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What HPV vaccines are available?

Human Papillomavirus (HPV) Vaccines

What HPV vaccines are available?

Three vaccines are approved by the FDA to prevent HPV infection: Gardasil, Gardasil 9, and Cervarix. All three vaccines prevent infections with HPV types 16 and 18, two high-risk HPVs that cause about 70 percent of cervical cancers and an even higher percentage of some of the other HPV-associated cancers (warts (quadrivalent vaccine. Gardasil 9 prevents infection with the same four HPV types plus five additional high-risk HPV types (31, 33, 45, 52, and 58) and is therefore called a nonavalent, or 9-valent, vaccine. All three vaccines are given through a series of three injections into muscle tissue over a 6-month period.

The FDA has approved Gardasil and Gardasil 9 for use in females ages 9 through 26 for the prevention of HPV-caused cervical, vulvar, vaginal, and anal cancers; precancerous cervical, vulvar, vaginal, and anal lesions; and genital warts. Gardasil and Gardasil 9 are also approved for use in males for the prevention of HPV-caused anal cancer, precancerous anal lesions, and genital warts. Gardasil is approved for use in males ages 9 through 26, and Gardasil 9 is approved for use in males ages 9 through 15.

Females and males who have previously received Gardasil may be able to also receive Gardasil 9. FDA has information for patients about Gardasil 9 available at http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM426460.pdf.

The Cervarix vaccine is produced by GlaxoSmithKline (GSK). It targets two HPV types—16 and 18—and is called a bivalent vaccine. The FDA has approved Cervarix for use in females ages 9 through 25 for the prevention of cervical cancer caused by HPV.

In addition to providing protection against the HPV types included in these vaccines, the vaccines have been found to provide partial protection against a few additional HPV types that can cause cancer, a phenomenon called cross-protection. The vaccines do not prevent other sexually transmitted diseases, nor do they treat existing HPV infections or HPV-caused disease.

Because currently available HPV vaccines do not protect against all HPV infections that cause cancer, it is important for vaccinated women to continue to undergo cervical cancer screening. There could be some future changes in recommendations for vaccinated women.

Fuente: Tweet de @theNCI: https://twitter.com/theNCI/status/745934456733732864?s=09

V Curso de Patología Digital


V Curso de Patología Digital

Lugar de celebración:
Oporto, Portugal
Fecha de inicio:
26 de octubre de 2016
Fecha de finalización:
28 de octubre de 2016
Más información:
El V Curso de Patología Digital, se celebra en Oporto, Portugal, los días 26 al 28 de octubre de 2016, bajo los auspicios científicos del Club de Patología Digital de la Sociedad Española de Anatomía Patológica (SEAP).
 
Gracias al entusiasmo y colaboración de los compañeros de Ipatimup (Instituto de Patologia e Imunologia Molecular e Celular da Universidade do Porto, http://www.ipatimup.pt/), esta nueva edición tendrá lugar por primera vez fuera de España, en este caso, con el fin de incrementar las ya excelentes relaciones entre patólogos portugueses y españoles y crear vínculos de colaboración entre España y Portugal. Esto permitirá demostrar de forma efectiva que la patología digital no sólo rompe barreras organizativas y tecnológicas sino que permite crear redes de profesionales de diferentes países europeos que, apoyándose en una tecnología de imagen cada vez más avanzada, son capaces de ayudarse mutuamente.
 
Otra de las novedades importantes de este año será la colaboración del proyecto Europeo AIDPATH (http://aidpath.eu/) en la organización del curso, permitiendo la participación de ponentes de primer nivel europeo
 
En el V Curso de Patología Digital se presta atención especial a los temas de calidad de la imagen digital y el análisis de imagen automatizado. También se abordarán de forma detallada los avances tecnológicos en patología digital.
 
En esta edición se mantienen los talleres prácticos, que tanto éxito tuvieron en la III edición anterior, en los que los asistentes podrán realizar ejercicios prácticos usando el ordenador, bajo la supervisión y guía del profesor del curso.
 
