages of infection, but at a much reduced level.
Tracht, Jessica M; Davis, Antoinette D; Fasciano, Danielle N; Eltoum, Isam-Eldin A
The objective of this study was to compare cervical high-grade squamous intraepithelial lesions subcategorized as cervical intraepithelial neoplasia-3 (CIN-3)-positive after a negative cytology result but positive for high-risk human papillomavirus (HR-HPV) testing to those with a negative HR-HPV test but positive cytology (atypical squamous cells of undetermined significance [ASCUS]-positive/HPV-negative) and to assess reasons for discrepancies. The authors retrospectively analyzed women who underwent screening with cytology and HPV testing from 2010 through 2013. After a review of surgical specimens and cytology, discrepancies were classified as sampling or interpretation error. Clinical and pathologic findings were compared. In total, 15,173 women (age range, 25-95 years; 7.1% were aged HPV and cytologic testing, and 1184 (8.4%) underwent biopsy. Cytology was positive in 19.4% of specimens, and HPV was positive in 14.5%. Eighty-four CIN-3-positive specimens were detected, including 55 that tested ASCUS-positive/HPV-positive, 11 that tested negative for intraepithelial lesion or malignancy (NILM)/HPV-positive, 10 that tested ASCUS-positive/HPV-negative, 3 that tested NILM/HPV-negative, and 5 tests that were unsatisfactory. There was no significant difference between NILM/HPV-positive and ASCUS-positive/HPV-negative CIN-3 in terms of size, time to occurrence, the presence of a cytopathic effect, screening history, race, or age. Six of 11 NILM/HPV-positive cases were reclassified as ASCUS, indicating an interpreting error of 55% and a sampling error of 45%. No ASCUS-positive/HPV-negative cases were reclassified. Seven cases of CIN-3 with positive cytology were HPV-negative. There are no significant clinical or pathologic differences between NILM/HPV-positive and ASCUS-positive/HPV-negative CIN-3-positive specimens. Cytologic sampling or interpretation remains the main reason for discrepancies. However, HPV-negative CIN-3 with positive cytology exists and may be
Zeila Facci Torezan
Full Text Available O conceito de sublimação não ganhou, com Freud, o desenvolvimento em um artigo específico, tendo sido trabalhado em textos destinados a outras temáticas e em distintos momentos de sua obra, carecendo da organização desses fragmentos e da lapidação das ambiguidades e contradições possíveis de ser identificadas neste material. O labor lacaniano sobre o texto de Freud produz o resgate do conceito de sublimação, promovendo o distanciamento do reducionismo pelo qual a sublimação é tomada como um conceito normativo. Este artigo objetiva traçar a construção do conceito de sublimação em Freud, e indicar o resgate deste mesmo conceito feito por Lacan.Sublimation: from the construction to the rescue of the concept. The sublimation concept was not developed by Freud in a single article, but was worked in several texts concerning other matters and in different times of his production, lacking both an organization of these fragments and the discussion of the contradictions found in Freud's theory. Lacan rescued the concept of sublimation in Freud's work, trying to prevent its reduction to a normative concept. This article aims to draw the construction of sublimation concept by Freud and to indicate the rescue of this concept produced by Lacan.
Full Text Available O objetivo deste artigo é expor três conceitos, ou nexos ideativos, articuladores do conceito de geração de ambiências: a relação meio em torno/meio entre, a interpretação instauradora, a relação dialógica das lógicas/dialógica do diálogo. Esses conceitos têm sido consolidados como nexos ideativos e bases operacionais para o conceito de geração de ambiências, ao longo de um percurso de diálogos com diversas práticas
Lim, Myong Cheol; Lee, Do-Hoon; Hwang, Sang-Hyun; Hwang, Na Rae; Lee, Bomyee; Shin, Hye Young; Jun, Jae Kwan; Yoo, Chong Woo; Lee, Dong Ock; Seo, Sang-Soo; Park, Sang-Yoon; Joo, Jungnam
Human papillomavirus (HPV) testing based on cervical samples is important for use in cervical cancer screening. However, cervical sampling is invasive. Therefore, non-invasive methods for detecting HPV, such as urine samples, are needed. For HPV detection in urine samples, two real-time PCR (RQ-PCR) tests, Roche cobas 4800 test (Roche_HPV; Roche Molecular Diagnostics) and Abbott RealTime High Risk HPV test (Abbott_HPV; Abbott Laboratories) were compared to standard cervical samples. The performance of Roche_HPV and Abbott_HPV for HPV detection was evaluated at the National Cancer Center using 100 paired cervical and urine samples. The tests were also compared using urine samples stored at various temperatures and for a range of durations. The overall agreement between the Roche_HPV and Abbott_HPV tests using urine samples for any hrHPV type was substantial (86.0% with a kappa value of 0.7173), and that for HPV 16/18 was nearly perfect (99.0% with a kappa value of 0.9668). The relative sensitivities (based on cervical samples) for HPV 16/18 detection using Roche_HPV and Abbott_HPV with urine samples were 79.2% (95% CI; 57.9-92.9%) and 81.8% (95% CI; 59.7-94.8%), respectively. When the cut-off CT value for Abbott_HPV was extended to 40 for urine samples, the relative sensitivity of Abbott_HPV increased to 91.7% from 81.8% for HPV16/18 detection and to 87.0% from 68.5% for other hrHPV detection. The specificity was not affected by the change in the CT threshold. Roche_HPV and Abbott_HPV showed high concordance. However, HPV DNA detection using urine samples was inferior to HPV DNA detection using cervical samples. Interestingly, when the cut-off CT value was set to 40, Abbott_HPV using urine samples showed high sensitivity and specificity, comparable to those obtained using cervical samples. Fully automated DNA extraction and detection systems, such as Roche_HPV and Abbott_HPV, could reduce the variability in HPV detection and accelerate the standardization of HPV
Corbitt, G; Zarod, A P; Arrand, J R; Longson, M; Farrington, W T
Biopsy specimens from 14 patients treated for laryngeal papillomatosis were tested for the presence of human papillomavirus (HPV) genome by the technique of DNA-DNA hybridisation. According to the age of initial presentation, cases were subdivided into juvenile (less than 16 years) and adult onset (older than 16 years) groups. Histological investigation confirmed that it was impossible to distinguish the groups on this basis. Molecular virology using both dot blot and Southern transfer techniques showed that 10 cases carried the HPV type 6 genome, three cases HPV type 11, and in one case no HPV DNA was detected. All six adult onset cases carried HPV 6 sequences while the juvenile onset group comprised four HPV 6 and three HPV 11 cases. In the juvenile onset group more females were affected; in the adult onset group more males were affected. Two of the patients shown to have HPV type 11 sequences in their biopsy material were the most resistant to treatment. One of the adult onset cases subsequently developed a squamous cell carcinoma of the larynx in which HPV 6 DNA was detected. As far as we know this is first time that HPV-DNA has been confirmed in laryngeal papilloma undergoing malignant change. Images Figs 1 a, b Fig 2 PMID:2834419
Megwalu, Uchechukwu C; Chen, Michelle M; Ma, Yifei; Divi, Vasu
The utility of cancer databases for oropharyngeal cancer studies is limited by lack of information on human papillomavirus (HPV) status. The purpose of this study was to develop a surrogate that can be used to adjust for the effect of HPV status on survival. The study cohort included 6419 patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012, identified in the National Cancer Database (NCDB). The HPV surrogate score was developed using a logistic regression model predicting HPV-positive status. The HPV surrogate score was predictive of HPV status (area under the curve [AUC] 0.73; accuracy of 70.4%). Similar to HPV-positive tumors, HPV surrogate positive tumors were associated with improved overall survival (OS; hazard ratio [HR] 0.73; 95% confidence interval [CI] 0.59-0.91; P = .005), after adjusting for important covariates. The HPV surrogate score is useful for adjusting for the effect of HPV status on survival in studies utilizing cancer databases. © 2017 Wiley Periodicals, Inc.
Berois, Nora; Heard, Isabelle; Fort, Zoraida; Alonso, Rafael; Sica, Adela; Moerzinger, Patricia; Rodriguez, Guillermo; Sancho-Garnier, Hélène; Osinaga, Eduardo; Favre, Michel
The aim of this work was to describe the prevalence of type-specific Human papillomavirus (HPV) infection in women attending organized cervical cancer screening program in Uruguay. Nine hundred sixty-five liquid cervical cell samples obtained after collection of cervical smears for cytology were assessed for HPV DNA using the Papillocheck system (Greiner BioOne). The overall prevalence of High-Risk (HR) HPV infections was 20.8% and increased from 16.5% in women with normal cytology to 93.3% in HSIL. Prevalence of HPV 16 and/or 18 was 6.3% and HPV 16 was the most prevalent genotype in normal cytology (3.6%). The five most prevalent genotypes were HPV 16, 31, 51, 56, and 39. The overall prevalence peaked below age 30. This study provides essential baseline information at national level on type-specific HPV prevalence in Uruguay before the introduction of HPV vaccination. It documents the current prevalence of each of the oncogenic genotypes in a population attending cervical cancer screening program, suggesting that at least 64.7% of high risk lesions are potentially preventable by available HPV vaccines, and possibly augmentable if cross-protection against non-vaccine HPV types 31, 33, and 45 is confirmed. © 2013 Wiley Periodicals, Inc.
Wakeham, Katie; Kavanagh, Kim; Cuschieri, Kate; Millan, David; Pollock, Kevin G; Bell, Sarah; Burton, Kevin; Reed, Nicholas S; Graham, Sheila V
It is universally accepted that high-risk human papillomavirus (HR-HPV) is the cause of cervical dysplasia and cancer. More recently, it has been shown that HPV is also a marker of clinical outcome in oropharyngeal cancer. However, contemporary information is lacking on both the prevalence of HPV infection in vulvar cancer (VSCC), its precursor lesion, vulvar intraepithelial neoplasia (VIN) and the influence of HPV-status on the prognosis of this malignancy. We have conducted a detailed population-based study to examine rates of progression of VIN to VSCC, type-specific HPV prevalence in vulvar disease and the influence of HPV status on clinical outcome in VSCC. We observed that the age at which women are diagnosed with VSCC is falling and there is a significant time gap between first diagnosis of VIN and progression to invasive disease. HR-HPV infection was detected in 87% (97/112) cases of VIN and 52% cases (32/62) of VSCC. The presence of HR-HPV in squamous intraepithelial lesion was associated with lower rates of progression to invasive cancer (hazard ratio, 0.22, p = 0.001). In the adjusted analysis, HR-HPV was associated with improved progression-free survival of VSCC compared to those with HPV negative tumours (hazard ratio, 0.32, p = 0.02). © 2016 UICC.
Oliveira Isabel Oliveira de
Full Text Available Os processos de crescimento e pigmentação do cabelo não são completamente conhecidos. Da mesma forma, o papel que os melanócitos foliculares desempenham nesses processos ainda não foi esclarecido. A identificação do destino dos melanócitos foliculares ao final da fase de crescimento do folículo piloso e a localização do reservatório dessas células, que voltam a povoar a porção inferior do novo folículo ao final da fase telógena do ciclo de crescimento do cabelo, constituem objeto de estudo. Investigações têm sido realizadas visando identificar se os melanócitos são responsáveis por algum sinal molecular de comunicação envolvido com as mudanças observadas na estrutura do folículo piloso durante o ciclo do cabelo. Alguns fatores têm sido descritos como participantes dos processos essenciais para a biologia dos melanócitos. A importância da proteína antiapoptótica, Bcl-2, para a manutenção dos melanócitos já foi demonstrada. A via SCF/kit foi mencionada como um mecanismo primário para a regulação dos processos de proliferação e diferenciação dos melanócitos. Por outro lado, o mecanismo de ação dos androgênios sobre as células do folículo piloso tem sido objeto de muitos estudos que tentam explicar como esses hormônios participam da regulação dos processos de crescimento e pigmentação do cabelo. Portanto, o objetivo dessa revisão é apresentar os atuais conhecimentos envolvendo a biologia dos melanócitos foliculares.
Tran, Nam Phuong; Hung, Chien-Fu; Roden, Richard; Wu, T-C
Human papillomavirus (HPV), the most common sexually transmitted virus, and its associated diseases continue to cause significant morbidity and mortality in over 600 million infected individuals. Major progress has been made with preventative vaccines, and clinical data have emerged regarding the efficacy and cross-reactivity of the two FDA approved L1 virus like particle (VLP)-based vaccines. However, the cost of the approved vaccines currently limits their widespread use in developing countries which carry the greatest burden of HPV-associated diseases. Furthermore, the licensed preventive HPV vaccines only contain two high-risk types of HPV (HPV-16 and HPV-18) which can protect only up to 75 % of all cervical cancers. Thus, second generation preventative vaccine candidates hope to address the issues of cost and broaden protection through the use of more multivalent L1-VLPs, vaccine formulations, or alternative antigens such as L1 capsomers, L2 capsid proteins, and chimeric VLPs. Preventative vaccines are crucial to controlling the transmission of HPV, but there are already hundreds of millions of infected individuals who have HPV-associated lesions that are silently progressing toward malignancy. This raises the need for therapeutic HPV vaccines that can trigger T cell killing of established HPV lesions, including HPV-transformed tumor cells. In order to stimulate such antitumor immune responses, therapeutic vaccine candidates deliver HPV antigens in vivo by employing various bacterial, viral, protein, peptide, dendritic cell, and DNA-based vectors. This book chapter will review the commercially available preventive vaccines, present second generation candidates, and discuss the progress of developing therapeutic HPV vaccines.
Fleming, Wayne S; Sznajder, Kristin K; Nepps, Margaret; Boktor, Sameh W
This study determined facilitators and barriers to human papillomavirus (HPV) vaccination perceived by providers of healthcare in the federally funded Pennsylvania Vaccines for Children (PA VFC) program. The cross-sectional study gathered descriptive data through a survey research design. Providers of healthcare were recruited through an email containing a link to an 18-question online survey. The survey was divided into four main sections which assessed the perceived facilitators and barriers to HPV vaccination of PA VFC program-eligibles. Survey respondents represented 65 of 66 Pennsylvania counties covered by the PA VFC Program. The study recruited 772 PA VFC participating healthcare facilities for a response rate of 52%. Ninety eight percent of the responding facilities reported that they offered the HPV vaccine. The most common barriers to vaccine administration were the parental belief that HPV vaccination is associated with sexual activity and parent/patient refusal of the HPV vaccination which together accounted for (44%) of responses. The majority of respondents (75.6%) indicated counseling parents and adolescents on the benefits of HPV vaccination was a very important factor in HPV vaccination uptake. Healthcare provider facility based training (32%) and web-based training for healthcare providers (22%) were the most recommended avenues for HPV training. The most common barrier to HPV vaccination was identified as the parental misconception that HPV vaccination is associated with sexual activity. Providers believed that the best way to increase HPV vaccination is through counseling parents and adolescents on the benefits of HPV vaccination and to correct misconceptions and change attitudes. Providers are desirous of receiving HPV web-based or workplace training.
Cox, J Thomas; Castle, Phillip E; Behrens, Catherine M; Sharma, Abha; Wright, Thomas C; Cuzick, Jack
The objective of the study was to compare 9 cervical cancer screening strategies to the current screening standard (cytology with human papillomavirus [HPV] triage of atypical squamous cells of undetermined significance) for the detection of high-grade cervical disease. Women (n = 34,254) aged 30 years or older from the Addressing the Need for Advanced HPV Diagnostics (ATHENA) study underwent screening with cytology and HPV testing with simultaneous HPV16/18 genotyping; those with atypical squamous cells of undetermined significance cytology or greater or HPV-positive status were referred for colposcopy. In general, screening strategies that offered greater sensitivity also required more referral to colposcopy. HPV testing was more sensitive than cytology for detection of cervical intraepithelial neoplasia grade 2 or greater, but strategies that depended on cytology for triage of HPV-positive women decreased this sensitivity. Various strategies of cotesting with cytology increased sensitivity but did so by increasing testing. Strategies that included integrated HPV16/18 testing provided more efficient referral to colposcopy. Strategies that maximize detection of women at greatest risk of cervical intraepithelial neoplasia grade 3 or greater by immediate referral to colposcopy, with follow-up testing of women at intermediate risk, maximize the benefits of cervical cancer screening while decreasing the potential harm. Incorporating screening with HPV and triage of HPV-positive women by a combination of genotyping for HPV16/18 and cytology provided a good balance between maximizing sensitivity (benefit) and specificity by limiting the number of colposcopies (potential harm). Copyright © 2013 Mosby, Inc. All rights reserved.
Pinto, Ligia A; Dillner, Joakim; Beddows, Simon; Unger, Elizabeth R
When administered as standard three-dose schedules, the licensed HPV prophylactic vaccines have demonstrated extraordinary immunogenicity and efficacy. We summarize the immunogenicity of these licensed vaccines and the most commonly used serology assays, with a focus on key considerations for one-dose vaccine schedules. Although immune correlates of protection against infection are not entirely clear, both preclinical and clinical evidence point to neutralizing antibodies as the principal mechanism of protection. Thus, immunogenicity assessments in vaccine trials have focused on measurements of antibody responses to the vaccine. Non-inferiority of antibody responses after two doses of HPV vaccines separated by 6 months has been demonstrated and this evidence supported the recent WHO recommendations for two-dose vaccination schedules in both boys and girls 9-14 years of age. There is also some evidence suggesting that one dose of HPV vaccines may provide protection similar to the currently recommended two-dose regimens but robust data on efficacy and immunogenicity of one-dose vaccine schedules are lacking. In addition, immunogenicity has been assessed and reported using different methods, precluding direct comparison of results between different studies and vaccines. New head-to-head vaccine trials evaluating one-dose immunogenicity and efficacy have been initiated and an increase in the number of trials relying on immunobridging is anticipated. Therefore, standardized measurement and reporting of immunogenicity for the up to nine HPV types targeted by the current vaccines is now critical. Building on previous HPV serology assay standardization and harmonization efforts initiated by the WHO HPV LabNet in 2006, new secondary standards, critical reference reagents and testing guidelines will be generated as part of a new partnership to facilitate harmonization of the immunogenicity testing in new HPV vaccine trials. Copyright © 2018 Elsevier Ltd. All rights
Leon, Sandra; Sánchez, Ricardo; Patarroyo, Manuel A; Camargo, Milena; Mejia, Adriano; Urquiza, Mauricio; Patarroyo, Manuel E
To assess the frequency of HPV-DNA detection, human papillomavirus (HPV) seropositivity, presence of cervical lesions, and its relationship with certain socio-demographic factors in women from Girardot, Colombia from 2006 to 2007. Nine hundred fifty-three women attending their regular Pap smear control voluntarily provided cervical cells and blood samples for HPV-DNA analysis and ELISA detection of anti-L1 peptides and virus-like particles (VLPs) antibodies after answering a questionnaire regarding sexual behaviors, number of births, smoking habits, and socio-demographic background. Twenty-six of the 953 women being examined (2.73%) presented cervical cell abnormalities. A frequency of 36.62% (95% CI: 33.52%-39.7%) HPV seropositivity was detected with peptide 18301, 35.36% (95% CI: 32.3%-38.4%) with 18283, and 32.95% (95% CI: 29.9%-36%) with 18294, whereas VLPs detected a 43% seropositivity (95% CI: 39.8%-46.2%). Antibody frequency found with all peptides was significantly higher in women having cervical abnormalities (atypical squamous cells of undetermined significance and high-grade squamous intraepithelial lesions) compared with those having normal cytologies. Peptide 18283 reported a significantly higher seropositivity (35.71%) in women >44 years old, whereas peptides 18301 and 18294 evidenced a significantly lower seropositivity in those who had never given birth. HR-HPV-DNA was detected in 157 (20.50%) of 766 cervical samples amplifying positively for the beta-globin housekeeping gene. Peptides 18283, 18294, and 18301 were more specific and more sensitive than VLPs for detecting women with HR-HPV-DNA positive cervical lesions. Therefore, they could be useful in the design of a serological test for detecting HR-HPV-infected women having cervical lesions at a risk of progressing to cervical cancer.
Daniela Coneglian Brocchetto
Full Text Available A córnea possui grande influência no processo visual. Porém é passível de deformação, tal como o aplanamento. Quando esse aplanamento é causado pelo uso de lentes de contato, chamamos de "corneal warpage". Neste caso, alguns sintomas podem ocorrer como visão embaçada com os óculos, hiperemia conjuntival, sensação de corpo estranho, etc. Pensava-se que a córnea era mais rígida e, com o tempo, percebeu-se que a córnea possui entidade viscoelástica. Podemos dizer que a córnea possui uma entidade biomecânica e que, quando sofre instabilidade, ocorrem algumas alterações, como no caso do ceratocone, onde ocorre uma degeneração progressiva corneana. Com o intuito de buscar a estabilização corneana, foi desenvolvida a técnica de "crosslink", que consiste em promover ligações covalentes entre as lamelas da córnea para torná-la mais firme e menos elástica. Outra alteração corneana pode ser induzida, de forma planejada, através do modelamento corneano com o uso de lentes de contato rígidas, com coeficiente de transmissibilidade de oxigênio (DK/L maior. Elas são usadas somente durante o sono, não sendo necessário o seu uso diurno. Esta técnica é conhecida como Ortoceratologia e seus conceitos serão abordados neste estudo.The cornea has a great influence in the visual process. However, it is liable to distortion, such as flattening. When this flattening is caused by the use of contact lenses, we call "corneal warpage". In this case, some symptoms may occur as blurred vision with glasses, conjunctival hyperemia, foreign body sensation, etc… Used to think that the cornea was more rigid and, in time, realized that the cornea has viscoelastic properties. We can say that the cornea has a body biomechanics property and suffers instability when there are some changes, such as keratoconus, which is a progressive corneal degeneration. In order to preserve the cornea more stable, the cross-linking technique was developed to
Veldhuijzen, Nienke J; Polman, Nicole J; Snijders, Peter J F; Meijer, Chris J L M; Berkhof, Johannes
A main challenge of human papilloma (HPV)-based screening for cervical cancer is to adequately identify HPV-positive women at highest risk of cervical intraepithelial neoplasia grade 3 or worse, CIN3+. The prognostic value of currently used adjunct markers (HPV16/18 genotyping and reflex cytology) may change after multiple rounds of HPV-based screening because of a change in the proportion of HPV-positive women with incident infections. To this end, we re-analyzed results from the POBASCAM trial (Population Based Screening Study Amsterdam). Women were randomized to HPV/cytology cotesting (intervention group) or to cytology-only (HPV blinded; control group) at enrolment. Our analytical population consisted of women with an HPV-positive result at the second round, 5 years after enrolment (n = 381 intervention, n = 392 control). Nine-year CIN3+ risks were estimated by Kaplan-Meier. HPV-positive women were stratified by risk markers: HPV16/18 genotyping, reflex cytology and preceding HPV results. When comparing one to two rounds of HPV-based screening, the prognostic value of an abnormal cytology result did not change (40.0% vs. 42.3%, p = 0.5617), but diminished for an HPV16/18 positive result (25.4% vs. 38.0%, p = 0.0132). HPV16/18 genotyping was nondiscriminative in women with incident HPV infections (HPV16/18 positive 10.0% vs. negative 12.1%, p = 0.3193). Women from the intervention group were more likely to have incident infections compared to women from the control group (incident screen-positive results 75.6% vs. 64.6%, p = 0.001) Our results indicate that at a second round of HPV-based screening, risk differentiation by cytology remained strong, but was diminished for HPV 16/18 genotyping because of a larger proportion of incident infections. © 2017 UICC.
Anna R. Giuliano
Full Text Available Background: Protection from naturally acquired human papillomavirus (HPV antibodies may influence HPV infection across the lifespan. This study describes seroconversion rates following genital, anal, and oral HPV 6/11/16/18 infections in men and examines differences by HPV type and anatomic site. Methods: Men with HPV 6/11/16/18 infections who were seronegative for those genotypes at the time of DNA detection were selected from the HPV Infection in Men (HIM Study. Sera specimens collected ≤36 months after detection were analyzed for HPV 6/11/16/18 antibodies using a virus-like particle-based ELISA. Time to seroconversion was separately assessed for each anatomic site, stratified by HPV type. Results: Seroconversion to ≥1 HPV type (6/11/16/18 in this sub-cohort (N=384 varied by anatomic site, with 6.3%, 18.9%, and 0.0% seroconverting following anal, genital, and oral HPV infection, respectively. Regardless of anatomic site, seroconversion was highest for HPV 6 (19.3%. Overall, seroconversion was highest following anal HPV 6 infection (69.2%. HPV persistence was the only factor found to influence seroconversion. Conclusions: Low seroconversion rates following HPV infection leave men susceptible to recurrent infections that can progress to HPV-related cancers. This emphasizes the need for HPV vaccination in men to ensure immune protection against new HPV infections and subsequent disease. Keywords: HPV, Men, Seroconversion, HPV antibodies, Human papillomavirus
Do estudo conclui-se que o exercício da actividade profissional influencia a auto-eficácia da grávida, mas não as outras dimensões do auto-conceito; o estado civil influencia o auto-conceito da grávida, excepto a dimensão maturidade pscológica; a paridade influencia a dimensão impulsivide/actividade; a patologia obstétrica, a idade da grávida, o tempo de gestação e a aceitação por parte da mulher não influenciam o seu auto-conceito.
