Scielo RSS <![CDATA[Revista médica de Chile]]> https://scielo.conicyt.cl/rss.php?pid=0034-988720080011&lang=es vol. 136 num. 11 lang. es <![CDATA[SciELO Logo]]> https://scielo.conicyt.cl/img/en/fbpelogp.gif https://scielo.conicyt.cl <![CDATA[<b>Virus papiloma humano y cáncer cérvico-uterino</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100001&lng=es&nrm=iso&tlng=es Molecular, clinical and epidemiolagical studies have established beyond doubt that human papiloma viruses (HPV) cause cervical cancer. The virus is also associated with genital warts and other less common cancers in oropharynx, vulva, vagina and penis. Worldwide, VPH genotypes 16 and 18 are the most common high risk genotypes, detected in near 70% of women with cervical cáncer. The discovery of a cause-effect relationship between several carcinogenic microorganisms and cancer open avenues for new diagnostic, treatment and prevention strategies. In this issue of Revista Médica de Chile, two papers on HPV are presented. Guzman and colleagues demonstrate that HPV can be detected in 66% to 77% of healthy male adolescents by polymerase chain reaction and that positivity depends on the site of the penis that is sampled. These results support the role of male to female transmission of high risk HPVs in Chile and should lead to even more active educational campaigns. The second paper provides recommendations for HPV vaccine use in Chile, generated by the Immunization Advisory Committee of the Chilean Infectious Disease Society. To issue these recommendations, the Committee analyzes the epidemiological information available on HPV infection and cervical cancer in Chile, vaccine safety and effectiveness data, and describes cost-effectiveness studies. Taking into account that universal vaccination is controversial the Committee favors vaccine use in Chile and it's incorporation into a national program. However, there is an indication that the country requires the implementation of an integrated surveillance approach including cross matching of data obtained from HPV genotype surveillance, monitoring of vaccination coverage, and surveillance of cervical cáncer The final decision of universal vaccine use in Chile should be based on a through analysis of information. <![CDATA[<b>Interacción entre los polimorfismos del receptor ß<sub>1</sub> y ß<sub>2</sub> adrenérgico como predictor de riesgo de insuficiencia cardiaca crónica</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100002&lng=es&nrm=iso&tlng=es Background: ß adrenergic receptors (AR) are highly polymorphic and important regulators of cardiovascular homeostasis. Among these, ß1 and ß2 AR regulate cardiac contractility and frequency and are important pharmacological targets. Aim: To evaluate genotype and gene-gene interaction between ß1-AR Arg389Gly and ß2-AR ArglSGly GlnZ7Gly and Thrl 64Ile polymorphisms, as risk factors for HF. Material and methods: Eighty chronic HF patients and eighty-eight controls matched by age and sex were genotyped for ß1 -AR Arg389Gly ß2-AR ArgWGly, GlnZ7Glu and Thr164Ile polymorphisms. Results: The presence of ß2-AR Glu afiele was a risk predictor for HF (odds ratio (OR) =2.81; 95% confidence intervals (CI) =1.49-5.31). Interactions that increased the risk for HF were found in patients carrying at least one of the ß2-AR Glu and ß2-AR Gly allele (OR =3.81; 95% CI =1.50-0.70) and ß2-AR Glu and ß1 -AR Gly allele combination (OR =5.51; 95% CI =2.19-13.86). Furthermore, the frequency of ß2-AR Glu allele was higher among patients with a history ofacute myocardial infarction (with infarction: 0.534, without: 0.313, p =0.01). Conclusions: ß2-AR Glu allele could be a risk predictor for HF. This risk could be enhanced by the additional presence of ß2-AR GlyW or ß1-AR Arg389 alleles. The frequency of ß2-AR Gln27 Glu allele was higher among patients with a history of myocardial infarction. <![CDATA[<b>Prevalencia de la infección genital por virus papiloma humano en hombres universitarios voluntarios de la IX Región, Chile</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100003&lng=es&nrm=iso&tlng=es Background: Human papillomavirus (HPV) infection is the most common sexually transmitted disease. Aim: To determine prevalence of HPV genital infection in voluntary asymptomatic male university students. Material and methods: A cross-sectional study in 62 asymptomatic, sexually active male students. Exfoliated cells were obtained from the penüe shaft and coronal sulcus. Samples were analyzed for HPV DNA detection and genotyping by polymerase chain reaction and Reverse Line Blot. Results: The prevalence of HPV infection was 84%. HPV detection was 77% in penile shaft and 66% in coronal sulcus. The most commonly detected types were HPV-16 (45%), HPV-11 (19%), HPV-6 (10%) and HPV-18 (9%). Múltiple infection wasfoundin 54%. The most frequent combinations were VPH11/16 (18%) and VPH16/18 (5%). Conclusions: HPV infection is highly frequent in asymptomatic male university students, high rísk HPV types were greatly predominant. <![CDATA[<b>La melatonina reduce la respuesta de cortisol al ACTH en humanos</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100004&lng=es&nrm=iso&tlng=es