Estamos seguros que todos los asistentes disfrutarán del magnífico entorno que ofrece Oporto.
 

Understanding Cervical Changes: A Health Guide for Women

Most women who have abnormal cervical screening tests do not have cervical cancer. Most have early cell changes that can be monitored, since they often go away on their own – or treated early, to prevent problems later. It is important to get the follow-up visits, tests, or treatment that your health care provider advises.

You can also access the information on this page as an e-book or PDF. Use this information to help you talk with your doctor after an abnormal cervical cancer screening result. If you have additional questions about cervical cancer screening, you may contact the National Cancer Institute.

Fuente: Tweet de @theNCI: https://twitter.com/theNCI/status/740137011043045376?s=09

Aumento del cancer oral

Mouth cancer rates are increasing, but why?

Over the decades, our society has changed enormously – and with it our lifestyles.

And because the rates of many types of cancer are linked to things we do (or not) every day, as well as our jobs and things in our environment, cancer rates have changed too.

November is mouth cancer action month. Mouth cancers are now the tenth most common cancer in UK men, and fifteenth most common in UK women.

That’s compared to thirteenth in men, and seventeenth in women, back in 2002.

To put this in context, the rate of being diagnosed has risen by around a third over that period, increasing from nine cases per 100,000 people in 2002 to 12 cases per 100,000 in 2012.

Fuente Tweet de @CR_UK - Cancer Research UK > Cancer news > Science blog >Mouth cancer rates are increasing, but why?

Carta Abierta sobre el Síndrome del Bebé Sacudido y los Tribunales: Una Premisa Falsa y Defectuosa

Carta Abierta sobre el Síndrome del Bebé Sacudido y los Tribunales: Una Premisa Falsa y Defectuosa -

Abstract--- La Carta Abierta sobre el Síndrome del Bebé Sacudido y los Tribunales ha sido preparada bajo los auspicios del International Public Health Research Group [IPHRG] (Grupo Internacional de Investigación sobre Salud Pública). Los primeros borradores fueron elaborados por Bill Bache y Charles Pragnell. La redacción final y la corrección fue de la Dra Lynne Wrennall, Directora Ejecutiva del International Public Health Research Group y Editora Gerente de Argument & Critique. El proceso de escribir la carta contó con investigaciones publicadas en este área, en muchos casos, investigaciones publicadas por los firmantes de la carta. Durante la redacción también se aprovechó la reiterada contribución de las reflexiones de los firmantes de la carta. A los efectos de la elaboración de la carta abierta, el International Public Health Research Group funcionó como un grupo Delphi, aconsejando en el proceso y contenido relativo a la carta. La lista completa de los expertos internacionales que han firmado su acuerdo con la carta se incluye al pie. Nosotros, los abajo firmantes miembros de diversas profesiones en todo el mundo, estamos profundamente preocupados por la protección de niños ante el maltrato, el descuido y la explotación. Nuestra formación profesional, experiencia y conocimientos periciales incluyen la medicina, protección de niños, psicología, epidemiología, biomecánica, física, ingeniería, investigación, la universidad, periodismo médico, derecho, trabajo social y criminología. Somos investigadores, escritores, profesores y médicos. Escribimos porque estamos profundamente preocupados por el uso del constructo de lo que es vulgarmente conocido como Síndrome del Bebé Sacudido [SBS], si bien se ha transformado diversamente en Lesión por Sacudida e Impacto, Trauma Craneal Abusivo (TCA), Lesión Cerebral Adquirida [LCA], y otras variantes similares.