Francisco Antonio Coelho Junior
Full Text Available A literatura em comportamento organizacional apresenta diversos estudos referenciando o conceito aprendizagem aplicado no âmbito das organizações. Porém, verifica-se o uso pouco crítico ou sistemático deste conceito. O objetivo do presente artigo consiste em realizar uma análise conceitual do termo aprendizagem, justificando sua transposição para estudos organizacionais. Aplicaram-se técnicas de análise conceitual propostas por Ryle. Como resultado, verificou-se que a natureza multifacetada do conceito de aprendizagem favorece o advento das diversas definições associadas a ele. Espera-se que haja maior sistematicidade acerca do uso do termo aprendizagem aplicado em estudos organizacionais, considerando seus níveis de análise e as dimensões presentemente discutidas.
Dunne, Eileen F; Unger, Elizabeth R; Sternberg, Maya; McQuillan, Geraldine; Swan, David C; Patel, Sonya S; Markowitz, Lauri E
Human papillomavirus (HPV) infection is estimated to be the most common sexually transmitted infection. Baseline population prevalence data for HPV infection in the United States before widespread availability of a prophylactic HPV vaccine would be useful. To determine the prevalence of HPV among females in the United States. The National Health and Nutrition Examination Survey (NHANES) uses a representative sample of the US noninstitutionalized civilian population. Females aged 14 to 59 years who were interviewed at home for NHANES 2003-2004 were examined in a mobile examination center and provided a self-collected vaginal swab specimen. Swabs were analyzed for HPV DNA by L1 consensus polymerase chain reaction followed by type-specific hybridization. Demographic and sexual behavior information was obtained from all participants. HPV prevalence by polymerase chain reaction. The overall HPV prevalence was 26.8% (95% confidence interval [CI], 23.3%-30.9%) among US females aged 14 to 59 years (n = 1921). HPV prevalence was 24.5% (95% CI, 19.6%-30.5%) among females aged 14 to 19 years, 44.8% (95% CI, 36.3%-55.3%) among women aged 20 to 24 years, 27.4% (95% CI, 21.9%-34.2%) among women aged 25 to 29 years, 27.5% (95% CI, 20.8%-36.4%) among women aged 30 to 39 years, 25.2% (95% CI, 19.7%-32.2%) among women aged 40 to 49 years, and 19.6% (95% CI, 14.3%-26.8%) among women aged 50 to 59 years. There was a statistically significant trend for increasing HPV prevalence with each year of age from 14 to 24 years (PHPV vaccine types 6 and 11 (low-risk types) and 16 and 18 (high-risk types) were detected in 3.4% of female participants; HPV-6 was detected in 1.3% (95% CI, 0.8%-2.3%), HPV-11 in 0.1% (95% CI, 0.03%-0.3%), HPV-16 in 1.5% (95% CI, 0.9%-2.6%), and HPV-18 in 0.8% (95% CI, 0.4%-1.5%) of female participants. Independent risk factors for HPV detection were age, marital status, and increasing numbers of lifetime and recent sex partners. HPV is common among females in the
Full Text Available Cervical cancer is one of the most common and lethal cancers in West Africa. Even though vaccines that protect against the most common Human papillomavirus (HPV strains, 16 and 18, are currently in use in developed countries, the implementation of these vaccines in developing countries has been painfully slow, considering the pre-eminence of HPV-associated cervical cancer among women in those countries.We performed serological and PCR-based assessment of blood and tissue specimens obtained from women undergoing cervical cancer-related surgery at a major urban hospital in Bamako. Since several therapeutic HPV vaccines are currently in clinical trials, we also assessed willingness to participate in HPV cancer vaccine trials.Blood and biopsy samples of 240 women were evaluated for HPV types 16 and 18 by serology and PCR. Knowledge regarding the HPV vaccine and autonomy to decide to vaccinate their own child was assessed with a standardized questionnaire.HPV 16 and 18 were identified in 137/166 (82.5% cervical cancer biopsy samples by PCR. Co-infection with both HPV 16 and 18 was significantly more frequent in women over 50 years of age than in younger women (63.0% vs. 37.0%. 44% of study participants said they would be willing to vaccinate their child with HPV vaccine. Only 39% of women participating in this study reported that they would be able to make an autonomous decision to receive HPV vaccination. Permission from a male spouse or head of household was identified as important for participation by 59% of the women.This study provides strong support for the introduction of currently available HPV vaccines in Mali, and also provides key information about conditions for obtaining informed consent for HPV vaccine trials and HPV vaccination in Mali.
Téguété, Ibrahima; Dolo, Amadou; Sangare, Kotou; Sissoko, Abdoulaye; Rochas, Mali; Beseme, Sarah; Tounkara, Karamoko; Yekta, Shahla; De Groot, Anne S; Koita, Ousmane A
Cervical cancer is one of the most common and lethal cancers in West Africa. Even though vaccines that protect against the most common Human papillomavirus (HPV) strains, 16 and 18, are currently in use in developed countries, the implementation of these vaccines in developing countries has been painfully slow, considering the pre-eminence of HPV-associated cervical cancer among women in those countries. We performed serological and PCR-based assessment of blood and tissue specimens obtained from women undergoing cervical cancer-related surgery at a major urban hospital in Bamako. Since several therapeutic HPV vaccines are currently in clinical trials, we also assessed willingness to participate in HPV cancer vaccine trials. Blood and biopsy samples of 240 women were evaluated for HPV types 16 and 18 by serology and PCR. Knowledge regarding the HPV vaccine and autonomy to decide to vaccinate their own child was assessed with a standardized questionnaire. HPV 16 and 18 were identified in 137/166 (82.5%) cervical cancer biopsy samples by PCR. Co-infection with both HPV 16 and 18 was significantly more frequent in women over 50 years of age than in younger women (63.0% vs. 37.0%). 44% of study participants said they would be willing to vaccinate their child with HPV vaccine. Only 39% of women participating in this study reported that they would be able to make an autonomous decision to receive HPV vaccination. Permission from a male spouse or head of household was identified as important for participation by 59% of the women. This study provides strong support for the introduction of currently available HPV vaccines in Mali, and also provides key information about conditions for obtaining informed consent for HPV vaccine trials and HPV vaccination in Mali.
Ramos Rivera, G; Khader, S N; Lajara, S; Schlesinger, K; Goldstein, D Y; Naeem, R C; Suhrland, M J; Fox, A S
Persistent infection with oncogenic high risk HPV (hrHPV) types causes virtually all cases of cervical cancer. HPV 16 and 18 have been targeted for individual genotyping and vaccination because of their presence in 71% of invasive cervical cancers worldwide. Montefiore Medical Center, Bronx, New York serves a population known for ethnic and racial diversity. Given this diversity it is possible that HPV genotypes not individually detected by current testing are causing significant disease. We conducted a retrospective analysis of liquid based cervicovaginal cytology and Cobas HPV results reported between October 5, 2015 and March 30, 2016. This included 20 483 samples from patients aged 16-95 (average age 42), with racial distribution including: African-American 32.4%, Other (includes denied, unknown, mixed, Hispanic) 52.1%, Caucasian 14.5%, Asian 0.7%, American Indian/Alaskan Native 0.3%. In all, 14 938 samples (72.9%) were submitted for clinically requested COBAS 4800 HPV testing, which separately reports HPV 16, 18 and a pool of 12 other hrHPV. A total of 3180 (21.5%) tested hrHPV positive. The percentage of patients with cytologic diagnosis of HSIL (high-grade squamous intraepithelial lesion) that were positive only for HPV 16 was 19.4% vs 1.8% for all cytologic diagnoses. However, only one of the HSIL cases was HPV 18 positive along with other hrHPV (OHR). Surprisingly, a majority (64.5%) was positive for only OHR. Further evaluation is needed to determine if this pool of other hrHPV includes individual genotypes that in our population carry a higher risk of persistence and progression to cancer. © 2017 John Wiley & Sons Ltd.
Sung Hee Lee
Full Text Available High-risk human papillomaviruses (e. g., HPV16, HPV18 are closely associated with the development of head and neck cancers including oral/oropharyngeal squamous cell carcinoma (OSCC. We previously demonstrated immortalization of normal human oral keratinocytes by introducing high-risk HPV whole genome, suggesting that HPV infection plays an important role in the early stage of oral carcinogenesis. Although HPV infection may occur in different stages of cancer development, roles of HPV in exacerbating malignant phenotypes in already-transformed cells in the context of cancer stemness are not clearly defined. In this study, we investigated the role of HPV16 in promoting the virulence of HPV-negative OSCC. Introducing HPV16 whole genome in HPV-negative OSCC increased malignant growth and self-renewal capacity, a key characteristic of cancer stem cells (CSCs. HPV16 also enhanced other CSC properties, including aldehyde dehydrogenase 1 (ALDH1 activity, migration/invasion, and CSC-related factor expression. Mechanistically, we found that HPV16 inhibited the expression of miR-181a and miR-181d (miR-181a/d at the transcriptional level. Ectopic expression of miR-181a/d decreased anchorage independent growth and CSC phenotype of HPV16-transfected OSCC. Furthermore, silencing of miR-181a/d target genes, i. e., K-ras and ALDH1, abrogated the effects of HPV16 in HPV16-transfected OSCC, supporting the functional importance of HPV16/miR-181a/d axis in HPV-mediated oral carcinogenesis. Our study suggests that high-risk HPV infection further promotes malignancy in HPV-negative OSCC by enhancing cancer stemness via miR-181a/d regulation. Consequently, miR-181a/d may represent a novel therapeutic agent for the treatment of HPV-positive OSCC. Keywords: HPV, OSCC, cancer stem cells, miR-181
Mauricio Rodrigues de Souza
Full Text Available O presente artigo analisa o conceito de esclarecimento em Horkheimer, Adorno e Freud. Para tanto, traça um paralelo entre duas das mais representativas obras destes autores no âmbito da crítica cultural. Trata-se, respectivamente, dos textos O Conceito de Esclarecimento e O Futuro de uma Ilusão. Embora uma primeira leitura dos trabalhos citados possa sugerir diferentes perspectivas teóricas, aposta-se aqui na sua complementaridade em defesa de uma utilização mais adequada do pensamento conceitual.
Este trabalho tem o objetivo de estudar o sentido epistemológico do conceito de sustentabilidade ambiental que compreende a revisão teórica dos paradigmas, cartesiano e econômico, orientadores do desenvolvimento da sociedade moderna, que causam as degradações nos âmbitos ambiental e social; e do histórico ambiental, que expressa as diferentes significações atribuídas ao conceito sustentabilidade, ao longo do tempo, sendo hoje a idéia de desenvolvimento sustentável uma idéia amplamente usada. ...
Caio F. Miguel
Full Text Available Em termos gerais, operações estabelecedoras podem ser definidas como eventos ambientais que alteram a efetividade reforçadora de um estímulo, assim como evocam todo comportamento que, no passado, foi seguido por tal estímulo. O conceito parece descrever, em termos comportamentais, o que é usualmente chamado de motivação. O presente artigo pretende apresentar de uma forma didática o desenvolvimento teórico do conceito e seu status na Análise Experimental e Aplicada do Comportamento.
Cirne, Adriana Damasceno Pereira Pinto
As concepções alternativas são ideias dos estudantes sobre conhecimentos específicos, constituindo-se em uma causa importante que pode levar a erros conceituais, dificultando a aprendizagem significativa de conceitos científicos, especialmente aqueles com alto grau de abstração, como biologia celular e genética. Objetivou-se, com este trabalho, avaliar as dificuldades de aprendizagem de estudantes de ensino fundamental sobre conceitos de genética, em uma escola da rede pública no Estado do RN...
Ramires,Vera Regina Röhnelt; Schneider,Michele Scheffel
Este artigo propõe uma releitura de alguns conceitos da teoria do apego, especialmente os de apego, comportamento de apego e modelo representacional interno. Visa discutir tais conceitos à luz das concepções de Bowlby e de autores contemporâneos. A dicotomia entre comportamento e representação do apego é questionada, bem como a estabilidade e unicidade do modelo representacional interno, com base na análise das contribuições dos principais teóricos desse campo, especialmente na vertente psica...
Full Text Available Persistent viral infection with high-risk human papillomavirus (HPV genotypes causes virtually all cancer of the cervix. The same HPV genotypes (“types” also cause cases of anal cancer. Cervical cancer is the third most frequent cancer in women worldwide after breast and colorectal cancers. It ranks fourth of women’s cancers according to the mortality ratio. Two vaccines have been developed against HPV infection; one is a quadrivalent vaccine (Gardasil™ and the other is a bivalent vaccine (Cervarix™. This topic will cover issues related to HPV infections, routine HPV immunization recommendations, vaccination in special patient populations, the cost-effectiveness of HPV vaccination, and vaccine safety. [TAF Prev Med Bull 2013; 12(3.000: 327-334
Anantharaman, Devasena; Muller, David C; Lagiou, Pagona
is not understood. METHODS: Using HPV serology as a marker of HPV-related cancer, we examined the interaction between smoking and HPV16 in 459 oropharyngeal (and 1445 oral cavity and laryngeal) cancer patients and 3024 control participants from two large European multi-centre studies. Odds ratios and credible...... intervals [CrI], adjusted for potential confounders, were estimated using Bayesian logistic regression. RESULTS: Both smoking [odds ratio (OR [CrI]: 6.82 [4.52, 10.29]) and HPV seropositivity (OR [CrI]: 235.69 [99.95, 555.74]) were independently associated with oropharyngeal cancer. The joint association......BACKGROUND: Although smoking and HPV infection are recognized as important risk factors for oropharyngeal cancer, how their joint exposure impacts on oropharyngeal cancer risk is unclear. Specifically, whether smoking confers any additional risk to HPV-positive oropharyngeal cancer...
Auvinen, Eeva; Niemi, Marja; Malm, Christian; Zilliacus, Robert; Trontti, Anu; Fingerroos, Rita; Lehtinen, Matti; Paavonen, Bjorma
We studied the prevalence of HPV DNA among university students within the Helsinki metropolitan area in Finland. First-y students attending a general health examination as well as students visiting a general practitioner for contraception were enrolled. Vaginal self-samples or cervicovaginal swabs were collected from a total of 1469 students. HPV DNA was determined using a liquid hybridization test. Of all students 33.0% were positive for HPV DNA. Of all positive samples 84.3% were positive for high-risk HPV. The study demonstrated a strikingly high HPV DNA prevalence among the young women. Self-collected samples proved to be acceptable for HPV DNA detection using liquid hybridization.
Brogaard, Kim Agerholm; Munk, Christian; Iftner, Thomas
The knowledge on risk factors of being human papillomavirus (HPV)-positive among older women is sparse. The aim was to determine the frequency of oncogenic HPV appearance after 7 years among initially HPV-negative women and to examine potential risk factors that influence the occurrence of HPV...
Muñoz, Nubia; Kjaer, Susanne K; Sigurdsson, Kristján
The impact of the prophylactic vaccine against human papillomavirus (HPV) types 6, 11, 16, and 18 (HPV6/11/16/18) on all HPV-associated genital disease was investigated in a population that approximates sexually naive women in that they were "negative to 14 HPV types" and in a mixed population...
Ratanasiripong, Nop T.
Objective: To identify human papillomavirus (HPV) infection and HPV vaccine-related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to…
Mariani, Luciano; Preti, Mario; Cristoforoni, Paolo; Stigliano, Carlo M; Perino, Antonio
HPV-related diseases affect anogenital and oropharyngeal regions, heavily affecting the psychosexual dimension of both male and female individuals. HPV vaccination programs based on a bivalent or quadrivalent vaccine have opened broad perspectives for primary prevention. A nonavalent HPV vaccine (9vHPV), covering nine genotypes (HPV6, HPV11, HPV16, HPV18, HPV31, HPV33, HPV45, HPV52, and HPV58), might provide further improvement in terms of direct protection. In the present report, efficacy and safety data from 9vHPV vaccine development programs are examined. Efficacy data come from a pivotal trial, which was conducted among women aged 16-26 years randomly assigned to receive either the 9vHPV or the quadrivalent HPV (4vHPV) vaccine. The 9vHPV vaccine was shown to have potential benefits as compared with 4vHPV, increasing the overall estimated rate of prevention to 90% for cervical cancer and up to 80% for precancerous cervical lesions. For all other HPV-related pre-invasive and invasive lesions, 9vHPV showed potentially greater disease reduction, depending on the anatomic region examined. Thus, the 9vHPV vaccine shows clinical potential for the prevention of HPV-related diseases in both sexes. Future adoption of 9vHPV will depend on factors including market price, cost-effectiveness data, use of a two-dose schedule, and safety and efficacy monitoring in real-life programs. © 2016 International Federation of Gynecology and Obstetrics.
Kaspersen, Maja D; Peter B Larsen; Hans Jakob Ingerslev; Jens Fedder; Gert Bruun Petersen; Jesper Bonde; Per Höllsberg
Human papillomaviruses (HPV) may cause sexually transmitted disease. High-risk types of HPV are involved in the development of cervical cell dysplasia, whereas low-risk types may cause genital condyloma. Despite the association between HPV and cancer, donor sperm need not be tested for HPV according to European regulations. Consequently, the potential health risk of HPV transmission by donor bank sperm has not been elucidated, nor is it known how HPV is associated with sperm. The presence of ...
Adelia Perwita Sari
Full Text Available ABSTRACT Cervical cancer is one of most common diseases among women worldwide. Human papilloma virus (HPV is known as precursor of cervical cancer. Cervical cancer can be prevented effectively by practicing hpv vaccine. But the coverage of HPV vaccine is remain low. The objection of study was to analyze factors related to HPV vaccine pratice among adult women. This study used case control design with sample size 25 for each group. Sample case was women who took HPV vaccine in IBI Kota Kediri on 2013, while sample control was neighboor from the sample case who didn’t take HPV vaccine. The independent variabels were age, education level, marital status, income level, knowledge, family support, family history of cervical cancer and the dependent variable was HPV vaccine practice. Those variables was analyzed with chi square or Fisher’s exact with significancy level at 95%. The result showed that there were correlation between education level (p = 0.006; c = 0.346, knowledge (p = 0.001; c = 0.464, and family support (p = 0.000; c = 0.516 with HPV vaccination practice. While there were no correlation between age (p = 0.275, marital status (0.490 and income level (p = 0.098 and family history of cervical cancer (p = 1.000 with HPV vaccination practice. Based on data from this study can be concluded that family support and knowledge had average strenght correlation withHPV vaccine practice among adult women. So, the intervention should be focused in increasing knowledge among women and their family about the important of HPV vaccine as a cervical cancer prevention. Keywords: practice, preventive, HPV, vaccine, adult women
Pils, S; Joura, E A
An investigational monovalent human papillomavirus (HPV) 16 virus-like particle vaccine has been shown to prevent persistent infection and cervical disease related to HPV 16 and was proof of concept (2002). Designed to prevent the bulk of invasive cervical cancer, quadrivalent (HPV 6/11/16/18) and bivalent (HPV 16/18) vaccines have been available since 2006 and 2007, respectively. They are highly effective in preventing HPV 16/18-related cervical precancer; the quadrivalent version also prevents genital warts related to HPV 6/11. It has been shown that the precursors of vulvar, vaginal and anal cancer related to the vaccine types are effectively prevented. This led to a paradigm shift from a female-only cervical cancer vaccine to a vaccine for the prevention of HPV-related disease and cancer for both sexes. Vaccination before the start of sexual activity is most effective, and consequently most programs target 9- to 12-year-olds. Additionally, recent studies have proven the noninferior immunoresponse of a two-dose schedule in these age cohorts. Gender-neutral vaccination has become more common; it improves coverage and also provides protection to all males. Recently a nine-valent HPV vaccine (HPV 6/11/16/18/31/33/45/52/58) was licensed; it provides high and consistent protection against infections and diseases related to these types, with ∼90% of cervical and other HPV-related cancers and precancers potentially being avoided. Coverage is key. Efforts must be made to provide HPV vaccination in low-resource countries that lack screening programs. In countries with cervical cancer screening, HPV vaccination will greatly affect screening algorithms. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Hammer, Anne; Petersen, Lone Kjeld; Rolving, Nanna
HPV vaccination offers protection against ~70% of cervical cancers, however, serious concerns have been raised about the possible side effects from HPV vaccination. Studies have found no increased risk of neurologic disease, autoimmune disorder, thromboembolic disease, postural orthostatic...... tachycardia syndrome, or complex regional pain syndrome in HPV-vaccinated persons compared to unvaccinated persons. Affected individuals should undergo a proper clinical examination to ensure a correct diagnosis and treatment, because symptoms might arise due to a somatic, psychiatric or functional disorder....
Harper, Diane M; DeMars, Leslie R
Pre-adolescent girls (9-15years) have the option of receiving a two dose HPV vaccine series at either a six month or one year interval to provide protection from HPV 16, the most prevalent type associated with cervical cancers, as well as several other less prevalent types. This series of vaccinations is highly likely to protect her from HPV infection until she enters the routine screening program, whether that be primary HPV testing or a combination of HPV testing and cytology. The two dose program has been recommended by the World Health Organization (WHO) since 2015. For women 15years and older, the three dose vaccine schedule is still recommended. The past ten years of Gardasil use has provided evidence of reduced HPV 16/18 infections in countries where there has been high coverage. Gardasil9 has replaced Gardasil. Gardasil9 has the same rapid anti-HPV 18 and HPV45 titer loss as Gardasil did. Cervarix remains equivalent to Gardasil9 in the prevention of HPV infections and precancers of any HPV type; Cervarix also has demonstrated sustained high antibody titers for at least 10years. One dose of Cervarix provides protection against HPV 16/18 infection with robust antibody titers well above natural infection titers. This may offer the easiest and most cost effective vaccination program over time, especially in low and lower middle income countries. Cervical cancer screening must continue to control cancer incidence over the upcoming decades. Future studies of prophylactic HPV vaccines, as defined by the WHO, must demonstrate protection against six month type specific persistent infections, not actual cervical cancer precursor disease endpoints, such as cervical intraepithelial neoplasia grade 3 (CIN 3) or adenocarcinoma in situ (AIS). This simplifies and makes less expensive future comparative studies between existing and new generic vaccines. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
Alanbay, İbrahim; Öztürk, Mustafa; Fıratlıgil, Fahri Burçin; Karaşahin, Kazım Emre; Yenen, Müfit Cemal; Bodur, Serkan
Discrepancies between abnormal cervical cytology or high-risk human papillomavirus (HR-HPV) status (cytolo-gy negative/HPV positive) and subsequent histological findings are a common occurrence. After using co-testing, the dis-crepancies between the HR-HPV status and cervical cytology have become an issue. In this study, we aimed to determine the characteristics of women with a discrepancy between histology and cytology/HR-HPV status, in terms of diagnosis, review and identification. A total of 52 women, patients of the University Hospital between 2013-2015, with cytohistologi-cal or HR-HPV status discrepancy were recruited for the study and retrospectively analyzed. The cytological samples were liquid-based Pap smears, classified according to the 2001 Bethesda system. The HR-HPV status was identified using the Hybrid Capture 2 HR-HPV DNA assay. The histological samples were obtained by cervical biopsy as well as large loop exci-sion of the transformation zone (LLETZ). A cytohistological discrepancy was demonstrated in patients with (-)cytology/HR-HPV(+), ASCUS, LSIL, ASC-H, HSIL, AGC-NOS: 17.3%, 23.07%, 26.9%, 9.5%, 17.3% and 5.7%, respectively. When the degree of atypia in cytology increases, the concurrency of cervical cytology with biopsy also increases. A positive HR-HPV co-test result (19/24, 79.1%) was observed in nearly all CIN2 ≥ (+) cases. Our study emphasizes the significance of HR-HPV testing to determine CIN2 ≥ (+) cases, even in the presence of a normal cytological result. In case of cytohistological or HR-HPV discrepancies, a careful review of the HR-HPV status and the degree of cytological atypia should be performed before further intervention.