Background: Melatonin receptors are widely distributed in human tissues but they have not been reported in human adrenal gland. Aim: To assess if the human adrenal gland expresses melatonin receptors and if melatonin affeets cortisol response to ACTH in dexamethasone suppressed volunteers. Material and methods: Adrenal glands were obtained from 4 patients undergoing unilateral nephrectomy-adrenalectomy for renal cáncer. Expression of mRNA MT1 and MT2 melatonin receptors was measured by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). The effect of melatonin on the response to intravenous (i.v.) ACTH was tested (randomized cross-over, double-blind, placebo-controlled tríal) in eight young healthy males pretreated with dexamethasone (1 mg) at 23:00 h. On the next day at 08:00 h, an i.v. Une was inserted, at 08:30 h, and after a blood sample, subjeets ingested 6 mg melatonin or placebo. At 09:00 h, 1-24 ACTH (Cortrosyn, 1µg/1.73 m² body surface área) was injected, drawing samples at 0, 15, 30, 45 and 60 minutes after. Melatonin, cortisol, cortisone, progesterone, aldosterone, DHEA-S, testosterone and prolactin were measured by immunoassay. Results: The four adrenal glands expressed only MT1 receptor mRNA. Melatonin ingestión reduced the cortisol response to ACTH from 14.6+1.45µg/dl at 60 min in the placebo group to 10.8+1.2µg/dl in the melatonin group (p <0.01 mixed model test). It did not affect other steroid hormone levels and abolished the morningphysiological decline of prolactin. Conclusions: The expression ofMTl melatonin receptor in the human adrenal, and the melatonin reduction of ACTH-stimulated cortisol production suggest a direct melatonin action on the adrenal gland . <![CDATA[<b>El escrutinio diagnóstico limitado puede disminuir el impacto económico directo del síndrome de intestino irritable (SII)</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100005&lng=es&nrm=iso&tlng=es Background: The economic impact of irritable bowel syndrome (IBS) in México in terms of excessive diagnostic testing can be considerably reduced if the recommendations of the Latín American Consensus (LATAM) for IBS are followed. Aim: To estímate the economic impact of IBS in terms of excessive diagnostic testing. Material and Methods: Based on a previously published study the costs of diagnostic testing for IBS were compared to the theoretical costs according to the recommendations of the consensus. These costs were compared to estímate the economic impact of excessive diagnostic testing. A cost-minimization analysis was also done. Results: For the lowest socioeconomic level in academic medicine, the excessive diagnostic testing had an approximate cost of US$21.38, compared to US$1.72 if the LATAM Consensus recommendations would have been followed, representing a saving of 92.0%. The cost for the highest socioeconomic level in academic medicine was US$1080.36 versus US$103.60 (a saving of 90.4%) and for prívate medicine, the costs were US$3121.60 versus US$159.90 (a saving of 94.9%) if the recommendations would have been followed. Conclusions: Limited diagnostic testing recommended by the LATAM Consensus for IBS can significantly decrease the economic impact of this disease in México. <![CDATA[<b>Estilos de vida y estado nutricional de trabajadores en empresas públicas y privadas de dos regiones de Chile</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100006&lng=es&nrm=iso&tlng=es Background: Lifestyles and a poor nutritional status are two factors iníluencing the high prevalence of non communicable chronic diseases among Chilean workers. Aim: To characterize lifestyles and nutritional status of workers from the public and prívate sector, residing in the Fifth and in the Metropolitan regions of Chile. Material and methods: Nutritional status, blood pressure, cholesterol, glycemia, previous medical history, feeding habits and smoking status were assessed in 1,036 women and 709 men aged 38+11 years. Results: Feeding habits were characterized by a low consumption of fruits, vegetables, fish and dairy products and a high consumption offat and sugar Forty five percent smoked and 88% were sedentary. Forty two percent were overweight, 18% were obese, 39% had high blood cholesterol, 23% hypertension and 4% diabetes. There was a positive relationship between obesity and hypertension with an odds ratio (OR) adjusted for sex and educationallevéis of 2.6 (95% confidence intervals (Cl) 1.9-3.7) and diabetes with an OR of 2.8 (95% CI 1.6-4.7). Eighty two percent of obese and 28% of overweight subjects underestimated their nutritional status. Conclusions: A high prevalence of overweight and inadequate lifestyles was found in this population. There was a low self perception of obesity and lack of knowledge about risk factors for chronic diseases. <![CDATA[<b>Evaluación a largo plazo del estado nutricional, composición corporal y densidad mineral ósea en mujeres operadas de <i>bypass </i>gástrico</b>: <b>impacto del nivel socioeconómico</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100007&lng=es&nrm=iso&tlng=es Background: Roux-en-Y gastric bypass (RYGBP) has had a positive impact on