[REA :: EJAutopsy]

Guía de Patología Autópsica

Guía de Patología Autópsica -

Abstract--- El trabajo que aquí se publica se trata de la Guía Clinica de Consenso redactada por el Club de Autopsias de la Sociedad Española de Anatomía Patológica para el Libro Blanco de la Anatomía Patológica presentado en el XXVIII Congreso Nacional de la SEAP-IAP, XXII Congreso Nacional Sociedad Española de Citología y III Congreso Nacional Sociedad Española de Patología Forense, en mayo de 2015 en la ciudad de Santander. En palabras de su presidente, el Dr. M.A. Piris, “el papel de estas guías docentes buscan optimizar la asistencia, consolidar el grado de conocimiento existente en un área precisa, defendiendo el derecho de los pacientes a recibir la mejor atención médica y protegiendo la práctica clínica responsable”. La Guía de Patología Autópsica que presentamos no pretende ser un manual al uso, sino un punto de partida para intentar unificar criterios en el procedimiento de la autopsia. Como quiera que hay muchos puntos en común con la patología forense, en la redacción de esta guía han participado patólogos clínicos y forenses. Hemos creído conveniente dividir este capítulo en varios apartados: autopsia clínica y autopsia médico legal, indicaciones de la autopsia clínica, requisitos para realizar una autopsia clínica, procedimientos normalizados de trabajo en la autopsia general y especial, la autopsia fetal y perinatal y, finalmente, requisitos del informe anatomopatológico de autopsia. Los temas de legislación y seguridad y salud laboral merecen un capítulo aparte, sin embargo recomendamos como punto de partida sendas revisiones publicadas en REA, y en el foro temático del Club de Autopsias de la SEAP. Cada apartado va acompañado de una bibliografía básica de referencia que hemos insertado al final del manuscrito donde se podrá encontrar amplia informa- ción, conceptual y técnica, incluída las revisiones comentadas sobre legislación y salud laboral en autopsias. Finalmente, hemos insertado varios anexos, que pueden servir de modelo para elaborar consentimientos informados, formularios y otros documentos utilizados en patología autópsica.

[REA :: EJAutopsy]

Cancer Protocols CAP

CAP

Magnífico recurso para patólogos asistenciales: CAP: CANCER PROTOCOLS.

The Pap Test and Bethesda 2014

The Pap Test and Bethesda 2014
“The reports of my demise have been greatly exaggerated.” (after a quotation from Mark Twain)

Nayar R., Wilbur D.C.

Abstract: The history of ‘The Bethesda System' for reporting cervical cytology goes back almost 3 decades. This terminology and the process that created it have had a profound impact on the practice of cervical cytology for laboratorians and clinicians alike. The Bethesda conferences and their ensuing output have also set the stage for standardization of terminology across multiple organ systems, including both cytology and histology, have initiated significant research in the biology and cost-effective management for human papillomavirus-associated anogenital lesions, and, finally, have fostered worldwide unification of clinical management for these lesions. Herein, we summarize the process and rationale by which updates were made to the terminology in 2014 and outline the contents of the new, third edition of the Bethesda atlas and corresponding website.

Acta Cytologica 2015;59:121-132. (

Cancer oral • Información relevante (gráfica)

Entrevista con el Cardenal Ricardo Ezzati, Mensaje

ENTREVISTA: Proyecto de despenalización aborto en tres causales / Cardenal Ricardo Ezzati, Mensaje

Current status of human papillomavirus vaccination

Current status of human papillomavirus vaccination

Brotherton, Julia M.L.; Ogilvie, Gina S.

Abstract: Purpose of review: In this article, we review the impact of the quadrivalent and bivalent prophylactic human papillomavirus (HPV) vaccines on HPV infection and disease, review alternative vaccine dosing schedules, the vaccination of men and the nine-valent HPV vaccine. Recent findings: HPV vaccines have had dramatic impacts on the prevalence of targeted HPV types (6,11,16 and 18), genital warts and precancerous cervical lesions. Population coverage would be facilitated by adopting two-dose schedules, with recent findings that two-dose schedules in young adolescents are as immunogenic as three doses in young adults. Extension of vaccination to men, particularly for men who have sex with men, could further reduce population prevalence of HPV and provide direct protection to men against genital warts and anal, penile and oropharyngeal cancers. The nine-valent HPV vaccine has demonstrated equivalent protection against the four types in the quadrivalent vaccine and high efficacy against the next five commonest causes of cervical cancer (HPV types 31,33,45,52 and 58). If cost-effective, it may extend the spectrum of protection against cervical cancer available through vaccination. Summary: HPV vaccination is an effective strategy for reducing the burden of HPV-related disease. New schedules, target populations and vaccines promise to expand this potential further.