Nathalie Dauphin Mckenzie
Full Text Available Background: There is growing evidence that HIV-infected women might have a different HPV type distribution in cervical dysplasia specimens as compared to the general population. This has implications for primary prevention.Objective: We aimed to obtain preliminary data on the human papillomavirus (HPV genotypes prevalent in histological samples of HIV-infected women with CIN 3/ CIS of the cervix in Miami, Florida. Method: Retrospective data were collected on HIV-infected women referred to the UM-JMH colposcopy clinic between years 2000 and 2008. The histology slides of CIN3/CIS biopsies underwent pathological review and sections were cut from these archived specimens for HPV DNA extraction. HPV genotyping was then performed using the GeneSquare™ HPV genotyping assay. We report on our first set of 23 samples.Results: Eight high risk HPV (HR-HPV types were detected. Types in decreasing order of frequency were 16, 35, 45, 52, 59, 31, 58, and 56. Most cases had multiple infections. HPV type 16 was the most common (45% followed by HPV-35 and -45 with equal frequency (40%. No samples contained HPV-18Conclusion: Our preliminary data suggest that cervical dysplasia specimens of HIV-infected women more likely (55% contain non -16 and -18 high risk HPV types. We show that this held true for histologically confirmed carcinoma in situ. Epidemiological studies guide vaccine development, therefore HPV type prevalence in CIS and invasive cervical cancer among HIV-infected women should be more rigorously explored to ensure that this highly vulnerable population receives appropriate primary prevention.
Kumar, Satish; Jena, Lingaraja; Daf, Sangeeta; Mohod, Kanchan; Goyal, Peyush; Varma, Ashok K.
Human papillomavirus (HPV) infection is the leading cause of cancer mortality among women worldwide. The molecular understanding of HPV proteins has significant connotation for understanding their intrusion in the host and designing novel protein vaccines and anti-viral agents, etc. Genomic, proteomic, structural, and disease-related information on HPV is available on the web; yet, with trivial annotations and more so, it is not well customized for data analysis, host-pathogen interaction, st...
Chowdhury, Naweed; Alvi, Sameer; Kimura, Kyle; Tawfik, Ossama; Manna, Pradip; Beahm, David; Robinson, Ann; Kerley, Spencer; Hoover, Larry
Human papilloma virus (HPV) infection has been shown to play an integral role in the development and prognosis of various head and neck cancers. Generational changes in sexual behavior may have led to an increased incidence of positivity in recent years. HPV positivity in both benign and malignant lesions of the sinonasal cavities has been shown in previous studies (estimates range from 20%-30% for malignancy). We intend to investigate if HPV positivity affected survival outcomes in our patient cohort. Twenty-six patients diagnosed pathologically for sinonasal squamous cell carcinoma (SCC) with available archived biopsy specimens were retrospectively analyzed to obtain HPV status using a real-time, multiplex polymerase chain reaction assay that detects and quantifies 15 known high-risk HPV types. Demographic information was collected, and survival analyses were performed using the Kaplan-Meier estimation. Sixteen of 26 (62%) SCC tumors in the patient cohort were positive for HPV DNA. HPV types 16 and 18 were the most common (n = 8 and 2, respectively), although a wide range of HPV types across the 15 tested were positive. Survival analyses showed a statistically significant survival advantage (median survival of 12 vs. 54 months) when accounting for HPV positivity using log-rank testing (P HPV positivity appears to be present in a significant proportion of squamous cell carcinoma cases of the nasal cavity. In our limited patient population there does appear to be a survival advantage to HPV positivity. Further prospective, multi-institutional trials with standardized treatment protocols are needed to elucidate the true impact of HPV positivity in this subset of head and neck cancers. 4. Laryngoscope, 127:1600-1603, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Yang YANG; Jia, Chan-Wei; Ma, Yan-Min; Zhou, Li-Ying; Wang, Shu-Yu
Human papillomavirus (HPV) is one of the most common sexually transmitted diseases which comprises a group of small DNA viruses that infect both cutaneous and mucous squamous epithelia. Liquid bead microarray technology (LBMA) were used to evaluate 24 HPV genotypes in confirmed fertile and infertile males of North China so that the effects of HPV infection on semen parameters and relationship with male infertility could be discussed. A total of 1138 subjects were recruited in this study; 142 ...
Iftner, Thomas; Germ, Liesje; Swoyer, Ryan
Human papillomavirus (HPV) DNA genotyping is an essential test to establish efficacy in HPV vaccine clinical trials and HPV prevalence in natural history studies. A number of HPV DNA genotyping methods have been cited in the literature, but the comparability of the outcomes from the different...... methods has not been well characterized. Clinically, cytology is used to establish possible HPV infection. We evaluated the sensitivity and specificity of HPV multiplex PCR assays compared to those of the testing scheme of the Hybrid Capture II (HCII) assay followed by an HPV PCR/line hybridization assay...
Yao, Ye-li; Tian, Qi-fang; CHENG, BEI; Cheng, Yi-fan; Ye, Jing; Lu, Wei-Guo
Cytology triage has been generally recommended for human papillomavirus (HPV)-positive women, but is highly dependent on well-trained cytologists. The present study was designed to explore whether HPV E6/E7 mRNA detection in cervical exfoliated cells can be a potential triage for HPV-positive women from a clinic-based population. Both the primary HPV testing and Papanicolaou (Pap) test were performed on all eligible HPV-positive women. HPV E6/E7 mRNA was detected by QuantiVirus? HPV E6/E7 mRN...
Kosenko, Kami A; Hurley, Ryan J; Harvey, Jacquelyn A
Women with genital human papillomavirus (HPV) experience considerable stress and uncertainty as a result of the diagnosis; however, little is known about the sources of uncertainty in HPV. Given that uncertainty creates stress, which might be linked to the pathogenesis of cervical cancer, research on these sources of uncertainty is warranted. To this end, we completed semistructured interviews with 25 women living with HPV, and identified seven sources of uncertainty: The meaning of the diagnosis, the potential for disease progression, finances, the source of the infection, disclosure, sex and reproduction, and the HPV vaccine. In the discussion we articulate the relevance and importance of study findings to research, theory, and practice.
Javitt, Gail; Berkowitz, Deena; Gostin, Lawrence O
In 2007, many legislatures considered, and two enacted, bills mandating HPV vaccination for young girls as a condition of school attendance. Such mandates raise significant legal, ethical, and social concerns. This paper argues that mandating HPV vaccination for minor females is premature since long-term safety and effectiveness of the vaccine has not been established, HPV does not pose imminent and significant risk of harm to others, a sex specific mandate raises constitutional concerns, and a mandate will burden financially existing government health programs and private physicians. Absent careful consideration and public conversation, HPV mandates may undermine coverage rates for other vaccines.
Junge, Jette; Poulsen, H; Horn, T
whereas no case of pure basaloid type was found. Various combinations of warty and basaloid types were shown in 52 cases and mixed forms in 7 cases. The results indicate that pure forms of warty and basaloid types probably do not exist. HPV DNA was detected by PCR in 51/58 cases (88%) (45 with HPV type 16...... and 6 with HPV type 33) evenly distributed in all age groups and in all types of lesions (WHO and Toki et al. 1991). By ISH HPV was detected in 24/62 cases (39%) (21 with HPV type 16/18 and 3 with HPV type 31/33), nearly always in warty areas. All these cases were positive for the same virus type by PCR....... No case revealed more than one type of HPV. HPV type 6, 11, 18, and 31 were not detected by PCR. The results indicate a correlation between HPV type 16 and 33 and dysplasia/carcinoma in situ in the vulva....
Badoual, C; Tartour, E; Roussel, H; Bats, A S; Pavie, J; Pernot, S; Weiss, L; Mohamed, A Si; Thariat, J; Hoffmann, C; Péré, H
Worldwide, approximately 5 to 10% of the population is infected by a Human Papilloma Virus (HPV). Some of these viruses, with a high oncogenic risk (HPV HR), are responsible for about 5% of cancer. It is now accepted that almost all carcinomas of the cervix and the vulva are due to an HPV HR (HPV16 and 18) infection. However, these viruses are known to be involved in the carcinogenesis of many other cancers (head and neck [SCCHN], penis, anus). For head and neck cancer, HPV infection is considered as a good prognostic factor. The role of HPV HR in anal cancer is also extensively studied in high-risk patient's population. The role of HPV infection in the carcinogenesis of esophageal, bladder, lung, breast or skin cancers is still debated. Given the multiple possible locations of HPV HR infection, the question of optimizing the management of patients with a HPV+ cancer arises in the implementation of a comprehensive clinical and biological monitoring. It is the same in therapeutics with the existence of a preventive vaccination, for example. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Klumb, E M; Pinto, A C; Jesus, G R; Araujo, M; Jascone, L; Gayer, C R; Ribeiro, F M; Albuquerque, E M N; Macedo, J M B
Human papillomavirus (HPV) is the etiological agent of cervical cancer, the second most prevalent neoplasia among women. Although it has been proven that systemic lupus erythematosus (SLE) patients have higher frequency of cervical dysplasia, few studies have focused on HPV prevalence among them. This study aimed to investigate HPV prevalence among SLE patients and to evaluate associated risk factors, including the use of immunosuppressors (IM). Total DNA extracted from cervical samples of 173 SLE patients and 217 women (control group) submitted to routine cervical cytopathology was used as template in polymerase chain reaction (PCR)-based assays for detection of HPV DNA. HPV genotyping was performed by type-specific PCR, PCR-RFLP and/or DNA sequencing. Statistical methods included univariate analysis and logistic regression. Despite presenting significantly fewer HPV risk factors, SLE patients were found to have a threefold increase in HPV infection, mostly genotypes 53, 58, 45, 66, 6, 84, 83, 61, as compared with controls, who presented types 6, 18 and 61 more frequently. The higher rate of HPV infection was associated with immunosuppressive therapy. This study provides evidence that SLE patients have a high prevalence of HPV infection, which is even higher with the use of IM, a condition that might necessitate a more frequent cervical cancer screening program for these women.
Nearly all sexually active men and women will get infected with the human papillomavirus, or HPV, at some point in their lives. HPV can lead to serious health problems later in life, including certain cancers in both men and women. Since 2006, a vaccine has been available that protects against the most frequent cancer-causing types of HPV. In this podcast, Shannon Stokley discusses the importance of getting the HPV vaccine. Created: 7/25/2013 by MMWR. Date Released: 7/25/2013.
Marlow, Laura A V; Wardle, Jane; Grant, Nina; Waller, Jo
With the introduction of human papillomavirus (HPV) testing and vaccination in the UK, health professionals will start to receive questions about the virus from their patients. This study aimed to identify the key questions about HPV that British women will ask when considering having an HPV test or vaccination. Face-to-face interviews were carried out with 21 women to discover what they wanted to know about HPV. A thematic framework approach was used to analyse the data and identify key themes in women's HPV knowledge requirements. Women's questions about HPV fell into six areas: identity (e.g. What are the symptoms?), cause (e.g. How do you get HPV?), timeline (e.g. How long does it last?), consequences (e.g. Does it always cause cervical cancer?) and control-cure (e.g. Can you prevent infection?). In addition, they asked procedural questions about testing and vaccination (e.g. Where do I get an HPV test?). These mapped well onto the dimensions identified in Leventhal's description of lay models of illness, called the 'Common Sense Model' (CSM). These results indicated that the majority of the questions women asked about HPV fitted well into the CSM, which therefore provides a structure for women's information needs. The findings could help health professionals understand what questions they may be expected to answer. Framing educational materials using the CSM themes may also help health educators achieve a good fit with what the public want to know.
Cipriano, Joseph J; Scoloveno, Robert; Kelly, Angela
The purposes of this study were to evaluate parental attitudes toward general vaccination protocols and increase parental knowledge of the human papilloma virus (HPV) vaccine. A nonprobability convenience sample (N = 75) using a pre-/postintervention study design was conducted in a pediatric office in southern New Jersey. The Parental Attitudes Module measured the general disposition toward having children receive any type of vaccine. The HPV Knowledge Survey was a second tool used to specifically measures knowledge of the HPV vaccine. A self-directed computer-based learning was part of the educational intervention. A paired t test showed that HPV Knowledge Survey postintervention scores were significantly higher than HPV Knowledge Survey preintervention scores (t = -10.585, p HPV Knowledge Survey pretest showed a positive moderate relationship (rs = .552, p HPV vaccine has been on the market, there is a continued need to increase parental knowledge about the HPV vaccine to close the gap on vaccine nonadherence. A self-directed, computer-based learning tablet appears to be an effective tool to educate parents or legal guardians about the purpose, efficacy, and safety of the HPV vaccine. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Coscia, Maria Franca; Monno, Rosa; Ballini, Andrea; Mirgaldi, Rosanna; Dipalma, Gianna; Pettini, Francesco; Cristallo, Vincenzo; Inchingolo, Francesco; Foti, Caterina; de Vito, Danila
Since human papillomavirus (HPV) is the central casual factor in cervical cancer, understanding the epidemiology and geographical area distribution of the most prevalent HPV genotypes constitutes an important step towards development of strategies of prevention. The aim of this study was to investigate the prevalence of HPV infection and to determine HPV types distribution among 822 HPV positive women and some sexual male partners in Apulia (Italy). HPV DNA detection and genotyping was performed by nested-PCR for the L1 region and reverse line blot hybridization allowing the specific detection of 24 HPV genotyping both high risk (HR) and low risk (LR). The most prevalent HPV genotypes were HPV 16 (35%), HPV 31 (16%) HPV 6 (9%), HPV 58 and 66 (7%), followed by HPV 33 (6%), HPV 18 and 56 (4%), HPV 70 and 45 (3%), HPV 53 and 11 (2%). Currently 1.5% of tested specimens remained unclassified. Multiple infections with at last two different high- risk HPV genotypes were observed in 10% of specimens. This finding adds knowledge to HPV epidemiological investigation, and addresses further studies aimed to consider public health for identifying groups at risk for cervical cancer.
Maria Franca Coscia
Full Text Available INTRODUCTION. Since human papillomavirus (HPV is the central casual factor in cervical cancer, understanding the epidemiology and geographical area distribution of the most prevalent HPV genotypes constitutes an important step towards development of strategies of prevention. AIM. The aim of this study was to investigate the prevalence of HPV infection and to determine HPV types distribution among 822 HPV positive women and some sexual male partners in Apulia (Italy. METHODS. HPV DNA detection and genotyping was performed by nested-PCR for the L1 region and reverse line blot hybridization allowing the specific detection of 24 HPV genotyping both high risk (HR and low risk (LR. RESULTS. The most prevalent HPV genotypes were HPV 16 (35%, HPV 31 (16% HPV 6 (9%, HPV 58 and 66 (7%, followed by HPV 33 (6%, HPV 18 and 56 (4%, HPV 70 and 45 (3%, HPV 53 and 11 (2%. Currently 1.5% of tested specimens remained unclassified. Multiple infections with at last two different high-risk HPV genotypes were observed in 10% of specimens. CONCLUSIONS. This finding adds knowledge to HPV epidemiological investigation, and addresses further studies aimed to consider public health for identifying groups at risk for cervical cancer.
Dr. Phil Castle, an intramural research scientist at the National Institutes of Health, talks about the natural history of human papillomavirus (HPV) infections, and cervical cancer and other anogenital cancers. Created: 10/12/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC). Date Released: 6/9/2010.
Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about cotesting with human papillomavirus (HPV) as part of a cervical cancer screening program. Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC). Date Released: 6/9/2010.
Toft, Lars; Tolstrup, Martin; Müller, Martin; Sehr, Peter; Bonde, Jesper; Storgaard, Merete; Østergaard, Lars; Søgaard, Ole S
Individuals infected with human immunodeficiency virus (HIV) have excess risk of developing human papillomavirus (HPV)-related disease. A substantial fraction of HPV-associated cancers is caused by HPV serotypes not included in the currently available vaccines. Among healthy women, both Cervarix(®) (HPV-16/18, GlaxoSmithKline Biologicals, GSK) and Gardasil(®) (HPV-6/11/16/18, Merck) have demonstrated partial cross-protection against certain oncogenic non-vaccine HPV-types. Currently, there are no available data on vaccine-induced cross-protection in men and little is known about cross-reactive immunity after HPV-vaccination of HIV-infected individuals. In an investigator-initiated trial, we randomized 91 HIV-positive men and women to receive vaccination with Cervarix(®) or Gardasil(®). The HPV-DNA status of the participants was determined with pcr before and after immunization. Cross-reactive antibody responses against HPV-31, HPV-33, and HPV-45 were evaluated for up to 12 months using a pseudovirion-based neutralization assay (PBNA). Geometric mean antibody titers (GMTs) were compared among vaccine groups and genders at 7 and 12 months.: Both vaccines induced anti-HPV-31, -33, and -45 neutralizing antibodies in participants who were seronegative and HPV-DNA negative for those types at study entry. Geometric mean antibody titers were comparable between vaccine groups. Interestingly, anti-HPV-31 and -33 antibody titers were higher among women compared with men at 7 and 12 months.: In conclusion, both licensed HPV-vaccines induced cross-neutralizing antibodies against frequent oncogenic non-vaccine serotypes HPV-31, HPV-33, and HPV-45 in HIV-infected adults, and women had greater serological responses against HPV-31 and -33 compared with men.
Luciano Pessôa Candiotto
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O crescimento do interesse turístico pelo rural, aliado à recente expansão da oferta de turismo no espaço rural brasileiro são aspectos que apontam para uma popularização do turismo rural, e de sua divulgação em diversos meios de comunicação. Por conseguinte, o uso do termo turismo rural vem se ampliando, de modo que é comum a utilização aleatória e muitas vezes indevida do conceito. No meio acadêmico também há um debate acerca do conceito de turismo rural. Procurando dar uma contribuição para esse debate, apresentamos aqui, um artigo que aborda os conceitos de turismo no espaço rural, turismo rural, agroturismo, entre outros. Com base na leitura e interpretação de alguns pesquisadores, bem como em pesquisas empíricas sobre o turismo no espaço rural que realizamos, buscamos nos posicionar em relação aos conceitos trabalhados, apresentando uma proposta de definição.
Palavras-chave: conceitos; turismo rural; turismo no espaço rural; agroturismo.
The growth of interest in rural tourism and the recent expansion of rural tourism´s supply in Brazil indicate a tendency of popularization of rural tourism and its dissemination in various media. Therefore, the use of rural tourism
Full Text Available The incidence of oropharyngeal squamous cell carcinoma (OPSCC has markedly increased over the last three decades mostly due to human papillomavirus (HPV-related infections. Cancers resulting from HPV infection bear a better prognosis than those that are smoking-related. Because HPV-positive patients are often younger, with lower rates of co-morbid illness and longer overall life expectancies, long-term sequelae of therapy have become an important issue. Treatment of oropharyngeal cancers has typically involved the use of radiation and chemotherapy to avoid the morbidity of open surgery which included mandibulotomy and composite resection. Transoral robotic surgery (TORS is an emerging treatment option for this disease, avoiding the morbidity of open approaches while providing excellent oncologic and functional outcomes. With overall survival rate at 2 years exceeding 80%, and local failure rate of less than 3%, patients receiving TORS report relatively good health-related quality of life (QOL scores. The aim of the current review is to provide a summary of the current literature with regard to the oncologic and functional outcomes following treatment of OPSCC with TORS.
Joeli A. Brinkman
Full Text Available Cervical Cancer is the second leading cause of cancer–related deaths in women worldwide and is associated with Human Papillomavirus (HPV infection, creating a unique opportunity to treat cervical cancer through anti-viral vaccination. Although a prophylactic vaccine may be available within a year, millions of women, already infected, will continue to suffer from HPV-related disease, emphasizing the need to develop therapeutic vaccination strategies. A majority of clinical trials examining therapeutic vaccination have shown limited efficacy due to examining patients with more advanced-stage cancer who tend to have decreased immune function. Current trends in clinical trials with therapeutic agents examine patients with pre-invasive lesions in order to prevent invasive cervical cancer. However, longer follow-up is necessary to correlate immune responses to lesion regression. Meanwhile, preclinical studies in this field include further exploration of peptide or protein vaccination, and the delivery of HPV antigens in DNA-based vaccines or in viral vectors. As long as pre-clinical studies continue to advance, the prospect of therapeutic vaccination to treat existing lesions seem good in the near future. Positive consequences of therapeutic vaccination would include less disfiguring treatment options and fewer instances of recurrent or progressive lesions leading to a reduction in cervical cancer incidence.
Celina M. Hanson
Full Text Available Developing countries disproportionately suffer from the burden of cervical cancer yet lack the resources to establish systematic screening programs that have resulted in significant reductions in morbidity and mortality in developed countries. Human Papillomavirus (HPV vaccination provides an opportunity for primary prevention of cervical cancer in low-resource settings through vaccine provision by Gavi The Vaccine Alliance. In addition to the traditional national introduction, countries can apply for a demonstration program to help them make informed decisions for subsequent national introduction. This article summarizes information from approved Gavi HPV demonstration program proposals and preliminary implementation findings. After two rounds of applications, 23 countries have been approved targeting approximately 400,000 girls for vaccination. All countries are proposing primarily school-based strategies with mixed strategies to locate and vaccinate girls not enrolled in school. Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high. Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year. Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.
Hanson, Celina M; Eckert, Linda; Bloem, Paul; Cernuschi, Tania
Developing countries disproportionately suffer from the burden of cervical cancer yet lack the resources to establish systematic screening programs that have resulted in significant reductions in morbidity and mortality in developed countries. Human Papillomavirus (HPV) vaccination provides an opportunity for primary prevention of cervical cancer in low-resource settings through vaccine provision by Gavi The Vaccine Alliance. In addition to the traditional national introduction, countries can apply for a demonstration program to help them make informed decisions for subsequent national introduction. This article summarizes information from approved Gavi HPV demonstration program proposals and preliminary implementation findings. After two rounds of applications, 23 countries have been approved targeting approximately 400,000 girls for vaccination. All countries are proposing primarily school-based strategies with mixed strategies to locate and vaccinate girls not enrolled in school. Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high. Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year. Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.
Chesson, Harrell W.; Laprise, Jean-Fran��ois; Brisson, Marc; Markowitz, Lauri E.
Background.���We estimated the potential impact and cost-effectiveness of providing 3-doses of nonavalent human papillomavirus (HPV) vaccine (9vHPV) to females aged 13���18 years who had previously completed a series of quadrivalent HPV vaccine (4vHPV), a strategy we refer to as ���additional 9vHPV vaccination.���
Muñoz, Nubia; Kjaer, Susanne K; Sigurdsson, Kristján
The impact of the prophylactic vaccine against human papillomavirus (HPV) types 6, 11, 16, and 18 (HPV6/11/16/18) on all HPV-associated genital disease was investigated in a population that approximates sexually naive women in that they were "negative to 14 HPV types" and in a mixed population...... of HPV-exposed and -unexposed women (intention-to-treat group)....
Rao, Arundhati; Sandri, Maria Teresa; Sideri, Mario; Young, Stephen; Sharma, Abha; Behrens, Catherine
The increasing importance of high-risk human papillomavirus (hrHPV) testing in cervical cancer screening warrants evaluation of HPV DNA tests with an equivocal zone requiring retesting of samples in the low positive range. To compare the results of the digene hc2 High Risk HPV DNA Test (hc2), which has a manufacturer's recommended retesting zone with the cobas HPV Test, a real-time polymerase chain reaction amplification test without an equivocal range. A retrospective subanalysis of the ATHENA study comparing results for hc2 High Risk HPV DNA Test and the cobas HPV Test using the LINEAR ARRAY HPV Genotyping Test (LA) and Sanger sequencing as comparators was performed. The ability of each test to detect high-grade cervical disease in the equivocal range was also evaluated. 5.2% of samples fell within the equivocal zone (RLU/CO 1.0-2.5) and required retesting with the hc2 High Risk HPV DNA Test. In this low-positive range the cobas HPV Test showed better positive percent agreement (PPA) than hc2 High Risk HPV DNA Test for LA and sequencing (84.2% vs.70.9% and 92.1% vs.82.5%, respectively). hc2 High Risk HPV DNA Test and the cobas HPV Test demonstrated comparable sensitivity for detection of high-grade disease in the equivocal range. In the low cobas HPV Test range (cycle threshold [Ct] 40-35), the cobas HPV test again demonstrated a better PPA than hc2 High Risk HPV DNA Test with LA and sequencing as comparators and more high-grade disease was detected by the cobas HPV Test than hc2 High Risk HPV DNA Test. The cobas HPV Test demonstrates reliable performance in the hc2 High Risk HPV DNA Test equivocal zone, thus supporting it as an option for HPV testing that avoids the need for retesting. Copyright © 2013 Elsevier B.V. All rights reserved.