co-morbidities associated with obesity. However, in the long-term it can induce micronutrient deficiencies. Aim: To perform a complete nutritional assessment in a group of women previously operated of RYGBP, from different socioeconomic levéis (SEL). Patients and Methods: Thirty three women (19 high SEL and 14 low SEL), were assessed by dietary recalls, anthropometric measurements, muscle strength, bone mineral density, routine clinical laboratory, serum levéis of vitamin B12, 250H-vitamin D, Mate, calcium, ferritine, ceruloplasmin and indicators ofbone turnover (parathohormone, osteocalcin and urinary pyridinolines). Their valúes were compared to those of 30 control women (18 high SEL and 12 low SEL). Results: Low SEL operated women consumed fewer vitamin and mineral supplements compared with their high SEL pairs. No cases of vitamin B12, folie acid or copper deficiencies were detected. Frequency of iron deficieney was similar in patients and controls. Vitamin D insufficieney was higher amongpatients than in controls (p =0,04 7), regardless SEL. Patients had also a higher frequency of high serum PTH and osteocalcin and urinary pyridinoline levéis. However, no differences in bone mineral density were observed between operated women and controls. Conclusions: Vitamin and mineral deficiencies were lower than expected among operated women. However, problems associated with vitamin D deficieney were highly prevalent among patients operated of RYGBP, irrespective SEL. These alterations were only detectable through speciñe markers at this stage, because they did not transíate into lower bone mineral density (BMD) of surgicalpatients, probably due to the higher pre-operative BMD of these morbidobese patients. <![CDATA[<b>Sobrevida alejada de pacientes operados por cáncer gástrico incipiente</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100008&lng=es&nrm=iso&tlng=es Background: Early gastric cancer involves mucosa and submucosa, independent of lymph node involvement. Radical gastrectomy is the standard treatment. Aim: To assess long term survival of patients operated for an early gastric cancer. Material and methods: Retrospective Rev iew of medical and pathology records of patients subjected to a gastrectomy for an early gastric cancer, between 1975 and 2002. All were treated using a standardized protocol and staged according to 2002 TNM classification of the American Joint Committee of Cáncer (AJCC). Demographic and pathologic features, operation performed and long term survival were recorded. Survival was analyzed using Kaplan-Meier method. Results: The series is comprised by 64 males and 41 females aged 61 + 1 years. Tumor was located in the upper third of the stomach on 33 subjects and a total gastrectomy was performed in 53. Pathology showed an intestinal type adenocarcinoma in 82 and a diffuse type in 23. In patients with involvement of mucosa and submucosa, 24 ± 14 and 22 ± 14 lymph nodes were excised, respectively. Lymph node involvement was present in 8% and 22% of patients with involvement of mucosa and submucosa, respectively. Five years survival was 94% and 78% in patients without and with lymph node involvement, respectively. Survival among patients in stage IA and IB was 94% and 76%, respectively. Multivariate analysis showed that the lymph node involvement was an independent mortality risk factor. Conclusions: Total gastrectomy in patients with early gastric cancer is associated with a good survival. Lymph node involvement is a mortality risk factor. <![CDATA[<b>Tratamiento endovascular de la disección aórtica tipo B mediante endoprótesis</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100009&lng=es&nrm=iso&tlng=es Background: Dissections that involve the ascending aorta are classified as type A, regardless of the site of the primary intimal tear, and all other dissections as type B. Type B dissections can have fatal ischemic and hemorrhagic complications. In the chronic state, dilatation and rupture can be mortal. Endovascular surgery is a therapeutic alternative, considering the high rate of complications of conventional surgery Aim: To report the results of endovascular treatment of type B aortic dissection. Material and methods: Report of 36 treated patients (30 males) aged 43 to 87 years, with a type B aortic dissection. Seventy eight percent were hypertensive and 39% smoked. The diagnosis was conñrmed by CAT sean. Acute patients were treated for complications and chronic patients, for dilatation. In the operating room, an endoprothesis was placed through the femoral artery, to cover the tear. The tear was located and the lumens were differentiated using angiography and transesophageal echocardiography. Results: All procedures were successful. In 16 acute dissections the indications were malperfusion syndrome or unmanageable hypertension in seven patients and imminent rupture or persistent pain in nine. Twenty chronic patients were operated due to dilatation (mean 6 cm). One patient died due to cardiac failure. One patient had a transient paraparesia and two had pulmonary embolism. No patient died in a follow up períod ranging from 2.5 to 74 months. Four patients