Current Opinion in Oncology. 2015; 2(5):399–404

Recent Papillomavirus Research Articles

Recently published articles available on ScienceDirect.

Elsevier wordmark

Recent Papillomavirus Research Articles

Additional Guidance Online for Providers Regarding 9-Valent HPV Vaccine Use Among Persons Who Previously Received HPVVaccination

CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

Additional Guidance Online for Providers Regarding 9-Valent HPV Vaccine Use Among Persons Who Previously Received HPV Vaccination

July 31, 2015 / 64(29);806

A 9-valent human papillomavirus (HPV) vaccine (Gardasil 9, Merck and Co., Inc.) was licensed for use in females and males in the United States in December 2014. This is the third HPV vaccine licensed by the Food and Drug Administration; the other vaccines are the bivalent HPV vaccine, licensed for use in females, and the quadrivalent HPV vaccine, licensed for use in females and males.

In February 2015, the Advisory Committee on Immunization Practices (ACIP) recommended 9-valent HPV vaccine as one of three HPV vaccines that can be used for routine vaccination of females and one of two HPV vaccines for routine vaccination of males. ACIP recommendations were published in a March 2015 report. Additional information has been posted on the CDC website to provide guidance on issues that were not addressed in the March report but are likely to arise during the transition to 9-valent HPV vaccine, including questions about use of 9-valent HPV vaccine among persons who previously received bivalent or quadrivalent HPV vaccine 9vHPV Guidance PDF.

Fuente: Tweet de @CDC_Cancer - CDC.gov

Detection of Human Papillomavirus in Non-Small Cell Carcinoma of the Lung

Detection of Human Papillomavirus in Non-Small Cell Carcinoma of the Lung

Sing Yun Chang, Michael Keeney, Mark Law, Janis Donovan, Marie-Christine Aubry, Joaquin Garcia

Abstract: High-risk human papillomavirus (hrHPV) is an etiologic agent in squamous cell carcinoma (SqCC) arising in the oropharynx and cervix, and a proven prognostic factor in oropharyngeal SqCC. Many studies have found HPV in non-small cell lung carcinoma (NSCLC). Recent studies advocate the detection of mRNA transcripts of E6/E7 as more reliable evidence of transcriptively active HPV in tumor cells. The clinical significance of finding HPV remains unclear in NSCLC. This study sought to determine the prevalence of biologically active HPV infection in NSCLC comparing different methodologies. Surgical pathology material from resected primary lung adenocarcinoma (ADC; n = 100) and SqCC (n = 96) were retrieved to construct tissue microarrays. In-situ hybridization (ISH) for hrHPV DNA (DNA-ISH), hrHPV E6/E7 RNA (RNA-ISH), and p16 immunohistochemistry (IHC) were performed. Cases of oropharyngeal SqCC with known HPV infection were used as positive controls. Expression of p16 was scored as positive if at least 70% of tumor cells showed diffuse and strong nuclear and cytoplasmic staining. Punctate nuclear hybridization signals by DNA-ISH in the malignant cells defined an HPV-positive carcinoma. Of the 196 patients (range 33-87 years; 108 men), p16 was positive in 19 ADC and 9 SqCC, but HPV DNA-ISH and RNA-ISH were negative in all cases. Our study did not detect HPV infection by DNA-ISH or RNA-ISH in any cases of primary NSCLC despite positive p16 expression in a portion of ADC and SqCC. p16 should therefore not be used as a surrogate marker for HPV infection in NSCLC.