Yu, Shinae; Kwon, Min-Jung; Lee, Eun Hee; Park, Hyosoon; Woo, Hee-Yeon
The cervical cancer screening guidelines suggest that early detection of HPV16 and HPV18 is helpful for identifying women with cervical intraepithelial neoplasia (CIN) grade two or higher. We comparatively evaluated three HPV DNA assays, Roche Cobas HPV, RFMP HPV PapilloTyper, and Hybrid Capture 2 (HC2). A total of 861 cervical swab samples from women over 30 years of age were classified into two groups, that is, high grade squamous intraepithelial lesion (HSIL) and non-HSIL, according to cervical cytology results and analyzed by three assays. The results of direct sequencing or Linear array HPV genotyping test were considered true when the three assays presented discrepancies. The concordance rates between Roche Cobas HPV versus RFMP HPV PapilloTyper, RFMP HPV PapilloTyper versus HC2, and Roche Cobas versus HC2 were 94.5%, 94.3%, and 95.9%, respectively. For detection of HPV16 and HPV18, Roche Cobas HPV showed the concordance rates of 98.3% (κ = 0.73) and 99.4% (κ = 0.40) with the confirmation tests, respectively; and RFMP HPV PapilloTyper showed the concordance rates of 99.5% (κ = 0.92) and 100.0% (κ = 1.00), respectively. In conclusion, Roche Cobas HPV, RFMP HPV PapilloTyper, and HC2 showed high agreement rates. Roche Cobas HPV and RFMP HPV PapilloTyper are particularly useful, since both provide HPV specific genotypes, HPV16 and HPV18. © 2015 Wiley Periodicals, Inc.
Full Text Available Pretendendo encarnar a figura universal desse modelo, o intelectual francês se impôs, desde o final do século XIX, como uma refer ência conceitual e moral. Partindo do momento em que o substantivo "intelectual" integra à língua francesa, por ocasião do caso Dreyfus, esse artigo tenta restituir a genealogia desse conceito, mostrando a sua intrínseca relação com a história e a ideologia em vigor. Como se verá, a noção do intelectual, de origem essencialmente francesa, tem um caráter polimorfo. O conceito muda de acepção segundo a evolução mesma da sociedade francesa e da História, assim como diferentes épocas forjam modelos distintos de representação do intelectual. Diretamente relacionada à idéia de uma missão - a defesa da verdade e da justiça -, os intelectuais franceses, até o final dos anos 1970, enfrentam os dilemas inerentes à ambigüidade mesma da sua função: crítica e utópica. As inflexões históricas e epistemológicas dessas últimas três décadas, incidindo sobre as maneiras de agir e de pensar, rompem, definitivamente, com a representação do intelectual enquanto "maître à penser" e "profeta político". Abandonando a política e o espaço público, o intelectual, re-convertido à sua nova função de "especialista", se confina nas institucionais de produção de conhecimento.Intending to embody the universal figure of this model, the French intellectuals imposed themselves, from the end of the nineteenth century, as a conceptual and moral reference. Beginning at the moment when the noun "intellectual" became a part of the French language on the occasion of the Dreyfus case, this article attempts to recover the genealogy of this concept, showing its intrinsic relation to the current history and ideology. As will be seen, the notion of the intellectual, of essentially French origin, has a polymorphjc character. The concept changes meaning according to the evolution of French society and of History
Singh, Vineeta; Husain, Nuzhat; Akhtar, Naseem; Khan, Mohammad Yahia; Sonkar, Abhinav A; Kumar, Vijay
p16 overexpression and wild-type p53 expression are associated with human papilloma virus (HPV) in cervical and oropharyngeal cancer. Role of HPV-related carcinogenesis in the etiology of oral squamous cell carcinoma (OSCC) is still vague in Indian population. We aimed to explore the expression pattern of p16 and p53 in HPV-positive and HPV-negative OSCC to elicit differences, if any. Further their effect on survival of patients was studied. Thirty-one consecutive HPV-positive as well as 31 age and sex-matched HPV-negative OSCC cases from a case series of 369 histologically diagnosed cases of OSCC were included in this study. HPV was detected by two methods, viz. real-time PCR and conventional PCR in biopsy samples. p16 and p53 protein expression was assessed by immunohistochemistry, and p16 mRNA expression was quantified with real-time PCR using SYBR Green assay. p16 was expressed in six (19.4%) HPV-positive and in four (12.9%) HPV-negative cases. Overall mutant-type p53 expression in 62 OSCC cases was 54.8%. Out of ten p16-positive cases, eight expressed mutant-type p53 and only two cases expressed wild-type p53. Risk factors including oral tobacco consumption and alcohol were present in all these ten p16-positive cases. Survival of patients was not affected by HPV, p16 and p53 status. Presence of mutant-type p53 and exposure to tobacco-related risk factors in both HPV-positive and negative cases suggest existence of p53-related carcinogenesis in HPV-positive cases in Indian population. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Heemskerk Mirjam HM
Full Text Available Abstract Background Infection with high risk Human Papilloma Virus (HPV is associated with cancer of the cervix, vagina, penis, vulva, anus and some cases of head and neck carcinomas. The HPV derived oncoproteins E6 and E7 are constitutively expressed in tumor cells and therefore potential targets for T cell mediated adoptive immunotherapy. Effective immunotherapy is dependent on the presence of both CD4+ and CD8+ T cells. However, low precursor frequencies of HPV16 specific T cells in patients and healthy donors hampers routine isolation of these cells for adoptive transfer purposes. An alternative to generate HPV specific CD4+ and CD8+ T cells is TCR gene transfer. Methods HPV specific CD4+ T cells were generated using either a MHC class I or MHC class II restricted TCR (from clones A9 and 24.101 respectively directed against HPV16 antigens. Functional analysis was performed by interferon-γ secretion, proliferation and cytokine production assays. Results Introduction of HPV16 specific TCRs into blood derived CD4+ recipient T cells resulted in recognition of the relevant HPV16 epitope as determined by IFN-γ secretion. Importantly, we also show recognition of the endogenously processed and HLA-DP1 presented HPV16E6 epitope by 24.101 TCR transgenic CD4+ T cells and recognition of the HLA-A2 presented HPV16E7 epitope by A9 TCR transgenic CD4+ T cells. Conclusion Our data indicate that TCR transfer is feasible as an alternative strategy to generate human HPV16 specific CD4+ T helper cells for the treatment of patients suffering from cervical cancer and other HPV16 induced malignancies.
Dhar, J Patricia; Essenmacher, Lynnette; Dhar, Renee; Magee, Ardella; Ager, Joel; Sokol, Robert J
This study evaluated the safety and immunogenicity of qHPV vaccine in SLE. Subjects: 34 women ages 19-50years (yrs.) with mild to moderate SLE & minimally active or inactive SLE received qHPV vaccine at the standard dosing schedule. active SLE disease (SELENA-SLEDAI>2), history of severe SLE disease, deep venous thrombosis, on >400mg/day of hydroxychloroquine, on >15mg/day of prednisone, or active infections. Patients were monitored for adverse events (AE), SLE flare, generation of thrombogenic antibodies and thrombosis. Antibody (Ab) levels to HPV 6, 11, 16 & 18 were measured by HPV competitive Luminex Immunoassay and Geometric Mean Titers (GMTs) were calculated for each HPV type. Seroconversion was assessed for those seronegative at baseline. The women in the study: African-American (79%), mean age=38.1years, mean age at diagnosis of SLE=28.6years, 35.3% had a history of smoking, 91% had 4 or more sexual partners, 50% had a history of sexually transmitted diseases, and 27.3% used condoms on a regular basis. Vaccine site reactions (VSRs) occurred in 62%, all mild. Ninety-seven percent experienced at least 1 non vaccine adverse event (nvAE) with a total of 493 nvAEs in 33 patients, of which 90% were mild and none were related to vaccine or SLE. There were 9 serious AEs, none were related to vaccine or SLE, all resolved. No patient experienced an SLE flare, thrombosis, or generation of thrombogenic antibodies. Seroconversion rate was 100% with mean GMTs comparable to Gardasil® package insert data. In this SLE vaccine study, qHPV vaccine was generally safe, well tolerated, and highly immunogenic. This clinical trial is registered on Clinical Trials.gov under number, NCT01741012 and was conducted under the FDA IND BB14113. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available El consentimiento informado constituye un eslabón crucial en las investigaciones que involucran seres humanos. Sin embargo, limitaciones del conocimiento que conducen a errores en su confección y/o aplicación han sido frecuentemente identificadas entre los profesionales a escala global. En correspondencia, se expone una breve revisión temática de su concepto y de los elementos relacionados con su adecuada confección y aplicación, lo que, creemos, permitirá clarificar la información que poseen los profesionales que conducen investigaciones con seres humanos.O consentimento informado constitui um obstáculo crucial nas pesquisas que envolvem seres humanos. No entanto, limitações do conhecimento que conduzem a erros em sua confecção e/ou aplicação têm sido frequentemente identificadas entre os profissionais em escala global. Em correspondência, se expõe uma breve revisão temática de seu conceito e dos elementos relacionados com a sua adequada confecção e aplicação, o que cremos permitirá esclarecer a informação que possuem os profissionais que conduzem pesquisas com seres humanos.Informed consent constitutes a crucial link in research involving human beings. Nevertheless, knowledge limitations which lead to errors of its process and application have been frequently identified by professionals globally. Hence, a brief review of the topic is exposed about the concept and the elements related to adequate process and application, which we belief will allow to clarify the information that professionals who do research involving human beings posses.
Luttmer, Roosmarijn; Berkhof, Johannes; Dijkstra, Maaike G; van Kemenade, Folkert J; Snijders, Peter J F; Heideman, Daniëlle A M; Meijer, Chris J L M
High-risk human papillomavirus (hrHPV) DNA positive women require triage testing to identify those with high-grade cervical intraepithelial neoplasia or cancer (≥CIN2). Comparing three triage algorithms (1) E7 mRNA testing following HPV16/18/31/33/45/52/58 genotyping (E7 mRNA test), (2) HPV16/18 DNA genotyping and (3) cytology, for ≥CIN2 detection in hrHPV DNA-positive women. hrHPV DNA-positive women aged 18-63 years visiting gynecology outpatient clinics were included in a prospective observational cohort study. From these women a cervical scrape and colposcopy-directed biopsies were obtained. Cervical scrapes were evaluated by cytology, HPV DNA genotyping by bead-based multiplex genotyping of GP5+6+-PCR-products, and presence of HPV16/18/31/33/45/52/58 E7 mRNA using nucleic acid sequence-based amplification (NASBA) in DNA positive women for respective HPV types. Sensitivities and specificities for ≥CIN2 were compared between E7 mRNA test and HPV16/18 DNA genotyping in the total group (n=348), and E7 mRNA test and cytology in a subgroup of women referred for non-cervix-related gynecological complaints (n=133). Sensitivity for ≥CIN2 of the E7 mRNA test was slightly higher than that of HPV16/18 DNA genotyping (66.9% versus 60.9%; ratio 1.10, 95% CI: 1.0002-1.21), at similar specificity (54.8% versus 52.3%; ratio 1.05, 95% CI: 0.93-1.18). Neither sensitivity nor specificity of the E7 mRNA test differed significantly from that of cytology (sensitivity: 68.8% versus 75.0%; ratio 0.92, 95% CI: 0.72-1.17; specificity: 59.4% versus 65.3%; ratio 0.91, 95% CI: 0.75-1.10). For detection of ≥CIN2 in hrHPV DNA-positive women, an algorithm including E7 mRNA testing following HPV16/18/31/33/45/52/58 DNA genotyping performs similar to HPV16/18 DNA genotyping or cytology. Copyright © 2015 Elsevier B.V. All rights reserved.
Sopracordevole, F; Cigolot, F; Gardonio, V; Di Giuseppe, J; Boselli, F; Ciavattini, A
The aim of this study was to assess teens' knowledge of HPV infection and vaccination one year after the initiation of the public vaccination programme and information campaign on the disease and the opportunity of vaccination. Between 15 May and 15 June 2009, a survey was carried out on 1,105 teenagers attending high schools in a town in the northeast of Italy by means of an anonymous and unannounced questionnaire covering the knowledge of HPV infection, transmission, prevention, vaccination and post-vaccination behaviours. Only 75% of teens knew what HPV infection is (92% of girls vs 51% of boys, p HPV disease prevention (72.6% girls vs 61.5% boys, p = 0.002). About 18.8% of girls and 33.2% of boys believe that HPV can lead to AIDS (p HPV vaccination, 7.6% of girls and 21.8% of boys believe that it can prevent AIDS (p use remains useful for HPV prevention after vaccination. The need for regular pap smears after vaccination is reported by 93.3% of girls. Teens' knowledge about HPV infection and vaccination remains insufficient, despite a broad information campaign. Erroneous information may increase risky sexual behaviours. Without complete information about HPV infection and vaccination and information about other sexually-transmitted diseases, the latter might become difficult to control among teenagers, while some misunderstandings about the usefulness of secondary prevention might linger.
Nilyanimit, Pornjarim; Chansaenroj, Jira; Karalak, Anant; Laowahutanont, Piyawat; Junyangdikul, Pairoj; Poovorawan, Yong
Human papillomavirus (HPV) is the leading cause of cervical cancer. Urine-based HPV testing offers a simple and non-invasive method because of its increasing acceptance. A total of 164 pairs of cervical swab and urine samples from Thai women who underwent cervical cancer screening were used for HPV testing with HPV GenoArray Diagnostic Kits. The overall concordance percentage for HPV detection in the cervical swab and urine samples was 65.2%. The HPV genotypes most commonly detected were HPV16 and HPV18. An analysis of the urine samples and a second analysis of the cervical swab samples showed that the differences in the overall HPV detection rate between women with normal and abnormal cytology were not significant (p > 0.05). Urine samples processed with the GenoArray assay is an alternative for women who decline to undergo Pap smear even though it is not ideal as the first-line screening option.
Maria Teresa Cícero Laganá
Full Text Available O presente estudo mostra a problemática da temperatura corporal enquanto um procedimento de enfermagem. Apresenta conceitos relacionados à temperatura e suas alterações, e descreve duas entidades nosológicas relacionadas com a elevação da temperatura: febre e hipertermia maligna.
Daniel Rodriguez de Carvalho Pinheiro
Full Text Available Normal 0 21 false false false PT-BR X-NONE X-NONE MicrosoftInternetExplorer4 RESUMO Um dos problemas para pesquisadores que investigam as mudanças tecnológicas do ponto de vista das ciências sociais aplicadas é saber precisamente o que é tecnologia. E quando ocorre uma mudança tecnológica. O objetivo deste texto é colaborar para esse debate tentando construir um conceito operacional de tecnologia a partir dos documentos produzidos no final dos anos de 1990 e início dos anos 2000, e reunidos pela Financiadora de Estudos e Projetos - FINEP em CD-ROM. Para elaborar a primeira versão do conceito operacional de tecnologia fez-se uma análise dos diversos conceitos reunidos pela FINEP seguindo uma ordem: do primeiro para o último. A crítica ao material propunha que um conceito é a tentativa de dizer o que alguma coisa é ou como funciona. E conceito operacional é aquele que foi constituído a partir de indicadores empírico-analíticos. Feito isso, o conceito provisório foi sendo enriquecido pelo debate com cada um dos novos conceitos que eram examinados. A busca de um conceito operacional de tecnologia mostrou que há pesquisadores que entendem tecnologia como coisas (máquinas, equipamentos, instalações e há pesquisadores que investigam tecnologia considerando as coisas e os processos de trabalho. O que fiz foi reunir as duas tendências num único conceito. Palavras-chave: Tecnologia; capital; mudança tecnológica; processo de trabalho; conceito
Ayres, Andréia Rodrigues Gonçalves; Silva, Gulnar Azevedo E; Teixeira, Maria Teresa Bustamante; Duque, Kristiane de Castro Dias; Machado, Maria Lúcia Salim Miranda; Gamarra, Carmen Justina; Levi, José Eduardo
Estimate the prevalence of cervical HPV infection among women assisted by the Family Health Strategy and identify the factors related to the infection. A cross-sectional study involving 2,076 women aged 20-59 years old residing in Juiz de Fora, State of Minas Gerais, who were asked to participate in an organized screening carried out in units were the Family Health Strategy had been implemented. Participants answered the standardized questionnaire and underwent a conventional cervical cytology test and HPV test for high oncogenic risk. Estimates of HPV infection prevalence were calculated according to selected characteristics referenced in the literature and related to socioeconomic status, reproductive health and lifestyle. The overall prevalence of HPV infection was 12.6% (95%CI 11.16-14.05). The prevalence for the pooled primer contained 12 oncogenic HPV types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) was 8.6% (95%CI 7.3-9.77). In the multivariate analysis, it was observed that the following variables were significantly associated with a higher prevalence of HPV infection: marital status (single: adjusted PR = 1.40, 95%CI 1.07-1.8), alcohol consumption (any lifetime frequency: adjusted PR = 1.44, 95%CI 1.11-1.86) and number of lifetime sexual partners (≥ 3: adjusted PR = 1.35, 95%CI 1.04-1.74). The prevalence of HPV infection in the study population ranges from average to particularly high among young women. The prevalence of HPV16 and HPV18 infection is similar to the worldwide prevalence. Homogeneous distribution among the pooled primer types would precede the isolated infection by HPV18 in magnitude, which may be a difference greater than the one observed. The identification of high-risk oncogenic HPV prevalence may help identify women at higher risk of developing preneoplastic lesions.
McKenzie, Nathalie Dauphin; Kobetz, Erin N.; Ganjei-Azar, Parvin; Rosa-Cunha, Isabella; Potter, JoNell E.; Morishita, Atsushi; Lucci, Joseph A.; Guettouche, Toumy; Hnatyszyn, James H.; Koru-Sengul, Tulay
Background: There is growing evidence that human immunodeficiency virus (HIV)-infected women might have a different human papillomavirus (HPV) type distribution in cervical dysplasia specimens as compared to the general population. This has implications for primary prevention. Objective: We aimed to obtain preliminary data on the HPV genotypes prevalent in histological samples of HIV-infected women with cervical intraepithelial neoplasia (CIN) 3/CIS of the cervix in Miami, FL, USA. Methods: Retrospective data were collected on HIV-infected women referred to the University of Miami-Jackson Memorial Hospital colposcopy clinic between years 2000 and 2008. The histology slides of CIN 3/CIS biopsies underwent pathological review and sections were cut from these archived specimens for HPV DNA extraction. HPV genotyping was then performed using the GeneSquare™ HPV genotyping assay. We report on our first set of 23 samples. Results: Eight high-risk HPV types were detected. Types in decreasing order of frequency were 16, 35, 45, 52, 59, 31, 58, and 56. Most cases had multiple infections. HPV type 16 was the most common (45%) followed by HPV-35 and -45 with equal frequency (40%). No samples contained HPV-18. Conclusion: Our preliminary results suggest that cervical dysplasia specimens of HIV-infected women more likely (55%) contain non-16 and -18 high-risk HPV types. We show that this held true for histologically confirmed severe dysplasia and carcinoma-in situ. Epidemiological studies guide vaccine development, therefore HPV type prevalence in CIS and invasive cervical cancer among HIV-infected women should be more rigorously explored to ensure that this highly vulnerable population receives appropriate primary prevention. PMID:25161956
Andratschke, M; Hagedorn, H; Nerlich, A G
HPV infections play a major role in the pathogenesis of squamous cell carcinomas of the head and neck. Regarding benign papillomas, the role of HPV is still uncertain. To clarify this issue, 100 exophytic papillomas of the oral cavity, pharynx and larynx were subjected to histopathological and molecular pathological examination. Excision biopsies were taken from 62 male and 38 female patients with an age range of 18 to 87 years. Biopsies were tested for p16 expression by immunohistochemistry and analyzed for HPV subtypes 6/11 (low-risk), 16/18 and 31/33/53 (high-risk) by chromogenic in situ hybridization. HPV infections were verified molecularly in 34 % of biopsies; in all cases with the low-risk HPV subtypes 6/11. Only one case showed infection with both 6/11 and 31/33/53 subtypes, but not subtype 16/18; whereas expression of p16 was found in 67 %. The rate of positive molecular verification of HPV infection (in situ hybridization) was highest in the laryngeal lesions with 61.1 %, followed by the oral cavity with 52.9 %, and lowest in pharyngeal lesions (21.5 %). Recurrent papillomas were seen in 18 cases (18 %), of which 14 were molecularly positive for HPV (in situ hybridization). A correlation between inflammatory infiltration and HPV infection could be verified in 82 %. Our data demonstrate an important role of HPV infection for the development of benign papillomas of the head and neck region. Furthermore, there is a positive correlation between HPV infection and recurrent papillomas. Therefore, a molecular morphological HPV analysis of papillomas could provide important prognostic data.
Grimes, Richard M; Benjamins, Laura J; Williams, Kendra L
Information is provided for clinicians who treat adolescents and adult women to use when counseling patients about human papillomavirus (HPV) vaccine. A literature search was done to determine: (1) reasons for refusal of the vaccine, including cost and concerns that immunization against HPV will lead to promiscuity; (2) potential for non-sexual transmission of HPV; (3) non-genital locations of HPV; (4) non-genital cancers associated with HPV. Vaccines for Children Program and the Affordable Care Act eliminate many costs.Neither biological nor behavioral evidence supports the idea that sexual behavior changes after immunization. HPV is transmitted from person to person by non-sexual routes including mother to child at birth and apparently by touch after birth. HPV is persistent in the environment, including medical environments. It has been found on apparently sterilized instruments used in vaginal exams. Pathogenic HPV has been recovered from breast tissue, sinonasal areas, and nipples as well as from hair follicles on arms, legs, scalps, eyebrows, and pubic hair. Pathogenic HPV was found in 6.5% of the oral cavities of a random sample of Americans. HPV is known to cause anal and oral cancers. It has also been associated with skin cancers, breast tumors, and prostate cancers. It is not known if the vaccine is protective against these cancers, but it is useful to educate about these other routes of transmission and non-genital HPV linked cancers so that patients/parents do not just focus on the sexual nature of the human papillomavirus.
Cooper, Crystale Purvis; Saraiya, Mona
To investigate the HPV testing recommendations of US physicians who perform cervical cancer screening. Data from the 2015 DocStyles survey of U.S. health care providers were analyzed using multivariate logistic regression to identify provider characteristics associated with routine recommendation of primary HPV testing for average-risk, asymptomatic women ≥30years old. The analysis was limited to primary care physicians and obstetrician-gynecologists who performed cervical cancer screening (N=843). Primary HPV testing for average-risk, asymptomatic women ≥30years old was recommended by 40.8% of physicians who performed cervical cancer screening, and 90.1% of these providers recommended primary HPV testing for women of all ages. The screening intervals most commonly recommended for primary HPV testing with average-risk, asymptomatic women ≥30years old were every 3years (35.5%) and annually (30.2%). Physicians who reported that patient HPV vaccination status influenced their cervical cancer screening practices were almost four times more likely to recommend primary HPV testing for average-risk, asymptomatic women ≥30years old than other providers (Adj OR=3.96, 95% CI=2.82-5.57). Many US physicians recommended primary HPV testing for women of all ages, contrary to guidelines which limit this screening approach to women ≥25years old. The association between provider recommendation of primary HPV testing and patient HPV vaccination status may be due to anticipated reductions in the most oncogenic HPV types among vaccinated women. Published by Elsevier Inc.