required a new aortic endovascular procedure due to progressive dilatation or endoleak. Conclusión: Endovascular treatment of type B aortic dissection has good immediate andlong term results. <![CDATA[<b>Validación de una versión en español de la Escala de Conflicto Decisional</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100010&lng=es&nrm=iso&tlng=es Background: In Chile, in approximately 50% of nursing students, nursing was not their first choice as career. Usually, during the first year, these students must decide whether they would like to continue in the same career. A valid tool is needed to identify decisional conflicts and their contributing factors among these students and to develop an appropriate strategy to support them duríng their decision-making process. Aim: To translate into Spanish and validate the Generic Decisional Conflict Scale (DCS). Material and methods: The DCS was translated from English to Spanish and was used with 331 first-year nursing students at the Pontificia Universidad Católica de Chile. The scale was assessed for validity and reliability using statistical tests, including factor analysis and Cronbach alpha test. Results: The Spanish version of the DCS had acceptable validity and reliability. Factorial analysis identified four factors and only the item: "advice" loaded the other factors. Cronbach alpha was 0.80. Conclusions: DCS is a valid and useful instrument to identify decisional conflicts and contributing factors to continue studies among nursing students. <![CDATA[<b>Micetoma por <i>Actinomadura madurae </i>en el pie</b>: <b>Reporte de un caso en Chile</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100011&lng=es&nrm=iso&tlng=es Mycetoma is a chronic infection that affects skin, subcutaneous tissue and bone. Its etiology can be mycotic or bacterial. It affects mainly the lower extremities ofmiddie age men livingin tropical climates. We repon a 44 year-old male ¡ivingin a template zone, consulting for swelling and pain in the left foot, lasting for 10 years. Physical examination showed a swollen left foot with hyperpigmented skin and a few crustedpapules. Radiology showed an extensive bone involvement of the midfoot with several oval and radiolucid images. Magnetic resonance showed son and bone tissue involvement, with múltiple oval and low intensity images in TI and T2. The biopsy was compatible with an unspecific chronic osteomyelitis. A bacterial identification by polymerase chain reaction and sequencing in the biopsy determined the presence of an Actinomadura madurae. Treatment with cotrimoxazol was started). <![CDATA[<b>Infección del líquido pleural y ascítico por <i>Listeria monocytogenes</i></b>: <b>Caso clínico</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100012&lng=es&nrm=iso&tlng=es Ascitic and pleural fluids infection by Listeria monocytogenes is uncommon. The association of spontaneous bacterial peritonitis and empyema caused by this microorganism has been seldom reported. A 61 year-old male with an alcoholic cirrhosis and an upper right ¡obectomy for a lung cáncer, consulted because of an exacerbation of dyspnea, abdominal pain and fever. Listeria monocytogenes was isolated from ascitic and pleural fluids and from blood cultures. He was successfully treated with ampicillin and a chest tube for drainage. <![CDATA[<b>Bezoar gástrico como complicación de banda gástrica en manejo de obesidad mórbida</b>: <b>Caso clínico</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100013&lng=es&nrm=iso&tlng=es Laparoscopic adjustable gastric banding (LAGB) is used for the management of morbid obesity. Phytobezoars are rarely reported as a complication of this operation and are usually extracted by endoscopic means. We report a 48 year-old male subjected to a gastric banding, that consulted for progressive dysphagia, six months after the operation. A barium meal x-ray examination demonstrated the presence of a bezoar that was dissolved in one week using papain. A control barium meal confirmed the disappearance of the bezoar . <![CDATA[<b>Genómica nutricional</b>: <b>una aproximación de la interacción genoma-ambiente</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100014&lng=es&nrm=iso&tlng=es Nutritional genomics forms part of the genomic sciences and addresses the interaction between genes and the human diet, its influence on metabolism and subsequent susceptibility to develop common diseases. It encompasses both nutrigenomics, which explores the effects of nutrients on the genome, proteome and metabolome; and nutrigenetics, that explores the effects of genetic variations on the diet/disease interaction. A number of mechanisms drive the gene/diet interaction: elements in the diet can act as links for transcription factor receptors and alter intermediary concentrations, thereby modifying chromatin and impacting genetic regulation; affect signal pathways, regulating phosphorylation of tyrosine in receptors; decrease signaling through the inositol pathway; and act through epigenetic mechanisms, silencing DNA fragments by methylation of cytosine. The signals generated by polyunsaturated fatty acids are so powerful that they can even