Human Pathology (in press) - DOI: j.humpath.2015.07.012

Fuente: Tweet de @pbaleixo

Gardasil 9 Vaccine Protects against Additional HPV Types

Gardasil 9 Vaccine Protects against Additional HPV Types

Summary: In a large randomized clinical trial, a new human papillomavirus (HPV) vaccine effectively prevented infection and disease caused by nine high-risk HPV types, including seven types that cause cervical and other cancers—five of which were not covered by the previously available HPV vaccines—and two types that cause genital warts.

A 9-Valent HPV Vaccine against Infection and Intraepithelial Neoplasia in Women

Elmar A. Joura, Anna R. Giuliano, Ole-Erik Iversen, Celine Bouchard, Constance Mao, Jesper Mehlsen, Edson D. Moreira, Jr., Yuen Ngan, Lone Kjeld Petersen, Eduardo Lazcano-Ponce, Punnee Pitisuttithum, Jaime Alberto Restrepo, Gavin Stuart, Linn Woelber, Yuh Cheng Yang, Jack Cuzick, Suzanne M. Garland, Warner Huh, Susanne K. Kjaer, Oliver M. Bautista, Ivan S.F. Chan, Joshua Chen, Richard Gesser, Erin Moeller, Michael Ritter, Scott Vuocolo, and Alain Luxembourg, for the Broad Spectrum HPV Vaccine Study

Abstract: Background. The investigational 9-valent viruslike particle vaccine against human papillomavirus (HPV) includes the HPV types in the quadrivalent HPV (qHPV) vaccine (6, 11, 16, and 18) and five additional oncogenic types (31, 33, 45, 52, and 58). Here we present the results of a study of the efficacy and immunogenicity of the 9vHPV vaccine in women 16 to 26 years of age.
Methods. We performed a randomized, international, double-blind, phase 2b–3 study of the 9vHPV vaccine in 14,215 women. Participants received the 9vHPV vaccine or the qHPV vaccine in a series of three intramuscular injections on day 1 and at months 2 and 6. Serum was collected for analysis of antibody responses. Swabs of labial, vulvar, perineal, perianal, endocervical, and ectocervical tissue were obtained and used for HPV DNA testing, and liquid-based cytologic testing (Papanicolaou testing) was performed regularly. Tissue obtained by means of biopsy or as part of definitive therapy (including a loop electrosurgical excision procedure and conization) was tested for HPV. Results. The rate of high-grade cervical, vulvar, or vaginal disease irrespective of HPV type (i.e., disease caused by HPV types included in the 9vHPV vaccine and those not included) in the modified intention-to-treat population (which included participants with and those without prevalent infection or disease) was 14.0 per 1000 person-years in both vaccine groups. The rate of high-grade cervical, vulvar, or vaginal disease related to HPV-31, 33, 45, 52, and 58 in a prespecified per-protocol efficacy population (susceptible population) was 0.1 per 1000 person-years in the 9vHPV group and 1.6 per 1000 person-years in the qHPV group (efficacy of the 9vHPV vaccine, 96.7%; 95% confidence interval, 80.9 to 99.8). Antibody responses to HPV-6, 11, 16, and 18 were noninferior to those generated by the qHPV vaccine. Adverse events related to injection site were more common in the 9vHPV group than in the qHPV group. Conclusions. The 9vHPV vaccine prevented infection and disease related to HPV-31, 33, 45, 52, and 58 in a susceptible population and generated an antibody response to HPV-6, 11, 16, and 18 that was noninferior to that generated by the qHPV vaccine. The 9vHPV vaccine did not prevent infection and disease related to HPV types beyond the nine types covered by the vaccine. (Funded by Merck; ClinicalTrials.gov number, NCT00543543).

Source: New England Journal of Medicine, February 18, 2015

Fuente: Tweet de @theNCI - Pubmed