Crosignani, Piergiorgio; De Stefani, Antonella; Fara, Gaetano Maria; Isidori, Andrea M; Lenzi, Andrea; Liverani, Carlo Antonio; Lombardi, Alberto; Mennini, Francesco Saverio; Palu', Giorgio; Pecorelli, Sergio; Peracino, Andrea P; Signorelli, Carlo; Zuccotti, Gian Vincenzo
The Human Papillomavirus (HPV) is generally recognized to be the direct cause of cervical cancer. The development of effective anti-HPV vaccines, included in the portfolio of recommended vaccinations for any given community, led to the consolidation in many countries of immunization programs to prevent HPV-related cervical cancers. In recent years, increasing evidence in epidemiology and molecular biology have supported the oncogenic role of HPV in the development of other neoplasm including condylomas and penile, anal, vulvar, vaginal, and oro-pharyngeal cancers. Men play a key role in the paradigm of HPV infection: both as patients and as part of the mechanisms of transmission. Data show they are affected almost as often as women. Moreover, no screening procedures for HPV-related disease prevention are applied in men, who fail to undergo routine medical testing by any medical specialist at all. They also do not benefit from government prevention strategies. A panel of experts convened to focus on scientific, medical, and economic studies, and on the achievements from health organizations' intervention programs on the matter. One of the goals was to discuss on the critical issues emerging from the ongoing global implementation of HPV vaccination. A second goal was to identify contributions which could overcome the barriers that impede or delay effective vaccination programs whose purpose is to eradicate the HPV infection both in women and men. The reviewed studies on the natural history of HPV infection and related diseases in women and men, the increasing experience of HPV vaccination in women, the analysis of clinical effectiveness vs economic efficacy of HPV vaccination, are even more supportive of the economic sustainability of vaccination programs both in women and men. Those achievements address increasing and needed attention to the issue of social equity in healthcare for both genders.
Petry, Karl Ulrich; Cox, J Thomas; Johnson, Kristin; Quint, Wim; Ridder, Ruediger; Sideri, Mario; Wright, Thomas C; Behrens, Catherine M
A post hoc analysis of the ATHENA study was performed to determine whether true HPV-negative cervical lesions occur and whether they have clinical relevance. The ATHENA database was searched for all CIN2 or worse (CIN2+) cases with cobas HPV-negative results and comparison was made with Linear Array (LA) and Amplicor to detect true false-negative HPV results. Immunostaining with p16 was performed on these cases to identify false-positive histology results. H&E slides were re-reviewed by the study pathologists with knowledge of patient age, HPV test results and p16 immunostaining. Those with positive p16 immunostaining and/or a positive histopathology review underwent whole tissue section HPV PCR by the SPF10/LiPA/RHA system. Among 46,887 eligible women, 497 cases of CIN2+ were detected, 55 of which tested negative by the cobas(®) HPV Test (32 CIN2, 23 CIN3/ACIS). By LA and/or Amplicor, 32 CIN2+ (20 CIN2, 12 CIN3/ACIS) were HPV positive and categorized as false-negatives by cobas HPV; nine of 12 false-negative CIN3/ACIS cases were p16+. There were 23 cases (12 CIN2, 11 CIN3/ACIS) negative by all HPV tests; seven of 11 CIN3/ACIS cases were p16+. H&E slides were available for six cases for re-review and all were confirmed as CIN3/ACIS. Tissue PCR was performed on the six confirmed CIN3/ACIS cases (and one without confirmation): four were positive for HPV types not considered oncogenic, two were positive for oncogenic genotypes and one was indeterminate. In summary, subanalysis of a large cervical cancer screening study did not identify any true CIN3/ACIS not attributable to HPV. © 2016 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
Nickel, Brooke; Dodd, Rachael H; Turner, Robin M; Waller, Jo; Marlow, Laura; Zimet, Gregory; Ostini, Remo; McCaffery, Kirsten
Direct international comparisons which aim to understand how factors associated with human papillomavirus (HPV) vaccine initiation and attitudes towards the HPV vaccination in parents differ are scarce. Parents (n = 179) of daughters aged 9-17 years in the US, UK and Australia completed an online survey in 2011 with questions measuring daughters' HPV vaccination status, HPV knowledge, HPV vaccination knowledge, and statements assessing attitude towards the HPV vaccine. The strongest factor associated with vaccination status across all countries was parental HPV knowledge (p HPV vaccination knowledge scores intended to vaccinate their daughters (if not already vaccinated) for protective reasons (p HPV (p HPV vaccination (US: 60.5%, UK: 36.4%, AUS: 15.4%; p HPV vaccination across three countries.
Mejlhede, Nina; Bonde, Jesper; Fomsgaard, Anders
Genital human papillomavirus infection (HPV) is common and usually harmless. However, chronic cervical infection with high-risk HPV types can cause cell changes that may eventually lead to cancer. To determine the frequency of individual HPV types among mixed infections, we examined the type...... distribution among cervical specimens from more than 1000 Danish women. We also examined the HPV type distribution and the frequency of single and multiple HPV types for specimens from 113 women who underwent conization and were diagnosed with cervical intraepithelial neoplasia grade II or worse (CIN2+). Using...... microarray technology, we found that 49% of the HPV-positive patients were infected with multiple HPV types. Among the CIN2+ diagnosed women, this frequency was 41%. The most frequently found high-risk HPV type was HPV-16, which was found in 25% of the HPV-positive cervical specimens. Among the HPV positive...
Du, Ping; Brendle, Sarah; Milici, Janice; Camacho, Fabian; Zurlo, John; Christensen, Neil; Meyers, Craig
Human papillomavirus (HPV)-associated cancers are important public health problems in HIV-infected people. Assays based on HPV virus-like particles (VLP) and pseudoviruses (PsV) are commonly used to examine HPV antibody responses in HIV-infected people, but neutralization assays with native HPV have not been utilized and a comparison of these three assays is lacking. We evaluated the agreement of assays using VLP, native HPV and PsV in detecting HPV16 and 18 antibodies in HIV-infected women. The VLP-based ELISA (VLP-ELISA) was used to detect antibody responses to HPV16 and 18 and cottontail rabbit papillomavirus (CRPV) VLP antigens. Neutralization assays with native HPV (NA-HPV) and with PsV (NA-PsV) were conducted to examine HPV16 or 18 neutralizing antibodies. Intra class correlation coefficients (ICC) and kappa coefficients were used to assess the agreements of seropositivity between the assays. The seroprevalence detected by the VLP-ELISA, NA-HPV and NA-PsV in 94 HIV-infected women was 35%, 51% and 27% for HPV16 and 14%, 44% and 21% for HPV18. Cross-reactivity between HPV16 and HPV18 was 0.35, 0.04 and 0.33 (kappa coefficients) for the VLP-ELISA, NA-HPV and NA-PsV. The agreements of seropositivity between the three assays were low. Six women who were HPV16 DNA positive were seropositive by the NA-HPV but only two were HPV16 seropositive by the VLP-ELISA or NA-PsV. One HPV18 DNA positive woman was seropositive by all three assays. Repeated tests indicated excellent reproducibility of the NA-HPV. HPV serology results vary across different assays. The NA-HPV appears to be a sensitive and reliable approach in detecting natural HPV antibodies in HIV-infected women. The NA-HPV can be applied in both HPV natural history studies and vaccine studies in HIV-infected people.
Giuliano, Anna R.; Viscidi, Raphael; Torres, B. Nelson; Ingles, Donna J.; Sudenga, Staci L.; Villa, Luisa L.; Baggio, Maria Luiza; Abrahamsen, Martha; Quiterio, Manuel; Salmeron, Jorge; Lazcano-Ponce, Eduardo
Background Protection from naturally acquired human papillomavirus (HPV) antibodies may influence HPV infection across the lifespan. This study describes seroconversion rates following genital, anal, and oral HPV 6/11/16/18 infections in men and examines differences by HPV type and anatomic site. Methods Men with HPV 6/11/16/18 infections who were seronegative for those genotypes at the time of DNA detection were selected from the HPV Infection in Men (HIM) Study. Sera specimens collected ≤36 months after detection were analyzed for HPV 6/11/16/18 antibodies using a virus-like particle-based ELISA. Time to seroconversion was separately assessed for each anatomic site, stratified by HPV type. Results Seroconversion to ≥1 HPV type (6/11/16/18) in this sub-cohort (N=384) varied by anatomic site, with 6.3, 18.9, and 0.0% seroconverting following anal, genital, and oral HPV infection, respectively. Regardless of anatomic site, seroconversion was highest for HPV 6 (19.3%). Overall, seroconversion was highest following anal HPV 6 infection (69.2%). HPV persistence was the only factor found to influence seroconversion. Conclusions Low seroconversion rates following HPV infection leave men susceptible to recurrent infections that can progress to HPV-related cancers. This emphasizes the need for HPV vaccination in men to ensure immune protection against new HPV infections and subsequent disease. PMID:26688833
Guan, Linlin; Sun, Na; Sun, Guangbin; Fang, Qin; Meng, Yang; Zhao, Xiaoyan; Meng, Lingchao
To investigate the correlation of laryngeal squamous cell carcinoma (LSCC) and precancerous lesion with HPV infection subtypes and possible clinical relationship. Eighty-three cases in paraffin embedded tissues were detected with thirty seven HPV subtypes by flow-through hybridization and gene chip (HybriMax), including 31 cases of laryngeal squamous cell carcinoma, 52 cases of precancerous lesions (29 cases of vocal cord leukoplakia and 23 cases of laryngeal papilloma), and 36 cases of vocal cord polyp as normal vocal mucosa were used as control. The total positive rate of HPV was 19.4% in the group of laryngeal squamous cell carcinoma (6/31), 0 in vocal cord leukoplakia, 65.2% in laryngeal papilloma (15/23), and the control group were all negative, HPV virus subtype of HPV-positive laryngeal squamous cell carcinoma were all high-risk HPV16; and there were 6 HPV virus subtypes in laryngeal papilloma (8: HPV6,4: HPV52, 1: HPV11, 1: HPV18, 2: HPV45, 3: HPV16), individual mixing two or more subtypes infection. HPV infection of laryngeal squamous cell carcinoma and precancerous lesions has no statistically significant difference according to gender, high low-risk subtypes. HPV infection related to laryngeal squamous cell carcinoma and precancerous lesions, but no significant correlation with the subtype distribution of high and low risk; HPV detection is making positive sense to clinical diagnosis of laryngeal carcinoma and precancerous lesions as well as the development of specific HPV subtype vaccine.
Hanley, Sharon Janet Bruce; Yoshioka, Eiji; Ito, Yoshiya; Konno, Ryo; Sasaki, Yuri; Kishi, Reiko; Sakuragi, Noriaki
No studies on male attitudes towards HPV and HPV vaccination have been conducted in Japan, and little is known globally whether attitudes of single fathers differ to those living with a female partner. This exploratory study assessed whether Japanese fathers were likely to have their daughter vaccinated against HPV in a publically funded program and whether any differences existed regarding attitudes and knowledge about HPV according to marital status. Subjects were 27 fathers (16 single; 11 married) who took part in a study on HPV vaccine acceptability aimed at primary caregivers of girls aged 11-14 yrs in three Japanese cities between July and December 2010. Knowledge about HPV was extremely poor (mean score out of 13 being 2.74 ± 3.22) with only one (3.7%) participant believing he had been infected with HPV and most (81.4%) believing they had no or low future risk. No difference existed regarding knowledge or awareness of HPV according to marital status. Concerning perceived risk for daughters, single fathers were significantly more likely to believe their daughter was at risk for both HPV (87.5% versus 36.4%; p=0.01) and cervical cancer (75.0% versus 27.3%; p=0.02). Acceptability of free HPV vaccination was high at 92% with no difference according to marital status, however single fathers were significantly more likely (p=0.01) to pay when vaccination came at a cost. Concerns specific to single fathers included explaining the sexual nature of HPV and taking a daughter to a gynecologist to be vaccinated. Knowledge about HPV among Japanese fathers is poor, but HPV vaccine acceptability is high and does not differ by marital status. Providing sexual health education in schools that addresses lack of knowledge about HPV as well as information preferences expressed by single fathers, may not only increase HPV vaccine acceptance, but also actively involve men in cervical cancer prevention strategies. However, further large-scale quantitative studies are needed.
Toft, Lars; Tolstrup, Martin; Müller, Martin; Sehr, Peter; Bonde, Jesper; Storgaard, Merete; Østergaard, Lars; Søgaard, Ole S.
Individuals infected with human immunodeficiency virus (HIV) have excess risk of developing human papillomavirus (HPV)-related disease. A substantial fraction of HPV-associated cancers is caused by HPV serotypes not included in the currently available vaccines. Among healthy women, both Cervarix® (HPV-16/18, GlaxoSmithKline Biologicals, GSK) and Gardasil® (HPV-6/11/16/18, Merck) have demonstrated partial cross-protection against certain oncogenic non-vaccine HPV-types. Currently, there are no...
Ko, Kiwoong; Yu, Shinae; Lee, Eun Hee; Park, Hyosoon; Woo, Hee-Yeon; Kwon, Min-Jung
Various assays for detecting high-risk human papillomavirus (HR HPV) have been introduced recently, including the Abbott RealTime High-Risk HPV assay. We sought to compare the performance of Abbott PCR to Hybrid Capture 2 for the detection of HR HPV. A total of 941 cervical swab specimens were obtained. We submitted all specimens for HR HPV detection with HC2 and Abbott PCR, and then additionally analyzed discordant and concordant positive results using restriction fragment mass polymorphism (RFMP) genotyping analysis. HC2 detected one of 13 HR HPV types in 12.3% (116/941) of cases, while Abbott PCR detected one of 14 detectable HR HPV types in 12.9% (121/941) of cases. The overall agreement rate was 97.3% with a kappa coefficient of 0.879. Discordant results between these two assays were observed in 25 cases. HC2 showed a sensitivity of 90.0% and specificity of 95.9%, while Abbott PCR showed a sensitivity of 98.0% and specificity of 96.8% when using RFMP results as the gold standard. For HPV 16/18 detection, Abbott PCR showed 95.8%/88.9% sensitivity and 99.2%/99.8% specificity, respectively. The overall coinfection rate between HPV 16, 18 and non-16/18 was 9.9% (12/121) in Abbott PCR analysis. Considering its high agreement rate with HC2, higher sensitivity/specificity compared to HC2, and ability to differentiate HPV 16/18 from other HPV types, Abbott PCR could be a reliable laboratory testing method for the screening of HPV infections. © 2016 by the Association of Clinical Scientists, Inc.
Löwhagen, G B; Bolmstedt, A; Ryd, W; Voog, E
To evaluate the prevalence of "high-risk" human papilloma virus (HPV) types in penile condyloma-like lesions and to correlate HPV types with clinical and histological features. The study included 94 male patients with signs of penile HPV infection. From acuminate, papular and macular lesions, specimens were collected for HPV DNA hybridisation, using the dot blot and Southern blot techniques. Biopsy specimens from 51 cases were examined by light microscopy for signs of koilocytosis and dysplasia. The STD outpatient clinic of the Department of Dermatovenereology of Sahlgrenska Hospital, Göteborg, Sweden. In 79 (90%) of 88 patients HPV DNA was detected by dot blot. Of 51 cases examined by histology 88% disclosed an evident koilocytosis. "High-risk" HPV types (16, 18, 31, 33, 35) were demonstrated in 8% of acuminate, 24% of papular and 56% of macular lesions. In 29% of 51 lesions examined histologically moderate to severe dysplasia was observed. There was a significant correlation between "high-risk" HPV types and dysplasia. "High-risk" HPV types are prevalent in papular and especially macular penile condyloma-like lesions. The histological finding of koilocytosis concomitant with dysplasia strongly indicates infection with a "high-risk" HPV type. Although the risk of penile cancer is low, it is from an epidemiological point of view important to diagnose these lesions. Until simple tests for HPV typing are available, biopsy for light microscopy (histology) should be obtained liberally from papular and macular condyloma-like lesions. In atypical cases of balanoposthitis HPV aetiology should also be considered.
Colón-López, Vivian; Del Toro-Mejías, Lizbeth M; Ortiz, Ana P; Tortolero-Luna, Guillermo; Palefsky, Joel M
An HPV vaccine has been approved for men aged 9 to 26 in the US for the prevention of genital warts and anal cancer. The purpose of this study is to describe 1) HPV vaccine awareness, 2) willingness to get the HPV vaccine and 3) perceived susceptibility to HPV-related cancers and genital warts among men 18-26 years old who attend an STI clinic in San Juan, Puerto Rico (PR). A cross-sectional pilot study consisting of 206 HIV+/HIV- men. For purpose of this analysis, only those participants aged vaccinated against HPV. Fewer than a third knew about the HPV vaccine (28.3%). However, more than half (76.9%) were willing to be vaccinated against HPV. Information sources about the HPV vaccine included their female sexual partners (13.0%), a female sexual partner who received the vaccine (8.7%) and a male sexual partner (2.2%). Most participants'reported that the main reason that would increase their willingness to get vaccinated was if a physician recommend the vaccine (95.7%). Perceived susceptibility was low, particularly for anal and oral cancer. This pilot study shows poor awareness of the HPV vaccine, although willingness to getting the HPV vaccine was high among those who knew about the vaccine. Future studies should try to evaluate this paradox and study in depth willingness and barriers to vaccination among male sub-groups, such as men who have sex with men (MSM). These studies should also evaluate predictors of uptake of the HPV vaccine among men in this and other STI clinics in PR, in order to develop interventions to increase male vaccination.
Audrey J King
Full Text Available Intratypic molecular variants of human papillomavirus (HPV type-16 and -18 exist. In the Netherlands, a bivalent vaccine, composed of recombinant L1 proteins from HPV-16 and -18, is used to prevent cervical cancer since 2009. Long-term vaccination could lead to changes in HPV-16 and -18 virus population, thereby hampering vaccination strategies. We determined the genetic diversity of the L1 gene in HPV-16 and -18 viral strains circulating in the Netherlands at the start of vaccination in order to understand the baseline genetic diversity in the Dutch population.DNA sequences of the L1 gene were determined in HPV-16 (n = 241 and HPV-18 (n = 108 positive anogenital samples collected in 2009 and 2011 among Dutch 16- to 24-year old female and male attendees of the sexually transmitted infection (STI clinics. Phylogenetic analysis was performed and sequences were compared to reference sequences HPV-16 (AF536179 and HPV-18 (X05015 using BioNumerics 7.1.For HPV-16, ninety-five single nucleotide polymorphism (SNPs were identified, twenty-seven (28% were non-synonymous variations. For HPV-18, seventy-one SNPs were identified, twenty-nine (41% were non-synonymous. The majority of the non-silent variations were located in sequences encoding alpha helix, beta sheet or surface loops, in particular in the immunodominant FG loop, and may influence the protein secondary structure and immune recognition.This study provides unique pre-vaccination/baseline data on the genetic L1 diversity of HPV-16 and -18 viruses circulating in the Netherlands among adolescents and young adults.
Van de Wall, Stephanie; Nijman, Hans W.; Daemen, Toos
Cervical cancer is the second most common malignancy among women worldwide. The prime causal factor of the disease is a persistent infection with human papillomavirus (HPV) with individuals failing to mount a sufficient immune response against the virus. Despite the current success of HPV16- and
The risk of progression to cervical cancer is greatest for women with. CIN III. ... to be associated with non-HPV 16/18 types, especially among HIV- infected women. ..... Fig. 3. hrHPV type distribution of vaccine-preventable infections. .... Franceschi S, Ronco G. The prevention of cervical cancer in HIV-infected women. AIDS.
Lee, Haeok; Kim, Minjin; Kiang, Peter; Shi, Ling; Tan, Kevin; Chea, Phala; Peou, Sonith; Grigg-Saito, Dorcas C
Parents have general influence over their children's health and health behavior. However, given the dearth of specific literature regarding knowledge level and social and cultural factors influencing HPV vaccination behaviors among Cambodian American (CA) parent, it is difficult to develop an effective, evidence-based public health HPV vaccination program. Therefore, the objectives of this study were to determine the HPV vaccine uptakes among CA teenagers and to examine factors influencing HPV vaccine uptakes. A descriptive, cross-sectional survey design and a combination of network and targeted sampling methods were used. CA mothers (n = 130) completed a health survey through face-to-face interviews in either English or Khmer language. Girls vaccination rates were 29% while that of boys was 16%. Awareness and knowledge of HPV among CA mothers was very low, and many believed that their daughters, who speak English and were educated in the U.S., had more knowledge about health than they did. Logistic regression analysis showed that CA girls had significantly higher odds of vaccination when their mothers possessed a higher level of English reading ability and had greater awareness and knowledge of HPV. The strikingly low rates of HPV vaccination among CA girls and boys underscore the need to improve vaccination outreach, education, and uptake. The findings can be used to develop targeted public health HPV vaccination programs for CAs, which will reduce cervical cancer disparities. © 2016 Wiley Periodicals, Inc.
Martin, Ellen; Senior, Naomi; Abdullah, Ammar; Brown, Janine; Collings, Suzanne; Racktoo, Sophie; Walpole, Sarah; Zeiton, Moez; Heffernan, Catherine
Purpose: The aim of this small-scale focus group study is to explore the impact the Human Papilloma Virus (HPV) vaccine has on attitudes towards HPV, cervical cancer and sexual risk taking amongst university students in the UK. Design/methodology/approach: Participants were recruited through advertisements placed on notice boards throughout the…
Kirkpatrick, A.; Bidwell, J; Brule, van den AJ; Meijer, C.J.L.M.; Pawade, J; Glew, S
OBJECTIVES: Persistent high-risk HPV infection of the uterine cervix is associated with CIN and cervical carcinoma. Women with a reduced pro-inflammatory response to HPV are likely to be susceptible to viral persistence, and therefore, potentially more vulnerable to cervical neoplasia. In this
Kaptein, R.; Boertjes, E.; Langley, D.
In this work we analyze the discussions on Twitter around the Human papillomavirus (HPV) vaccinations. We collect a dataset consisting of tweets related to the HPV vaccinations by searching for relevant keywords, by retrieving the conversations on Twitter, and by retrieving tweets from our user
Human papillomavirus, or HPV, is a virus that can cause certain cancers and is the most commonly sexually transmitted infection in the U.S. In this podcast, Dr. Laura Viens discusses the importance of getting vaccinated against HPV. Created: 7/7/2016 by MMWR. Date Released: 7/7/2016.
Human papillomavirus, or HPV, is the most common sexually transmitted infection in the U.S. and is associated with almost 39,000 cancers each year. This podcast discusses the importance of getting the HPV vaccine. Created: 7/7/2016 by MMWR. Date Released: 7/7/2016.
Human Papillomavirus (HPV) is an important cause of cancer, inclusive cervical cancer disease. Despite preventive efforts, the clinical and economic burden of cervical cancer remains high. With non-optimal performance of available cervical screening programs, HPV vaccination becomes an alternative
From 2008 to 2011, schoolgirls were vaccinated against HPV in two districts in Uganda following sensitization. This study assessed girls' knowledge of cervical cancer and HPV vaccine, and their acceptance of future vaccination of friends and hypothetical daughters. The cross-sectional, mixed methods comparative study ...
Pappa, Sara T.
The Human Papillomavirus (HPV) can cause some types of cancer and is the most common sexually transmitted infection in the US. Because most people turn to the internet for health information, this study analyzed HPV information found online. A content analysis was conducted on 69 web search results (URLs) from Google, Yahoo, Bing and Ask. The…
Daley, E; Dodd, V; DeBate, R; Vamos, C; Wheldon, C; Kline, N; Smith, S; Chandler, R; Dyer, K; Helmy, H; Driscoll, A
Epidemiological research indicates an association between the Human Papillomavirus (HPV) with a subset of oral cancers (OC). Dentists may play a role in primary prevention of HPV-related OC by discussing the HPV vaccine with patients. This study assessed dentists' readiness to discuss the HPV vaccine with female patients. Cross-sectional web-based survey. A web-based survey based on the Transtheoretical Model was administered among Florida dentists (n = 210). The majority of participants (97%) fell into the precontemplation and contemplation stages of readiness to discuss the HPV vaccine with patients. Perceived role and liability were determined to be predictive of dentists in contemplation stage as opposed to those in precontemplation (P dentists to primary prevention of HPV-related OC despite high levels of knowledge. As public awareness of HPV-related OC increases, dentists may become more involved in primary prevention. Results of the current study may assist in developing intervention strategies for engaging dentists in discussing the HPV vaccine with patients. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Since 2006, a vaccine has been available that protects against the most frequent cancer-causing types of HPV. This podcast discusses the importance of parents talking to their childrenâs health care providers about getting the HPV vaccine. Created: 7/25/2013 by MMWR. Date Released: 7/25/2013.