bypass insulin mediated lipogenesis, stimulated by carbohydrates. Some fatty acids modify the expression of genes that participate in fatty acid transport  by lipoproteins. Nutritional genomics has myriad possible therapeutic and preventive applications: in patients with enzymatic deficiencies; in those with a genetic predisposition to complex diseases such as dyslipidemia, diabetes and cancer; in those that already suffer these diseases; in those with altered mood or memory; during the aging process; in pregnant women; and as a preventive measure in the healthy population. <![CDATA[<b>Artritis reumatoide temprana</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100015&lng=es&nrm=iso&tlng=es This article reviews some key issues of early rheumatoid arthritis such as the difficulties to recognize this condition during the first months after onset. Therefore, three reference diagnostic criteria have been proposed for any patient presenting with more than three simultaneously inflammed joints, involvement of  metacarpophalangeal or proximal interphalangeal joints and morning stiffness lasting more than 30 minutes. Antibodies to cyclic citrullinated peptides are new markers that can be used for diagnosis. The immediate treatment during the "opportunity window" at the onset of inflammation may avoid the erosive joint damage. The use of synthetic or biological disease modifying medications, specially tumor necrosis factor alpha antagonists, also contribute to this purpose. Primary care physicians should be aware of the early signs of the disease to provide an adequate treatment and referral to specialists. <![CDATA[<b>Daño vascular en la enfermedad renal crónica</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100016&lng=es&nrm=iso&tlng=es Cardiovascular disease is a frequent complication of renal failure and is the most common cause of death in patients with chronic kidney disease (CKD). Accelerated atherogenesis has been widely documented in CKD and diabetic nephropathy is the leading cause of renal failure worldwide. Furthermore, CKD promotes hypertension and dyslipidemia, which in turn may contribute to the progression of renal failure. All together, hypertension, dyslipidemia and diabetes are considered major risk factors for the development of endothelial dysfunction and progression of atherosclerosis. Elevated inflammatory mediators and activation of the renin-angiotensin system contribute through enhanced production of reactive oxygen species, to atherogenesis in CKD. Vascular calcification is also important. Calcification of arteries occurs in the intima in association with atherosclerosis, where it may contribute to plaque formation, and in the media, where it causes stiffening. Increased serum levels of calcification promoters, such as hyperphosphatemia, and a decrease in circulating and local inhibitors of calcification, favor vascular calcification. On the other hand, transdifferentiation of vascular smooth muscle cells to osteblast-like cells would be the pivotal event in calcification. Bone morphogenetic protein agonists and antagonists are playing a role in this osteogenic differentiation. Accelerated atherosclerosis and media calcification will then lead to increased prevalence of coronary artery disease, heart failure, stroke, and peripheral arterial disease. Prevention and treatment of cardiovascular disease are major considerations in the management of individuals with CKD . <![CDATA[<b>Declaración del Comité Consultivo de Inmunizaciones de la Sociedad Chilena de Infectología respecto a la vacuna antivirus papiloma humano</b>: <b>Septiembre 2008</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100017&lng=es&nrm=iso&tlng=es This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific ínformatíon of the licensed HPV vaccines: Gardasil® and Cervarix®. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual actívíty, Le. approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program. <![CDATA[<b><i>Síndrome de Brugada</i></b>: <b><i>un camaleón letal</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100018&lng=es&nrm=iso&tlng=es This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific ínformatíon of the licensed HPV vaccines: Gardasil® and Cervarix®. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual actívíty, Le. approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program. <![CDATA[<b><i>Síndrome cistocerebral</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100019&lng=es&nrm=iso&tlng=es This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific ínformatíon of the licensed HPV vaccines: Gardasil® and Cervarix®. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual actívíty, Le. approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program. <![CDATA[<b><i>¿Qué es Medicina Interna?</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008001100020&lng=es&nrm=iso&tlng=es This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific ínformatíon of the licensed HPV vaccines: Gardasil® and Cervarix®. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual actívíty, Le. approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program.