Anantharaman, Devasena; Muller, David C; Lagiou, Pagona; Ahrens, Wolfgang; Holcátová, Ivana; Merletti, Franco; Kjærheim, Kristina; Polesel, Jerry; Simonato, Lorenzo; Canova, Cristina; Castellsague, Xavier; Macfarlane, Tatiana V; Znaor, Ariana; Thomson, Peter; Robinson, Max; Conway, David I; Healy, Claire M; Tjønneland, Anne; Westin, Ulla; Ekström, Johanna; Chang-Claude, Jenny; Kaaks, Rudolf; Overvad, Kim; Drogan, Dagmar; Hallmans, Göran; Laurell, Göran; Bueno-de-Mesquita, H B; Peeters, Petra H; Agudo, Antonio; Larrañaga, Nerea; Travis, Ruth C; Palli, Domenico; Barricarte, Aurelio; Trichopoulou, Antonia; George, Saitakis; Trichopoulos, Dimitrios; Quirós, J Ramón; Grioni, Sara; Sacerdote, Carlotta; Navarro, Carmen; Sánchez, María-José; Tumino, Rosario; Severi, Gianluca; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Francoise; Panico, Salvatore; Weiderpass, Elisabete; Lund, Eiliv; Gram, Inger T; Riboli, Elio; Pawlita, Michael; Waterboer, Tim; Kreimer, Aimée R; Johansson, Mattias; Brennan, Paul
BACKGROUND: Although smoking and HPV infection are recognized as important risk factors for oropharyngeal cancer, how their joint exposure impacts on oropharyngeal cancer risk is unclear. Specifically, whether smoking confers any additional risk to HPV-positive oropharyngeal cancer is not
FitzGerald, Serena; Cornally, Nicola; Hegarty, Josephine
The human papillomavirus (HPV) is associated with the diagnosis of anal, penile, and oropharyngeal cancers in men. Evidence indicates that correct condom use in addition to obtaining the HPV vaccine provides the greatest protection from HPV infections. To explore young men's beliefs and behavioral intention in relation to receiving the HPV vaccine and using a condom correctly and consistently for sexual contact. A cross-sectional study underpinned by the theory of planned behavior (TPB) was conducted with male participants (n = 359, 18-28 years) who completed an online survey. Descriptive, correlational, and hierarchical regression analyses were performed on both status variables and variables of the TPB. Subjective norms (β = 0.519, P HPV vaccine, while relationship status (β = -0.215, P HPV vaccine and 44% in intention to use a condom were explained by the TPB model. Results from this study will impact on future sexual health research, education programs, and interventions for both HPV preventative behaviors towards the elimination of HPV-related cancers in men. Copyright © 2017 John Wiley & Sons, Ltd.
Roensbo, Mette T; Blaakaer, Jan; Skov, Karin
INTRODUCTION: Women receiving immunosuppressive treatment due to organ transplantation are at increased risk of Human papilloma virus (HPV)-related diseases, including cervical neoplasia. This pilot study aimed to describe the cervical HPV prevalence and genotype distribution in immunosuppressed...... in 2014 had three cervical cytologies performed; one before and two after transplantation. The samples were examined for cytological abnormalities and tested for HPV using Cobas(®) HPV Test and CLART(®) HPV2 Test. RESULTS: Of 94 eligible cases we included 60 RTR and BMTR. The overall prevalence of high......-risk HPV was 15.0 (95% CI; 7.1-26.6) and the prevalence was higher among BMTR (29.4, CI; 10.3-56.0) than in RTR (9.3%, CI; 2.6-22.1) although this was not statistically significant (p=0.10). The distribution of high-risk HPV was broad with HPV 45 as the most common genotype (3.3%). The prevalences of high...
María de Fátima Quintal
Full Text Available O texto abordará brevemente a história da psicologia nos países da América Latina e destaca a maior visibilidade das praticas da psicologia em comunidade. Isso acontece porque nos últimos anos os governos neoliberais incluíram em suas agendas de políticas públicas a participação de profissionais comprometidos com os programas comunitários. São apresentados também os fundamentos principais que são guias importantes para a realização das práticas em comunidade. Esses fundamentos apóiam-se em aportes de Ignacio Martin-Baró, Silvia Lane e da filosofia de Paulo Freire. Entre eles estão os processos de conscientização e participação, e a recuperação da memória histórica dos grupos e comunidades. É feita uma crítica ao fato do trabalho ser considerado inédito por causa principalmente de aspectos superficiais, enquanto que os seus paradigmas permanecem os mesmos. Realiza-se uma comparação da psicologia social comunitaria em seu início e na atualidade, e para isso a análise utiliza as dimensões da intervenção comunitária e como isso se materializa na prática dos trabalhos em comunidade. Em continuidade, faz-se uma discussão sobre os tipos diferenciados da participação que acontecem na atualidade, e também sobre o uso generalizado e superficial de conceitos importantes para o campo comunitário. Finaliza-se com uma discussão sobre a possibilidade de mudança dos princípios e compromisso da psicologia social comunitária.
Cunningham-Erves, Jennifer; Talbott, Laura L.
The disease burden of the Human Papillomavirus (HPV) among females and its associated sequelae have been widely studied by social and behavioral science researchers and medical professionals. Approved for administration to males as young as nine years old, the vaccination of males continues to spark much debate when older age groups are brought…
Full Text Available Abstract Background HPV burden is a predictor for high-grade cervical intraepithelial neoplasia and cancer. The natural history of HPV load in young women being recently exposed to HPV is described in this paper. Methods A total of 636 female university students were followed for 2 years. Cervical specimens with HPV-16, -18, -31, or -45 DNA by consensus PCR were further evaluated with type-specific and β-globin real-time PCR assays. Proportional hazards regression was used to estimate hazard ratios (HR of infection clearance. Generalized estimating equations assessed whether HPV loads was predictive of HPV infection at the subsequent visit. Results HPV loads were consistently higher among women Conclusions The association between HPV load and persistence is not uniform across high-risk genital genotypes. HPV-16 integration was only rarely demonstrated in young women.
Mirkovic, Jelena; Howitt, Brooke E; Roncarati, Patrick; Demoulin, Stephanie; Suarez-Carmona, Meggy; Hubert, Pascale; McKeon, Frank D; Xian, Wa; Li, Anita; Delvenne, Philippe; Crum, Christopher P; Herfs, Michael
Recent studies have suggested the involvement of a unique population of cells at the cervical squamo-columnar junction (SCJ) in the pathogenesis of early (squamous intraepithelial lesion or SIL) and advanced (squamous cell and adeno-carcinomas) cervical neoplasia. However, there is little evidence to date showing that SCJ cells harbour carcinogenic HPV or are instrumental in the initial phases of neoplasia. This study was designed to (1) determine if normal-appearing SCJ cells contained evidence of carcinogenic HPV infection and (2) trace their transition to early SIL. Sections of cervix from high-risk reproductive age women were selected and SCJ cells were analysed by using several techniques which increasingly implicated HPV infection: HPV DNA (genotyping and in situ hybridization)/RNA (PCR), immunostaining for HPV16 E2 (an early marker of HPV infection), p16(ink4), Ki67, and HPV L1 protein. In 22 cases with a history of SIL and no evidence of preneoplastic lesion in the excision specimen, HPV DNA was isolated from eight of ten with visible SCJ cells, six of which were HPV16/18 DNA-positive. In five of these latter cases, the SCJ cells were positive for p16(ink4) and/or HPV E2. Transcriptionally active HPV infection (E6/E7 mRNAs) was also detected in microdissected SCJ cells. Early squamous atypia associated with the SCJ cells demonstrated in addition diffuse p16(ink4) immunoreactivity, elevated proliferative index, and rare L1 antigen positivity. We present for the first time direct evidence that normal-appearing SCJ cells can be infected by carcinogenic HPV. They initially express HPV E2 and their progression to SIL is heralded by an expanding metaplastic progeny with increased proliferation and p16(ink4) expression. Whether certain SCJs are more vulnerable than others to carcinogenic HPV genotypes and what variables determine transition to high-grade SIL remain unresolved, but the common event appears to be a vulnerable cell at the SCJ. Copyright © 2015
Stubbs, Brenda W.; Panozzo, Catherine A.; Moss, Jennifer L.; Reiter, Paul L.; Whitesell, Dianne H.; Brewer, Noel T.
Objectives To conduct outcome and process evaluations of school-located HPV vaccination clinics in partnership with a local health department. Methods Temporary clinics provided the HPV vaccine to middle school girls in Guilford County, North Carolina, in 2009–2010. Results HPV vaccine initiation was higher among girls attending host schools than satellite schools (6% vs. 1%, OR = 6.56, CI = 3.99–10.78). Of the girls who initiated HPV vaccine, 80% received all 3 doses. Private insurance or federal programs paid for most vaccine doses. Conclusions Lessons learned for creating more effective school-health department partnerships include focusing on host schools and delivering several vaccines to adolescents, not just HPV vaccine alone. PMID:24034684
Lee, Moon J; Cho, Jieun
We investigated the effects of message framing and online media channel on young adults' perceived severity of human papillomavirus (HPV), perceived barriers and benefits of getting HPV vaccination, and behavioral intention to get vaccinated. An experiment was conducted with 142 college students. We found an interaction effect: The loss-framed message posted on Facebook was more effective in increasing the number of people who expressed their willingness to get HPV vaccination than the gain-framed message presented on Facebook. However, this framing effect was not found when the identical message was presented on an online newspaper. People's perceptions of severity of HPV and barriers of getting HPV vaccination were also influenced, depending on which media channel the information was circulated.
Moreira, Edson D; Block, Stan L; Ferris, Daron G
OBJECTIVES: The overall safety profile of the 9-valent human papillomavirus (9vHPV) vaccine was evaluated across 7 Phase III studies, conducted in males and females (nonpregnant at entry), 9 to 26 years of age. METHODS: Vaccination was administered as a 3-dose regimen at day 1, and months 2 and 6....... More than 15 000 subjects received ≥1 dose of 9vHPV vaccine. In 2 of the studies, >7000 control subjects received ≥1 dose of quadrivalent HPV (qHPV) vaccine. Serious and nonserious adverse events (AEs) and new medical conditions were recorded throughout the study. Subjects testing positive...... for pregnancy at day 1 were not vaccinated; those who became pregnant after day 1 were discontinued from further vaccination until resolution of the pregnancy. Pregnancies detected after study start (n = 2950) were followed to outcome. RESULTS: The most common AEs (≥5%) experienced by 9vHPV vaccine recipients...
Full Text Available The focus for HPV genotyping has largely been on types 16 and 18, based on their high prevalence in cervix cancer. However screening is focussed on the detection of high grade precursor lesions (CIN3 and CIN2, where other types have a greater role. While HPV16 retains its high predictive value in this context, HPV31 and especially HPV33 emerge as important types with higher positive predictive values (PPVs than HPV18. Additionally full typing indicates that types 39, 56, 59 and 68 have much lower PPVs than types 16, 18, 31, 33, 35, 45, 51, 52 and 58 and they should be considered as ‘intermediate risk’ types, whereas type 66 should not be treated as having an increased risk. Available data are summarized to support this view.
Lucian Borges de Oliveira; Ana Paula Moreira Moreira; Raquel Souza Lobo Guzzo
Este trabalho toma como fundamento a Psicologia Social da Libertação e pretende constituir-se com um estudo piloto ao propor a reflexão sobre os conceitos de crise e situação-limite discutidos, respectivamente, por Leonardo Boff e Ignacio Martín- Baró. Para isso, propomos a leitura de textos de cada um destes autores: Crise – oportunidade de crescimento de Leonardo Boff e Guerra y Trauma Psicosocial Del Niño Salvadoreño e Guerra y Salud Mental de Ignacio Martín - Baró. O confronto entre es...
Jéssica Andréia Agnes
Full Text Available Nos dias atuais o desenvolvimento de produto é um assunto que exige um conjunto de procedimentos e ferramentas extenso para um funcionamento de acordo com as exigências do mercado. Para desenvolver um produto com qualidade é importante conhecer a usabilidade do produto do ponto de vista dos clientes. Pensando nisso foi feito uma pesquisa sobre as questões utilizadas no questionário para análise do nível de satisfação dos clientes referente a um produto desenvolvido numa empresa do ramo tecnológico. Assim o presente artigo tem como objetivo avaliar se um questionário de satisfação de clientes pode apresentar informações para estimar a usabilidade de um produto e se outros componentes da qualidade, definidos por Nielsen  estão presentes nas avaliações da organização estudada. A pesquisa tem caráter exploratório e ressalta conceitos de usabilidade visando à satisfação dos clientes. Dos principais resultados encontrados até o momento pode-se identificar que os problemas na relação empresa/cliente estão relacionados à análise parcial dos componentes da qualidade de um produto. O trabalho sugere o desenvolvimento e acréscimos de perguntas que promovam a avaliação dos outros componentes da qualidade buscando uma maior assertividade no desenvolvimento de produtos.
Antonio Rodrigues Ferreira Junior
entender os conceitos que o cerca, dificilmente conseguirá construir ideias claras sobre as temáticas que demandam adensamento teórico e metodológico com vistas a subisidiar novas práticas que ressignifiquem os “cotidianos”. Então, o campo plural das políticas públicas dá vazão aos subcampos: processo político, como ação que exige esforço para o seu entendimento, devido o aspecto mutável e inconstante; análise de políticas, como necessidade teórica para a compreensão mais acurada sobre as possibilidades que o campo pode trazer à baila; e avaliação de políticas, como financiador dos acertos e desafios dos conceitos inerentes à temática, denotando a realidade experimentada, mas, nem por isso, vivenciada. Portanto os conceitos do processo político na promoção da saúde, como apresentados, percorrem a temporalidade e podem ser concebidos na indagação: o que estamos fazendo? Sobre a análise das políticas encontramos o porvir: o que devemos fazer? E, o pretérito emerge na avaliação política: o que temos feito? Nesse ínterim, a eficiência e a eficácia conformam-se como atribuições que as políticas públicas, com viés na promoção da saúde, devem possuir para alcançar minimamente objetivos que priorizem as necessidades coletivas em detrimento das individuais. Para entender historicamente essas construções e ressignificar os conceitos atuais sobre a área, as concepções de Platão, Maquiavel, Thomas Hobbes, John Locke, James Madison, Adam Smith e John Stuart Mill despontam como leituras essenciais para perceber-se analiticamente a ação das sociedades sobre as políticas públicas, em diferentes cenários e temporalidades. Explicita-se que, atualmente, as políticas públicas que visem promoção da saúde precisam ser norteadas por ensino e pesquisas que considerem as iniquidades sociais presentes no mundo, buscando possíveis caminhos para impactar os resultados de saúde(8. Apropriando-se de reflexões sobre o tema, cabe
Zhang, Yanxiao; Koneva, Lada A.; Virani, Shama; Arthur, Anna E.; Virani, Alisha; Hall, Pelle B.; Warden, Charles D.; Carey, Thomas E.; Chepeha, Douglas B.; Prince, Mark E.; McHugh, Jonathan B.; Wolf, Gregory T.; Rozek, Laura S.; Sartor, Maureen A.
Structured Abstract Purpose There is substantial heterogeneity within human papillomavirus (HPV) associated head and neck cancer (HNC) tumors that predispose them to different outcomes, however the molecular heterogeneity in this subgroup is poorly characterized due to various historical reasons. Experimental Design We performed unsupervised gene expression clustering on deeply-annotated (transcriptome and genome) HPV(+) HNC samples from two cohorts (84 total primary tumors), including 18 HPV(−) HNC samples, to discover subtypes and characterize the differences between subgroups in terms of their HPV characteristics, pathway activity, whole-genome somatic copy number alterations and mutation frequencies. Results We identified two distinct HPV(+) subtypes (namely HPV-KRT and HPV-IMU). HPV-KRT is characterized by elevated expression of genes in keratinocyte differentiation and oxidation-reduction process, whereas HPV-IMU has strong immune response and mesenchymal differentiation. The differences in expression are likely connected to the differences in HPV characteristics and genomic changes. HPV-KRT has more genic viral integration, lower E2/E4/E5 expression levels and higher ratio of spliced to full length HPV oncogene E6 than HPV-IMU; the subgroups also show differences in copy number alterations and mutations, in particular the loss of chr16q in HPV-IMU and gain of chr3q and PIK3CA mutation in HPV-KRT. Conclusion Our characterization of two subtypes of HPV(+) HNC tumors provides valuable molecular level information that point to two main carcinogenic paths. Together, these results shed light on stratifications of the HPV(+) HNCs and will help to guide personalized care for HPV(+) HNC patients. PMID:27091409
Turhan, Ebru; Cetin, Sirin; Cetin, Meryem; Abacigil, Fatma
The aim of this study was to evaluate the knowledge and awareness levels of 18-year-old and older women and men on HPV infection, HPV vaccine, and the potential risk factors in Hatay, Turkey. In our study, it was found that overall 27.0 and 23.2% of the participants reported having heard of HPV infection and HPV vaccine. The rate of participants who had heard of HPV infection and HPV vaccine was higher in women than in men (p HPV triggers cervical cancer, 10.2% penile cancer, and 16.7% genital warts, respectively. The overall vaccination rate of the participants was 2.7%. When the total knowledge score of the participants about HPV infection and HPV vaccine was evaluated according to independent variables, it was found that being a woman, urbanization, and having a high level of education had a positive effect on knowledge score, while never having heard of HPV infection and HPV vaccine had a negative effect on knowledge score (p HPV infection before influenced knowledge levels. It was determined that the relation between these variables and the total knowledge scores of the participants was statistically significant (p HPV infection before had higher knowledge levels. The level of knowledge of the participants about HPV infection and HPV vaccine was found to be very low. Having adequate knowledge about HPV infection and increasing the acceptance of HPV vaccination in public will play an important role in decreasing the rate of mortality and morbidity of the different HPV-associated cancers in women and men.
De, P; Budhwani, H
Transmission of the human papillomavirus (HPV) is a significant public health concern. HPV is preventable through a series of vaccinations; however, knowledge gaps exist as to which groups are least likely to initiate vaccination. Considering this gap, the aim of this study is to examine HPV vaccine initiation rates in racial minorities, comparing foreign-born individuals to their American-born peers. Population-based data from the 2013 National Health Interview Survey (NHIS), a repeated large-scale household interview survey of a statistically representative sample of the United States civilian non-institutionalized population, were applied. Data were derived from two survey modules: the family and summary adult modules. Sampling weights were employed to logistic regression modelling the outcome of HPV vaccine initiation. Foreign-born persons, African Americans, males, those lacking health insurance coverage and those without a medical home (usual place to receive care) held statistically lower rates of HPV vaccine initiation. Being college educated was associated with higher odds of HPV vaccine initiation. Our findings support the persistence of health disparities in racial minorities and foreign-born persons residing in the United States. Addressing these gaps will likely require both individual-level (e.g. targeted health education) and system-level (e.g. HPV vaccine promoting policies) interventions. Since health insurance coverage and having a medical home were significant associates of HPV vaccine initiation, attempts to coverage may improve HPV vaccine initiation rates. Additionally, policies which require HPV vaccination for school entry could boost coverage across all population groups, including boys, foreign-born persons and racial minorities. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Warner, Echo L; Fowler, Brynn; Martel, Laura; Kepka, Deanna
Rural and highly religious Intermountain West states demonstrate low levels of HPV vaccination uptake. The Intermountain West HPV Vaccination Coalition (IWHVC) was formed to improve HPV vaccination by enhancing collaborations between cancer centers, health departments, health clinics, religious groups, and community organizations. Coalition members' perceptions and experiences are described within. A cross-sectional online survey was distributed to the IWHVC. N = 86 responded to the online survey. Six subsequent focus groups were conducted (N = 36). Participant demographics, barriers, and facilitators of HPV vaccination were summarized. The first three focus groups were coded in an iterative manner based on a coding scheme. The final three focus groups were selectively coded for content related to five themes: barriers and facilitators to HPV vaccination, how the coalition has been useful, future directions of the coalition, and how to engage religious communities. Participants suggested that HPV vaccination should occur in a doctor's office (70.9%), public health clinic (64.0%), or at a community health fair (58.1%). Perceived barriers included a lack of education/low knowledge about the HPV vaccine (55.8%), concerns about sexuality/promiscuity (44.2%), and not knowing the vaccine is recommended for boys (38.4%). Participants stressed the importance of gaining buy-in from religious leaders, and felt the coalition helped them advocate for HPV vaccination through networking, idea and information sharing, and voicing their community's needs. Future goals emphasized targeted outreach, sustainable funding, expanded environmental scans, gaining religious support, and policy reforms. Targeted coalition work builds community capacity and coordinates HPV vaccination efforts. A community driven coalition approach could help improve HPV vaccination in other rural and highly religious regions.
Gilkey, Melissa B.; Calo, William A.; Moss, Jennifer L.; Shah, Parth D.; Marciniak, Macary W.; Brewer, Noel T.
Background Receiving a healthcare provider’s recommendation is a strong predictor of HPV vaccination, but little is known empirically about which types of recommendation are most influential. Thus, we sought to investigate the relationship between recommendation quality and HPV vaccination among U.S. adolescents. Methods In 2014, we conducted a national, online survey of 1,495 parents of 11- to 17-year-old adolescents. Parents reported whether providers endorsed HPV vaccination strongly, encouraged same-day vaccination, and discussed cancer prevention. Using an index of these quality indicators, we categorized parents as having received no, low-quality, or high-quality recommendations for HPV vaccination. Separate multivariable logistic regression models assessed associations between recommendation quality and HPV vaccine initiation (≥1 dose), follow through (3 doses, among initiators), refusal, and delay. Results Almost half (48%) of parents reported no provider recommendation for HPV vaccination, while 16% received low-quality recommendations and 36% received high-quality recommendations. Compared to no recommendation, high-quality recommendations were associated with over nine times the odds of HPV vaccine initiation (23% vs. 74%, OR=9.31, 95% CI, 7.10–12.22) and over three times the odds of follow through (17% vs. 44%, OR=3.82, 95% CI, 2.39–6.11). Low-quality recommendations were more modestly associated with initiation (OR=4.13, 95% CI, 2.99–5.70), but not follow through. Parents who received high-versus low-quality recommendations less often reported HPV vaccine refusal or delay. Conclusions High-quality recommendations were strongly associated with HPV vaccination behavior, but only about one-third of parents received them. Interventions are needed to improve not only whether, but how providers recommend HPV vaccination for adolescents. PMID:26812078
De Vincenzo, Rosa; Ricci, Caterina; Conte, Carmine; Scambia, Giovanni
Prophylactic human papillomavirus (HPV) vaccines are administered in vaccination programs, targeted at young adolescent girls before sexual exposure, and in catch-up programs for young women in some countries. All the data indicate that HPV-virus-like particles (VLPs) effectively prevent papillomavirus infections with a high level of antibodies and safety. Since non-vaccine HPV types are responsible for about 30% of cervical cancers, cross-protection would potentially enhance primary cervical cancer prevention efforts. High levels of specific neutralizing antibodies can be generated after immunization with HPV VLPs. Immunity to HPV is type-specific. However, if we consider the phylogenetic tree including the different HPV types, we realize that a certain degree of cross-protection is possible, due to the high homology of some viral types with vaccine ones. The assessment of cross-protective properties of HPV vaccines is an extremely important matter, which has also increased public health implications and could add further value to their preventive potential. The impact of cross-protection is mostly represented by a reduction of cervical intraepithelial neoplasia CIN2-3 more than what expected. In this article we review the mechanisms and the effectiveness of Bivalent (HPV-16/-18) and Quadrivalent (HPV-6/-11/-16/-18) HPV vaccine cross-protection, focusing on the critical aspects and the potential biases in clinical trials, in order to understand how cross-protection could impact on clinical outcomes and on the new perspectives in post-vaccine era. Copyright © 2013 Elsevier Inc. All rights reserved.
Pierre-Victor, Dudith; Trepka, Mary Jo; Page, Timothy F.; Li, Tan; Stephens, Dionne P.; Madhivanan, Purnima
The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) immunization for 11- to 12-year-old adolescents. In 2008, Louisiana required the school boards to distribute HPV vaccine information to parents or guardian of students in Grades 6 to 12. This article investigates the impact of this policy on HPV…
Mooij, Sofie H.; Landén, Olivia; van der Klis, Fiona R. M.; van der Sande, Marianne A. B.; de Melker, Hester E.; Xiridou, Maria; van Eeden, Arne; Heijman, Titia; Speksnijder, Arjen G. C. L.; Snijders, Peter J. F.; Schim van der Loeff, Maarten F.
We assessed human papillomavirus (HPV) seroconversion following anal and penile HPV infection in HIV-negative and HIV-infected men who have sex with men (MSM). MSM aged ≥18 years were recruited in Amsterdam, the Netherlands (2010-2011), and followed up semiannually. Antibodies against 7 high-risk
Rahman, Shams; Pierce Campbell, Christine M.; Waterboer, Tim; Rollison, Dana E.; Ingles, Donna J.; Torres, B. Nelson; Michel, Angelika; Sudenga, Staci L.; Pawlita, Michael; Villa, Luisa L.; Lazcano Ponce, Eduardo; Borenstein, Amy R.; Wang, Wei
Data on cutaneous human papillomavirus (HPV) seroprevalence are primarily derived from skin cancer case–control studies. Few studies have reported the seroprevalence of cutaneous HPV among healthy men. This study investigated the seroprevalence of cutaneous HPV types and associated risk factors among men residing in Brazil, Mexico and the USA. Six hundred men were randomly selected from the HPV Infection in Men study. Archived serum specimens were tested for antibodies against 14 cutaneous HPV genotypes, β-HPV types (5/8/12/14/17/22/23/24/38/48), α-HPV 27, γ-HPV 4, µ-HPV1 and ν-HPV 41 using a glutathione S-transferase L1-based multiplex serology assay. Risk factor data were collected by a questionnaire. Binomial proportions were used to estimate seroprevalence, and logistic regression to examine factors associated with seropositivity. Overall, 65.4 % of men were seropositive to ≥1 of the 14 cutaneous HPV types, and 39.0 % were positive for ≥1 β-HPV types. Seroprevalence was 8.9, 30.9, 28.6 and 9.4 % for α-HPV 27, γ-HPV 4, µ-HPV 1 and ν-HPV 41, respectively. In multivariate analyses, seropositivity for any cutaneous HPV type was associated with higher education [adjusted odds ratio (AOR) 1.75; 95 % confidence interval (CI) 1.08–2.83], and seropositivity of any β-HPV type was significantly associated with increasing age (AOR 1.72; 95 % CI 1.12–2.63, for men aged 31–44 years vs men aged 18–30 years). Other factors associated with various type-specific cutaneous HPV seropositivity included country, circumcision and lifetime number of male sexual partners. These data indicate that exposure to cutaneous HPV is common. Future studies are needed to assess the role of cutaneous HPV in diseases. PMID:27902363
Rahman, Shams; Pierce Campbell, Christine M; Waterboer, Tim; Rollison, Dana E; Ingles, Donna J; Torres, B Nelson; Michel, Angelika; Sudenga, Staci L; Pawlita, Michael; Villa, Luisa L; Lazcano Ponce, Eduardo; Borenstein, Amy R; Wang, Wei; Giuliano, Anna R
Data on cutaneous human papillomavirus (HPV) seroprevalence are primarily derived from skin cancer case-control studies. Few studies have reported the seroprevalence of cutaneous HPV among healthy men. This study investigated the seroprevalence of cutaneous HPV types and associated risk factors among men residing in Brazil, Mexico and the USA. Six hundred men were randomly selected from the HPV Infection in Men study. Archived serum specimens were tested for antibodies against 14 cutaneous HPV genotypes, β-HPV types (5/8/12/14/17/22/23/24/38/48), α-HPV 27, γ-HPV 4, µ-HPV1 and ν-HPV 41 using a glutathione S-transferase L1-based multiplex serology assay. Risk factor data were collected by a questionnaire. Binomial proportions were used to estimate seroprevalence, and logistic regression to examine factors associated with seropositivity. Overall, 65.4 % of men were seropositive to ≥1 of the 14 cutaneous HPV types, and 39.0 % were positive for ≥1 β-HPV types. Seroprevalence was 8.9, 30.9, 28.6 and 9.4 % for α-HPV 27, γ-HPV 4, µ-HPV 1 and ν-HPV 41, respectively. In multivariate analyses, seropositivity for any cutaneous HPV type was associated with higher education [adjusted odds ratio (AOR) 1.75; 95 % confidence interval (CI) 1.08-2.83], and seropositivity of any β-HPV type was significantly associated with increasing age (AOR 1.72; 95 % CI 1.12-2.63, for men aged 31-44 years vs men aged 18-30 years). Other factors associated with various type-specific cutaneous HPV seropositivity included country, circumcision and lifetime number of male sexual partners. These data indicate that exposure to cutaneous HPV is common. Future studies are needed to assess the role of cutaneous HPV in diseases.
Kemp, Troy J; Hildesheim, Allan; Safaeian, Mahboobeh; Dauner, Joseph G.; Pan, Yuanji; Porras, Carolina; Schiller, John T.; Lowy, Douglas R.; Herrero, Rolando; Pinto, Ligia A
Human papillomavirus (HPV) L1 VLP-based vaccines are protective against HPV vaccine-related types; however, the correlates of protection have not been defined. We observed that vaccination with Cervarix™ induced cross-neutralizing antibodies for HPV types for which evidence of vaccine efficacy has been demonstrated (HPV31/45) but not for other types (HPV52/58). In addition, HPV31/45 cross-neutralizing titers showed a significant increase with number of doses (HPV31, p
Chesson, Harrell W; Markowitz, Lauri E; Hariri, Susan; Ekwueme, Donatus U; Saraiya, Mona
The objective of this study was to assess the incremental costs and benefits of the 9-valent HPV vaccine (9vHPV) compared with the quadrivalent HPV vaccine (4vHPV). Like 4vHPV, 9vHPV protects against HPV types 6, 11, 16, and 18. 9vHPV also protects against 5 additional HPV types 31, 33, 45, 52, and 58. We adapted a previously published model of the impact and cost-effectiveness of 4vHPV to include the 5 additional HPV types in 9vHPV. The vaccine strategies we examined were (1) 4vHPV for males and females; (2) 9vHPV for females and 4vHPV for males; and (3) 9vHPV for males and females. In the base case, 9vHPV cost $13 more per dose than 4vHPV, based on available vaccine price information. Providing 9vHPV to females compared with 4vHPV for females (assuming 4vHPV for males in both scenarios) was cost-saving regardless of whether or not cross-protection for 4vHPV was assumed. The cost per quality-adjusted life year (QALY) gained by 9vHPV for both sexes (compared with 4vHPV for both sexes) was cross-protection for 4vHPV and $8,600 when assuming cross-protection for 4vHPV. Compared with a vaccination program of 4vHPV for both sexes, a vaccination program of 9vHPV for both sexes can improve health outcomes and can be cost-saving.
Dunne, Eileen F; Nielson, Carrie M; Hagensee, Michael E; Papenfuss, Mary R; Harris, Robin B; Herrel, Nicholas; Gourlie, Jennifer; Abrahamsen, Martha; Markowitz, Lauri E; Giuliano, Anna R
A vaccine to prevent human papillomavirus (HPV) 6, HPV 11, HPV 16, or HPV 18 and associated diseases is licensed for females, and it may be licensed for men in the future. There are limited data on HPV 6/11, 16, and/or 18 seroprevalence in men. A total of 490 men aged 18 to 40 years were enrolled in a study of HPV in men in Tucson, AZ, and Tampa, FL. Enrolled men completed a self-administered questionnaire, and HPV serology was performed using HPV 6/11, 16, and 18 VLP assays. Overall, seroprevalence to HPV 16 was 12.1%, HPV 6/11 was 9.7%, and to HPV 18 was 5.4%. Seroprevalence to HPV 6/11, 16, and/or 18 was 21% and was highest among 35 to 40 year olds (48%); prevalence in this age group was significantly higher compared to the 18 to 24 year olds (adjusted odds ratio (aOR) 6.8, 95% confidence interval (CI) 3.7, 12.8). Independent predictors of seropositivity to HPV 6/11, 16, and/or 18 were older age, greater number of female sex partners in the past 3 months, and current smoking. HPV vaccine-type seroprevalence was highest in 35 to 40 year old men. These data on the epidemiology of HPV seroprevalence in men are useful for discussions regarding recommendations for HPV vaccine if licensed for use in men.
Conclusion: Our study showed high prevalence of high-risk human papillomavirus in urban Peru, mainly among young women. In both single and multiple infections other high-risk human papillomavirus were more prevalent than HPV 16 and HPV 18, which might influence vaccine impact in our country. Furthermore, the cobas 4800 HPV test may be considered a useful tool for HPV molecular diagnosis.
Baussano, Iacopo; Lazzarato, Fulvio; Ronco, Guglielmo; Lehtinen, Matti; Dillner, Joakim; Franceschi, Silvia
Human papillomavirus (HPV) vaccination is still not reaching many high-risk populations. HPV16/18 vaccines offer cross-protection against other types, for example, HPV45. Both direct vaccine efficacy and indirect herd protection contribute to vaccination effectiveness. We used a dynamic transmission model, calibrated to cervical screening data from Italy, to estimate vaccination effectiveness against HPV16 and HPV45 infection, assuming for HPV45 either 95% or lower cross-protection. Basic reproductive number was smaller (2.1 vs 4.0) and hence vaccine effectiveness and herd protection stronger for HPV45 than for HPV16. The largest difference in the reduction of infection prevalence in women vaccination programs (99% vs 83% for total protection for HPV45 and HPV16, respectively, mainly owing to stronger herd protection, ie, 37% vs 16%). In gender-neutral vaccination, the largest difference was at 40% coverage (herd protection, 54% vs 28% for HPV16 and HPV45, respectively). With ≥80% coverage, even 50% cross-protection would reduce HPV45 by ≥94%. The characteristics of individual high-risk HPV types strongly influence herd protection and determine the level of coverage and cross-protection required to reduce or eliminate the infection through HPV vaccination. HPV16 infection and related cancers are the most difficult to eliminate.
In this 30 second public service announcement, a mother talks about the importance of protecting 11-12 year-old boys and girls with HPV vaccination. No CDC tag at the end. (Una madre habla sobre la importancia de proteger a los niÃ±os y las niÃ±as de 11 a 12 aÃ±os con la vacuna contra el VPH.). Created: 1/15/2014 by National Center for Immunizations and Respiratory Diseases (NCIRD). Date Released: 1/15/2014.
Hesselink, A T; Sahli, R; Berkhof, J; Snijders, P J F; van der Salm, M L; Agard, D; Bleeker, M C G; Heideman, D A M
Anyplex™ II HPV HR Detection (Seegene, Seoul, Korea) is a multiplex real-time PCR using tagging oligonucleotide cleavage and extension (TOCE) technology for simultaneous detection and genotyping of 14 high-risk (HR) HPV types, including HPV16 and HPV18. To evaluate whether the clinical performance and reproducibility of Anyplex™ II HPV HR Detection meet the international consensus guidelines for HPV test requirements for cervical cancer screening . The clinical performance of Anyplex™ II HPV HR Detection for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was determined relative to that of the reference assay, i.e., HR HPV GP5+/6+-PCR-EIA, by analysis of a total of 879 cervical liquid based cytology (LBC) specimens from a screening population, of which 60 were from women with CIN2+. The intra-laboratory reproducibility and inter-laboratory agreement were determined on 509 LBC samples, of which 172 were positive by the reference assay. Anyplex™ II HPV HR Detection showed a clinical sensitivity for CIN2+ of 98.3% (59/60; 95% CI: 89.1-99.8) and a clinical specificity for CIN2+ of 93.6% (764/816; 95% CI: 89.8-96.1). The clinical sensitivity and specificity were non-inferior to those of HR HPV GP5+/6+-PCR-EIA (non-inferiority score test: P=0.005 and P=0.023, respectively). Both intra-laboratory reproducibility (96.8%; 95% CI: 95.3-98.1; kappa value of 0.93) and inter-laboratory agreement (96.0%; 95% CI: 94.3-97.4; kappa value of 0.91) were high. Anyplex™ II HPV HR Detection performs clinically non-inferior to HR HPV GP5+/6+-PCR-EIA. Anyplex™ II HPV HR Detection complies with international consensus validation metrics for HPV DNA tests for cervical cancer screening . Copyright © 2016 Elsevier B.V. All rights reserved.
Bottari, F; Sideri, M; Gulmini, C
that the BD Onclarity HPV assay has sensitivity comparable to that of the HC2 assay, with a trend to an increased specificity. Moreover, as Onclarity gives the chance to discriminate between the different genotypes, we calculated the genotype prevalence and the absolute risk of CIN2+: HPV 16 was the most......Analytical and clinical performance validation is essential before introduction of a new human papillomavirus (HPV) assay into clinical practice. This study compares the new BD Onclarity HPV assay, which detects E6/E7 DNA from 14 high-risk HPV types, to the Hybrid Capture II (HC2) HPV DNA test...
Juliana Mendanha Brandão; Miguel Mahfoud; Ingrid Faria Gianordoli-Nascimento
Este artigo apresenta um estudo teórico sobre resiliência que investiga, na literatura nacional e internacional, a forma como pesquisadores concebem o conceito e suas origens. Reconstituímos a história do conceito, estudamos a resiliência no campo da resistência dos materiais e da etimologia e questionamos a noção de que o termo/conceito "resiliência" teria sido tomado da física. Concluímos que as concepções de resiliência adotadas pelos pesquisadores - se ela é entendida como resistência ao ...
Full Text Available Resumo Este artigo analisa o que se pode conceber como o conceito de o momento decisivo de Henri Cartier-Bresson, tendo em vista a proliferação de interpretações que as palavras “momento decisivo” guardam em relação ao conceito cunhado por ele. Para investigar a raiz desse conceito analisam-se algumas de suas fotos em referência a outras imagens da história da arte, como o casal Arnolfini, de Van Eyck, a natureza morta, de Willen Kalf, e as pinturas de Vermeer, além das fotografias de Diane Arbus.
Barreira, Fernando Alves
Trata da relevância dos conceitos microeconõmicos para o trabalho do profissional de vendas industriais. Duas pesquisas são apresentadas a respeito da importância dada aos conceitos econômicos pelos profissionais da área de vendas industriais. É apresentada uma revisão bibliográfica de alguns dos conceitos microeconômicos básicos relacionados à atividade de vendas e são citadas analogias relacionando a teoria microeconômica com a prática de vendas industriais.
Kaspersen, Maja D; Larsen, Peter B; Ingerslev, Hans Jakob
Human papillomaviruses (HPV) may cause sexually transmitted disease. High-risk types of HPV are involved in the development of cervical cell dysplasia, whereas low-risk types may cause genital condyloma. Despite the association between HPV and cancer, donor sperm need not be tested for HPV...... according to European regulations. Consequently, the potential health risk of HPV transmission by donor bank sperm has not been elucidated, nor is it known how HPV is associated with sperm. The presence of 35 types of HPV was examined on DNA from semen samples of 188 Danish sperm donors using a sensitive...
Depuydt, C E; Beert, J; Bosmans, E; Salembier, G
In the natural history of HPV infections, the HPV virions can induce two different pathways, namely the infec- tious virion producing pathway and the clonal transforming pathway. An overview is given of the burden that is associated with HPV infections that can both lead to cervical cancer and/or temporal subfertility. That HPV infections cause serious global health burden due to HPV-associated cancers is common knowledge, but that it is also responsible for a substantial part of idiopathic subfertility is greatly underestimated. The bulk of the detected HPV DNA whether in men or women is however infectious from origin. Because the dissociation between HPV viruses and HPV virions or infection and disease remains difficult for clinicians as well as for HPV detection, we propose a review of the different effects caused by the two different HPV virion induced pathways, and highlight the mechanisms that are responsible for causing transient subfertility and cancer.
Didelot-Rousseau, Marie-Noelle; Diafouka, François; Yayo, Eric; Kouadio, Luc-Philippe; Monnet, Dagui; Segondy, Michel
Little is known about the semen shedding of human papillomaviruses (HPV) in African men. To detect and identify HPV types in semen samples from men seeking fertility evaluation in Abidjan, Ivory Cost. Sixty-three semen samples were tested by PCR using consensus primers and HPV types were determined by PCR product sequencing or by line probe assay (LiPA) when sequencing was inconclusive. A total of 19 HPV isolates belonging to 11 HPV types were identified in semen samples from 18 (28.6%) men. Ten (55.5%) of the HPV-positive men shed oncogenic HPV types. An association of borderline significance (P=0.06) was observed between HPV semen shedding and a lower sperm count. HPV shedding in semen is common in African men. The relationship between HPV semen shedding and sperm quality merits to be further investigated.
Lee, Sin Hang
Medical practitioners in nine countries submitted samples of Gardasil (Merck & Co.) to be tested for the presence of human papillomavirus (HPV) DNA because they suspected that residual recombinant HPV DNA left in the vaccine might have been a contributing factor leading to some of the unexplained post-vaccination side effects. A total of 16 packages of Gardasil were received from Australia, Bulgaria, France, India, New Zealand, Poland, Russia, Spain and the United States. A nested polymerase chain reaction (PCR) method using the MY09/MY11 degenerate primers for initial amplification and the GP5/GP6-based nested PCR primers for the second amplification were used to prepare the template for direct automated cycle DNA sequencing of a hypervariable segment of the HPV L1 gene which is used for manufacturing of the HPV L1 capsid protein by a DNA recombinant technology in vaccine production. Detection of HPV DNA and HPV genotyping of all positive samples were finally validated by BLAST (Basic Local Alignment Search Tool) analysis of a 45-60 bases sequence of the computer-generated electropherogram. The results showed that all 16 Gardasil samples, each with a different lot number, contained fragments of HPV-11 DNA, or HPV-18 DNA, or a DNA fragment mixture from both genotypes. The detected HPV DNA was found to be firmly bound to the insoluble, proteinase-resistant fraction, presumably of amorphous aluminum hydroxyphosphate sulfate (AAHS) nanoparticles used as adjuvant. The clinical significance of these residual HPV DNA fragments bound to a particulate mineral-based adjuvant is uncertain after intramuscular injection, and requires further investigation for vaccination safety. Copyright © 2012 Elsevier Inc. All rights reserved.
Toft, Lars; Tolstrup, Martin; Müller, Martin
(®) (HPV-16/18, GlaxoSmithKline Biologicals, GSK) and Gardasil(®) (HPV-6/11/16/18, Merck) have demonstrated partial cross-protection against certain oncogenic non-vaccine HPV-types. Currently, there are no available data on vaccine-induced cross-protection in men and little is known about cross......Individuals infected with human immunodeficiency virus (HIV) have excess risk of developing human papillomavirus (HPV)-related disease. A substantial fraction of HPV-associated cancers is caused by HPV serotypes not included in the currently available vaccines. Among healthy women, both Cervarix......-reactive immunity after HPV-vaccination of HIV-infected individuals. In an investigator-initiated trial, we randomized 91 HIV-positive men and women to receive vaccination with Cervarix(®) or Gardasil(®). The HPV-DNA status of the participants was determined with pcr before and after immunization. Cross...
Gemigniani, Franco; Hernández-Losa, Javier; Ferrer, Berta; García-Patos, Vicente
Focal epithelial hyperplasia (FEH) or Heck's disease is a rare, benign and asymptomatic mucosal proliferation associated with human papillomavirus (HPV) infection, mainly with genotypes 13 and 32. We report a florid case of FEH in an 11-year-old Haitian girl with systemic lupus erythematosus receiving immunosuppressive therapy. Cryotherapy was previously performed on numerous occasions with no results. We decided to prescribe a non-invasive and more comfortable treatment. A combination of topical retinoid and imiquimod cream was well tolerated and led to an important improvement. The evidence of infection by HPV-16 detected by polymerase chain reaction (PCR) technique, prompted us to prescribe the quadrivalent HPV vaccine (types 6, 11,16 and 18). Subsequent PCR sequencing with generic primers GP5-GP6 and further BLAST comparative analysis confirmed that genomic viral sequence in our case truly corresponded with HPV-32. This molecular misdiagnosis can be explained by the similarity between genomic sequences of both HPV-16 and -32 genotypes. At the 1-year follow up, we observed total clinical improvement and no recurrences of the disease. Complete healing in this case may correspond to a potential action of topical retinoid, imiquimod and the cross-protection mechanism of the quadrivalent HPV vaccine. © 2015 Japanese Dermatological Association.
A. H. Chapman
Full Text Available Uma das maiores contribuições do psiquiatra norte-americano Harry Stack Sullivan (1892-1949 foi a de eliminar o conceito de mente do seu pensamento psiquiátrico. Ele baseou todos os seus conceitos sobre o desenvolvimento da personalidade, e a natureza das doenças psiquiátricas que são causadas por fatores emocionais, sobre relações interpessoais. Relações interpessoais, em contraste com o funcionamento da mente, podem ser diretamente observadas, e quaisquer princípios baseados em relações interpessoais podem ser submetidos a pesquisas que podem ser provadas ou refutadas por investigadores psiquiátricos. Assim, as obras de Sullivan fornecem um caminho pelo qual a psicologia e psiquiatria podem tornar-se, com o tempo, em especialidades verdadeiramente científicas.
Stela Nazareth Meneghel
Full Text Available Resumo Este texto é um ensaio teórico que discute os conceitos, os tipos e os cenários de feminicídios e apresenta algumas propostas para a prevenção destas mortes prematuras, injustas e evitáveis. O texto traz o conceito original de femicídio proposto por Diana Russel e Jane Caputti, caracteriza tipos e mostra cenários novos e antigos onde estes crimes ocorrem. Aponta o patriarcado, entendido como sistema hierárquico de poder entre homens e mulheres, como um dos principais determinantes destas mortes. Finaliza apresentando ações e propostas para prevenir e combater estes crimes de gênero.
Jorge Marcelo Nomura
Full Text Available O objetivo deste artigo é analisar o conceito de Marketing Social, por meio do resgate de definições do tema e sua aplicabilidade na realidade brasileira. Para tanto, apresentamos as principais definições de marketing, questões sociais e marketing social, passando por alguns autores da área. Toda a análise é feita sob o enfoque crítico de autores que muito contribuíram para a evolução do marketing: Philip Kotler, Marcos Cobra e Francisco Alberto Madia, reconhecidos como pensadores contemporâneos, o primeiro com alcance mundial e os dois últimos contrapondo e buscando a reflexão sobre o uso e aplicabilidade deste conceito no contexto brasileiro.
Vera Regina Röhnelt Ramires
Full Text Available Este artigo propõe uma releitura de alguns conceitos da teoria do apego, especialmente os de apego, comportamento de apego e modelo representacional interno. Visa discutir tais conceitos à luz das concepções de Bowlby e de autores contemporâneos. A dicotomia entre comportamento e representação do apego é questionada, bem como a estabilidade e unicidade do modelo representacional interno, com base na análise das contribuições dos principais teóricos desse campo, especialmente na vertente psicanalítica. Discute-se a importância da dimensão representacional e seu papel regulador das emoções e organizador do self, as implicações desses papéis para a Psicologia Clínica e do Desenvolvimento e para futuros estudos.
Full Text Available Neste artigo discute-se a desconstrução do conceito de dislexia que se situa em dois polos: nas ciências da saúde que apresentam como causas da dislexia fatores orgânicos (funcionamento cerebral, fatores genéticos, dificuldades cognitivas e nas ciências humanas, causas ligadas a fatores sociais (letramento, singularidades, fatores educacionais cujas implicações recaem sobre dificuldades das crianças. Em um polo, há a construção de uma patologia, no outro, sua desconstrução por meio de conceitos como heterogeneidade e diferenças socioculturais. Trata-se de discussão relevante uma vez que os profissionais que trabalham nessas áreas tornam-se “cúmplices” ou “críticos” de uma dessas interpretações da realidade.
José Mauricio de Carvalho
Full Text Available http://dx.doi.org/10.5007/2178-4582.2009v43n2p331 Neste trabalho examinamos o conceito de circunstância desenvolvido por José Ortega y Gasset in El espectador (volume 2 da suas Obras completas. O volume contém ensaios organizados em oito livros. El espectador representa a transição da fase inicial de seu pensamento para o momento de maturidade. O conceito de circunstância objeto deste estudo é fundamental para se entender a fase madura do pensamento orteguiano, nele o eu não se separa da circunstância e são ambos fundamentais para pensar a vida, objeto fundamental da investigação orteguiana.
Ferreira, Sandy Lousada; Cunha, Marina (Orientadora)
Neste estudo propomo-nos estudar as possíveis diferenças existentes entre a idade adulta e a velhice ao nível da solidão e do auto-conceito. Analisámos o papel de variáveis psicossociais específicas e de variáveis psicológicas, como a depressão, ansiedade, stresse e estilos de coping, sobre a solidão, bem como qual o conjunto de variáveis que melhor prediz a solidão. A solidão e o auto-conceito constituem constructos relevantes na vida do ser humano nas mais variadas formas,...
Elio Chaves Flores
Full Text Available Resumo:Este ensaio procura compreender, por meio da reflexão da "cultura histórica" de Alberto Guerreiro Ramos, o conceito de "comunidade humana universal". O objetivo é contribuir para a cultura dos direitos humanos, especialmente quando se trata de pensar a gestão pública como forma de alavancar a democracia substantiva e a governança republicana. Portanto, para uma reflexão sobre o "conceito de comunidade humana universal", percebe-se a necessidade de abordar a questão por meio de três dimensões comparativas que, em nosso modo de ver, atravessam a obra sociológica de Guerreiro Ramos: a nacionalidade e o humano universal; a gestão do humano e o mundo do trabalho; e, não menos importante, a ciência social e a vida humana associada.
Jorge Ponciano Ribeiro
Full Text Available O autor faz um estudo da resistência em grupo baseado na obra de Siegmund Heinrich Foulkes, fundador da Psicoterapia Grupo Analítica. Foulkes utilizava os conceitos da Psicologia da Gestalt e da Teoria do Campo para fazer compreender o processo de mudança nos seus grupos, embora essas referências passassem desapercebidas, talvez pela dificuldade epistemológica que ele encontrava em combinar Psicanálise e essas teorias. O autor retoma os rastros de Foulkes e desenvolve, a partir dos conceitos de figura e fundo e aqui e agora, uma visão diferente na perspectiva foulkesiana, acenada por ele, mas não desenvolvida. Foulkes tem também uma linguagem fenomenológica que o autor procura explorar.
Rogério da Costa
Full Text Available Este texto trata basicamente da transmutação do conceito de "comunidade" em "redes sociais". Esta mudança se deve em grande parte à explosão das comunidades virtuais no ciberespaço, fato que acabou gerando uma série de estudos não apenas sobre essa nova maneira de se fazer sociedade, mas igualmente sobre a estrutura dinâmica das redes de comunicação. No centro dessa transformação, conceitos como capital social, confiança e simpatia parcial são invocados para que possamos pensar as novas formas de associação que regulam a atividade humana em nossa época.
Ney Klier Padilha Netto; Marta Rezende Cardoso
A Psicanálise tem como um de seus operadores centrais uma compreensão inovadora da sexualidade humana. O conceito de pulsão e, em particular, o de pulsão sexual possui lugar de destaque. As determinações e implicações dos remanejamentos sofridos por esse conceito na obra freudiana colocam dificuldades teóricas na questão do sexual e de sua relação com a alteridade. No primeiro dualismo pulsional, a pulsão sexual é força disruptiva, oposta às de autoconservação, por seu caráter desestabilizado...
Full Text Available Resumo: O artigo analisa o conceito de infinito na literatura de Jorge Luis Borges. Mostra como a literatura é capaz de tecer uma malha relacional criando situações para que conceitos oriundos de vários saberes possam ser aprendidos. Palavras-chave: Literatura argentina; Jorge Luis Borges; matemática; infinito.Resumen: El artículo analiza el concepto del infinito en la literatura de Jorge Luis Borges. Demuestra como la literatura es capaz de tejer una malla relacional creando situaciones para que conceptos venidos de varios saberes puedan ser aprehendidos.Palabras-clave: Literatura argentina; Jorge Luis Borges; matemática; infinito.Keywords: Argentinian literature; Jorge Luis Borges; mathematics; infinity.
Agostina Ventura; Mauro Carcheri; Emanuela Caci; Patrizia Caligiuri; Roberto Capuzzo; Ilaria Chiossone; Caterina Oliveri; Paola Milano; Rossana Cirillo; Gianni Tunesi
Human Papillomavirus (HPV) infection is the main cause of cervical cancer and cervical intraepithelial neoplasia (CIN) worldwide. Consequently, it would be useful to evaluate HPV testing to screen for cervical cancer. Recently several molecular biological tests able to detect different HPV types and to divide into high and lowrisk group have been developed. In this study we examined HPV prevalence and genotype distribution in a group of 446 women and evaluated the role of HPV-DNA testing in c...
Ports, Katie A.; Barnack-Tavlaris, Jessica L; Mosavel, Maghboeba; Murithi, Lydia Karuta
In the present study the authors sought to explore, in greater depth, the impact that HPV vaccination has on college-aged women’s reproductive and sexual health. Qualitative interviews were conducted with 30 HPV-vaccinated, college women and analyzed for reoccurring themes. Although findings revealed that women’s HPV-related knowledge was suboptimal, most women correctly believed that they were still at risk for HPV after having received the vaccination. Women indicated that having the HPV va...
Le?n-Maldonado, Leith; Wentzell, Emily; Brown, Brandon; Allen-Leigh, Betania; Torres-Ibarra, Leticia; Salmer?n, Jorge; Billings, Deborah L.; Thrasher, James F.; Lazcano-Ponce, Eduardo
Background HPV infection causes cervical cancer, a major contributor to morbidity and mortality among low-income Mexican women. Human papillomavirus (HPV) DNA testing is now a primary screening strategy in Mexico?s early cervical cancer detection program (ECDP). Research on Mexican women?s perceptions of HPV and testing is necessary for establishing culturally appropriate protocols and educational materials. Here, we explore perceptions about HPV and HPV-related risk factors among low-income ...
Kaspersen, Maja D; Larsen, Peter B; Ingerslev, Hans Jakob; Fedder, Jens; Petersen, Gert Bruun; Bonde, Jesper; Höllsberg, Per
Human papillomaviruses (HPV) may cause sexually transmitted disease. High-risk types of HPV are involved in the development of cervical cell dysplasia, whereas low-risk types may cause genital condyloma. Despite the association between HPV and cancer, donor sperm need not be tested for HPV according to European regulations. Consequently, the potential health risk of HPV transmission by donor bank sperm has not been elucidated, nor is it known how HPV is associated with sperm. The presence of 35 types of HPV was examined on DNA from semen samples of 188 Danish sperm donors using a sensitive HPV array. To examine whether HPV was associated with the sperm, in situ hybridization were performed with HPV-6, HPV-16 and -18, and HPV-31-specific probes. The prevalence of HPV-positive sperm donors was 16.0% and in 66.7% of these individuals high-risk types of HPV were detected. In 5.3% of sperm donors, two or more HPV types were detected. Among all identified HPV types, 61.9% were high-risk types. In situ hybridization experiments identified HPV genomes particularly protruding from the equatorial segment and the tail of the sperm. Semen samples from more than one in seven healthy Danish donors contain HPV, most of them of high-risk types binding to the equatorial segment of the sperm cell. Most HPV-positive sperm showed decreased staining with DAPI, indicative of reduced content of DNA. Our data demonstrate that oncogenic HPV types are frequent in men.
Maja D Kaspersen
Full Text Available Human papillomaviruses (HPV may cause sexually transmitted disease. High-risk types of HPV are involved in the development of cervical cell dysplasia, whereas low-risk types may cause genital condyloma. Despite the association between HPV and cancer, donor sperm need not be tested for HPV according to European regulations. Consequently, the potential health risk of HPV transmission by donor bank sperm has not been elucidated, nor is it known how HPV is associated with sperm. The presence of 35 types of HPV was examined on DNA from semen samples of 188 Danish sperm donors using a sensitive HPV array. To examine whether HPV was associated with the sperm, in situ hybridization were performed with HPV-6, HPV-16 and -18, and HPV-31-specific probes. The prevalence of HPV-positive sperm donors was 16.0% and in 66.7% of these individuals high-risk types of HPV were detected. In 5.3% of sperm donors, two or more HPV types were detected. Among all identified HPV types, 61.9% were high-risk types. In situ hybridization experiments identified HPV genomes particularly protruding from the equatorial segment and the tail of the sperm. Semen samples from more than one in seven healthy Danish donors contain HPV, most of them of high-risk types binding to the equatorial segment of the sperm cell. Most HPV-positive sperm showed decreased staining with DAPI, indicative of reduced content of DNA. Our data demonstrate that oncogenic HPV types are frequent in men.
Geraets, Daan; Cuzick, Jack; Cadman, Louise; Moore, Catherine; Vanden Broeck, Davy; Padalko, Elisaveta; Quint, Wim; Arbyn, Marc
The Validation of Human Papillomavirus (HPV) Genotyping Tests (VALGENT) studies offer an opportunity to clinically validate HPV assays for use in primary screening for cervical cancer and also provide a framework for the comparison of analytical and type-specific performance. Through VALGENT, we assessed the performance of the cartridge-based Xpert HPV assay (Xpert HPV), which detects 14 high-risk (HR) types and resolves HPV16 and HPV18/45. Samples from women attending the United Kingdom cervical screening program enriched with cytologically abnormal samples were collated. All had been previously tested by a clinically validated standard comparator test (SCT), the GP5+/6+ enzyme immunoassay (EIA). The clinical sensitivity and specificity of the Xpert HPV for the detection of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) and CIN3+ relative to those of the SCT were assessed as were the inter- and intralaboratory reproducibilities according to international criteria for test validation. Type concordance for HPV16 and HPV18/45 between the Xpert HPV and the SCT was also analyzed. The Xpert HPV detected 94% of CIN2+ and 98% of CIN3+ lesions among all screened women and 90% of CIN2+ and 96% of CIN3+ lesions in women 30 years and older. The specificity for CIN1 or less (≤CIN1) was 83% (95% confidence interval [CI], 80 to 85%) in all women and 88% (95% CI, 86 to 91%) in women 30 years and older. Inter- and intralaboratory agreements for the Xpert HPV were 98% and 97%, respectively. The kappa agreements for HPV16 and HPV18/45 between the clinically validated reference test (GP5+/6+ LMNX) and the Xpert HPV were 0.92 and 0.91, respectively. The clinical performance and reproducibility of the Xpert HPV are comparable to those of well-established HPV assays and fulfill the criteria for use in primary cervical cancer screening. PMID:27385707
Chesson, Harrell W; Laprise, Jean-François; Brisson, Marc; Markowitz, Lauri E
We estimated the potential impact and cost-effectiveness of providing 3-doses of nonavalent human papillomavirus (HPV) vaccine (9vHPV) to females aged 13-18 years who had previously completed a series of quadrivalent HPV vaccine (4vHPV), a strategy we refer to as "additional 9vHPV vaccination." We used 2 distinct models: (1) the simplified model, which is among the most basic of the published dynamic HPV models, and (2) the US HPV-ADVISE model, a complex, stochastic, individual-based transmission-dynamic model. When assuming no 4vHPV cross-protection, the incremental cost per quality-adjusted life-year (QALY) gained by additional 9vHPV vaccination was $146 200 in the simplified model and $108 200 in the US HPV-ADVISE model ($191 800 when assuming 4vHPV cross-protection). In 1-way sensitivity analyses in the scenario of no 4vHPV cross-protection, the simplified model results ranged from $70 300 to $182 000, and the US HPV-ADVISE model results ranged from $97 600 to $118 900. The average cost per QALY gained by additional 9vHPV vaccination exceeded $100 000 in both models. However, the results varied considerably in sensitivity and uncertainty analyses. Additional 9vHPV vaccination is likely not as efficient as many other potential HPV vaccination strategies, such as increasing primary 9vHPV vaccine coverage. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Vinzón, Sabrina E; Rösl, Frank
Cutaneous papillomaviruses are associated with specific skin diseases, such as extensive wart formation and the development of non-melanoma skin cancer (NMSC), especially in immunosuppressed patients. Hence, clinical approaches are required that prevent such lesions. Licensed human papillomavirus (HPV) vaccines confer type-restricted protection against HPV types 6, 11, 16 and 18, responsible of 90% of genital warts and 70% of cervical cancers, respectively. However, they do not protect against less prevalent high-risk types or cutaneous HPVs. Over the past few years, several studies explored the potential of developing vaccines targeting cutaneous papillomaviruses. These vaccines showed to be immunogenic and prevent skin tumor formation in certain animal models. Furthermore, under conditions mimicking the ones found in the intended target population (i.e., immunosuppression and in the presence of an already established infection before vaccination), recent preclinical data shows that immunization can still be effective. Strategies are currently focused on finding vaccine formulations that can confer protection against a broad range of papillomavirus-associated diseases. The state-of-the-art of these approaches and the future directions in the field will be presented.
Full Text Available Abstract Background Human Papillomavirus (HPV is a well-known pathogen for lower genital tract neoplasias, yet little is known regarding HPV prevalence in Turkey. The aim of this study was to investigate the prevalence of HPV DNA and to determine HPV types distribution among women with normal and abnormal cytology. Methods A total of five hundred seven (n = 507 women were retrospectively evaluated between 2004-2008. Conventional polymerase chain reaction was used to detect the presence of HPV types in cervicovaginal samples obtained from patients during gynecologic examination. Results One hundred four (n = 104 of the women were excluded from the study because of the incomplete data and a total of 403 women were used for the final analysis. There were, 93 (23% women with cytologic abnormality and 310 (77% women with normal cytology. Overall, 23% of the women was HPV positive. The overall prevalence of HPV in women with abnormal Pap smears was 36% (93/403, of which in ASCUS 22%, LSIL 51% and HSIL 60%. Also, HPV DNA was positive in 20% of the women with normal cervical cytology. The most common HPV types in cytologically normal women were as follows; HPV 16 (36%, HPV 6 (22% and HPV 18 (13%. The rate of other HPV types were as follows; HPV11 4.4%, HPV45 4.4%, HPV90 4.4%, HPV35 2.2%, HPV67 2.2%, HPV81 2.2%, and multiple type HPVs 8.9%. The most common HPV types in cytologically abnormal women were HPV 16 (35%, HPV6 (19% and HPV18 (8%. The rate of multiple HPV infections in women with normal Pap test was 2.2%. Conclusion HPV prevalence and type distribution in this study were similar to that reported worldwide at least in our study population. Hovewer, HPV prevalence was more common compared with previous studies reported from Turkey. This might be related with methodology and hospital based patient accrual and high rate of women with abnormal cytology. Further population based prospective studies are needed to eliminate the drawbacks of our study
Luana Caroline Künast Polon
Full Text Available A Geografia já foi considerada como uma ciência em crise, o que talvez ela ainda seja no contexto contemporâneo. As contradições e debates no âmbito da Geografia se perpetuam desde a questão da caracterização e finalidade da própria ciência, até aprofundamentos e questionamentos sobre os conceitos que embasam as discussões geográficas. O espaço aparece comumente como objeto central dos estudos geográficos e, ainda assim gera diversas definições, indagações e percepções por parte dos teóricos da Geografia. Apesar das indefinições acerca do conceito, compreender o espaço é de fundamental relevância no âmbito da Geografia, uma vez que sobre este estão estruturados os demais conceitos pertinentes à Ciência Geográfica. Os debates teóricos que se inserem no campo do questionamento acerca dos conceitos da Geografia, são fontes de amadurecimento conceitual e metodológico, gerando possibilidades de reafirmação ou modificação da forma pela qual as pesquisas na Geografia abordam os elementos conceituais. Assim, entende-se que historicamente os debates teóricos são promulgadores do processo de evolução da própria Ciência Geográfica.
Van de Wall, Stephanie; Nijman, Hans W; Daemen, Toos
Cervical cancer is the second most common malignancy among women worldwide. The prime causal factor of the disease is a persistent infection with human papillomavirus (HPV) with individuals failing to mount a sufficient immune response against the virus. Despite the current success of HPV16- and 18-specific prophylactic vaccination, established HPV infections and associated neoplasia require therapeutic vaccines with the induction of cellular immunity. The sustained expression of early proteins E6 and E7 from major oncogenic HPV genotypes in cervical lesions are ideal targets for the design of immunotherapeutic strategies. These strategies, particularly subunit vaccines, may require additional help from immunomodulators to enhance HPV-specific cellular responses. This review discusses recent studies, published since 2008, relating to immunotherapeutic strategies against HPV that include immunomodulators. These immunomodulators fall within the category of toll-like receptor adjuvants for innate immune activation, adjuvants directly contributing to adaptive immunity, such as cytokines and costimulatory molecules, and those that target tumor-induced immunosuppressive mechanisms. Using a combination of these strategies with delivery-based approaches may be most beneficial for the success of therapeutic vaccines against HPV-induced neoplasia in the clinic.
Senapati, Rashmirani; Nayak, Bhagyalaxmi; Kar, Shantanu Kumar; Dwibedi, Bhagirathi
Considering the limited cross protection offered by the current HPV vaccines, understanding the HPV genotype distribution among the different population is essential in predicting the efficacy of current vaccine and devising new vaccine strategy. The present work aimed at investigating the HPV genotypes distribution among women with and without cervical carcinoma in Odisha, Eastern India. A total of 607 participants have been enrolled between January 2014 and June 2016. L1-PCR, sequencing, and E6/E7 nested multiplex type- specific PCR were performed for HPV detection and genotyping. Cytological distribution of 440 cases includes invasive cervical carcinoma or ICC (n = 210), inflammatory smear (n = 162), normal cytology (n = 68). Statistical analyses were performed by using SPSS version 20.0 software and MediCal version 14.10.2(7). A p-value of ≤ 0.05 was considered statistically significant. The overall prevalence of HPV infection was (359/595) 60.33%. Prevalence of HPV infection was 93.80% (197/210) in invasive cervical cancer (ICC) cases, 54.32% (88/162) in inflammatory smear and 19.11% (13/68) in normal cervical cytology. The most prevalent genotype was HPV16 (87.28%) followed by HPV18 (24.56%) and HPV 51(3.46%). The overall prevalence of single type was 76.58% and highest (78.9%) among ICC cases. The most frequent genotype combination after HPV16 + 18(9.4%) was HPV16 + 66 + 68(2.7%) which was frequently observed in inflammatory cytology. Age > 45years, parity ≥3, low socio-economic condition, rural residential area and post menopause state were significantly associated with HPV infection. Multiple infections did not have a significant association with any of the clinicopathological variables (stage, LN metastasis, cell type) except tumor size ≥ 2cm in ICC cases. The impact of 2v, 4v, and 9v vaccines in preventing cervical cancer in Odisha were 89.99, 91.65, and 92.16% respectively. This data would help planning an
Estimation of the epidemiological burden of HPV-related anogenital cancers, precancerous lesions, and genital warts in women and men in Europe: Potential additional benefit of a nine-valent second generation HPV vaccine compared to first generation HPV vaccines
Full Text Available Introduction: A second generation HPV vaccine has been developed for the prevention of anogenital cancers and precancerous lesions of the cervix, vulva, vagina, anus and of genital warts due to nine HPV types.We estimated the annual burden of these diseases attributable to the nine HPV types compared to HPV types from first generation vaccines in women and men in Europe. Material and methods: Incidence rates from the IARC database, cancer registries, the literature and Eurostat population data were used.The burden attributable to the HPV types targeted by both vaccines was estimated by applying the relative contribution of the respective HPV types from epidemiological studies. Results: In 2013, the number of new anogenital HPV-attributable cancers was 44,480 with 39,494 of these cases related to second vs. 33,285 to first generation vaccine types.Among the 284,373 to 541,621 new HPV-attributable anogenital precancerous lesions 235,364–448,423 and 135,025–256,830 were estimated to be related to second and first generation vaccine types, respectively.The annual number of new genital warts was 753,608–935,318, with 90% related to HPV6/11. Conclusions: These data demonstrate how the large public health impact that was achieved by the first generation HPV vaccines could be further increased by second generation vaccines. Keywords: HPV, Burden of disease, Cancer, Precancerous lesions, Genital warts, HPV vaccine
Comparison of two commercial assays for detection of human papillomavirus (HPV) in cervical scrape specimens: validation of the Roche AMPLICOR HPV test as a means to screen for HPV genotypes associated with a higher risk of cervical disorders.
Ham, M.A. van; Bakkers, J.M.J.E.; Harbers, G.; Quint, W.G.V.; Massuger, L.F.A.G.; Melchers, W.J.G.
Certain high-risk (HR) human papillomavirus (HPV) types are a necessary cause for the development of cervical disorders. Women with persistent HR HPV infections have an increased risk of developing high-grade cervical lesions, compared with those who have no or low-risk HPV infections. Therefore,
Full Text Available O conceito de mito é uma das chaves para a compreensão do pensamento de Walter Benjamin. O objetivo deste texto é reconstituir a gênese deste conceito com base em suas primeiras formulações, tal como apresentadas em Destino e caráter, texto escrito em 1919. O presente artigo se divide em duas partes: na primeira, reconstituímos os argumentos de Benjamin, a partir da filiação do conceito de destino ao domínio de uma Teoria do Direito e sua necessária inserção em um modo de "temporalidade" definido pela "repetição"; a segunda parte pretende demonstrar que as posições de Benjamin estão estreitamente ligadas a uma posição também política: seu objetivo era, em nome de um anarquismo confesso, se contrapor a todos os "mitos" nacionalistas (que levaram a Alemanha à guerra e à necessidade de "líderes", "condutores" (Führer para o povo. Como exemplo dessa perspectiva política, nos baseamos na confrontação, sempre presente, de Benjamin com o Sionismo.
Paola Vargas Barbosa
Full Text Available A conquista da autonomia está descrita como uma importante tarefa desenvolvimental da adolescência. Todavia, a complexidade da temática dificulta a compreensão do que seja a autonomia, assim como a comparação dos resultados encontrados na literatura científica. Com o objetivo de descrever os principais conceitos, modelos teóricos e variáveis associadas à autonomia adolescente, realizou-se uma revisão sistemática das publicações brasileiras e internacionais. Selecionaram-se 46 artigos que tratassem da autonomia como capacidade pessoal. Foram classificados de acordo com: conceitos utilizados, amostra, instrumentos e variáveis associadas à autonomia. A análise revelou uma diversidade de conceitos e instrumentos para compreensão do fenômeno; a existência de um perfil de adolescente no qual se baseia grande parte das publicações; a associação desta habilidade a variáveis contextuais, de ajustamento e clima familiar. Percebeu-se a descrição da autonomia como complexa e marcada por variáveis contextuais. Uma discussão critica sobre a produção encontrada na área foi feita.
Isabel Simões Dias
Full Text Available O conceito de competência e a reflexão sobre o seu significado pedagógico assumem um papel de destaque na investigação em Educação a nível nacional e internacional. Este artigo procura enquadrar e definir o conceito de competência no contexto educativo, fazendo alusão à relação entre o construtivismo e uma abordagem por competências no processo de ensino/aprendizagem. Recorrendo a investigações multidisciplinares nacionais e internacionais, este estudo pretende constituir-se como um contributo para o entendimento do significado pedagógico do conceito de competências. Procura dados para reflectir acerca da intervenção educativa numa escola pluralista, multifacetada e em constante mutação. A educação é uma forma de intervenção no mundo, que solicita sujeito(s aprendente(s, acção e contextos específicos. Esta mobilização dos recursos pessoais para uma resposta efectiva numa situação particular ocorre autonomamente quando se proporcionam oportunidades para a sua construção.
Full Text Available O presente artigo tem como objetivo apresentar o pensamento e o conceito de justiça como equidade presente na obra Uma Teoria da Justiça (1971 de John Rawls. Para isso, demonstraremos como o autor relaciona os conceitos de posição original e véu de ignorância como procedimento da escolha racional. Além disso, pretendemos apresentar também o conceito de justiça presente na obra Anarquia, estado e utopia (1974 de Robert Nozick. Por isso, abordaremos a concepção libertária nozickiana dos direitos individuais e o estado mínimo, o qual deve ser fundamentado para proteger estes direitos. Desta forma, procederemos expondo os princípios que subjazem no pensamento político de ambos os autores e como estes constroem seu arcabouço conceitual. Ao fazer isso, colocaremos as duas propostas em diálogo.
Viviane Rolim de Holanda
Full Text Available Objetivou-se clarificar o conceito aprendizagem na educação online, expresso pela literatura da área da saúde. Trata-se de um estudo de análise de conceito, baseado nas etapas do Modelo Evolucionário, destacando-se os atributos, antecedentes, consequentes e termos substitutos. No contexto do ensino online, a aprendizagem é expressa por um processo dinâmico e contínuo de construção ativa do conhecimento e aquisição de habilidades, com separação física entre alunos e professores. Entre os eventos antecedentes abordados sobressaíram: interesse e motivação para aprender; dedicação e autogerenciamento do tempo; interação e ferramentas de comunicação. Quanto aos principais consequentes evidenciados mencionam-se: autonomia do aluno; estudo independente e ativo; e construção do próprio conhecimento. Como termos substitutos predominantes sugiram aprendizagem colaborativa e autoaprendizagem. A compreensão do conceito poderá contribuir para a sua aplicação nas práticas de ensino de enfermagem em ambientes virtuais.