Human papillomavirus genotypes in women with cervical cytological abnormalities from an area with high incidence of cervical cancer

It has been well demonstrated the relationship between the infection with high-risk human papillomavirus (HPVs) genotypes and cervical cancer. In Northeastern Argentina a high incidence of this pathology has been described and therefore a high prevalence of HPV infection is expected. In order to identify HPV genotypes associated with malignant and pre-malignant cervical lesions present in the area, 53 ecto-endo cervical cell specimens obtained from women with cytohistological alterations were studied by a PCR-RFLP technique. Out of 53 patients, 34 (64.2%) were positive for HPV infection, being HPV-16 (32.3%) the most frequently found genotype, followed by HPV-58 (14.7%), -6, -18 and -45 (5.9%), -33, -52, -53, -54, -56, -66, -MM4 and -LVX100 (2.9%). Also 5 cases of infection caused by multiple genotypes were found, which corresponded to 14.7% of the positive cases. Results indicate that besides HPV-16 and -18, the most prevalent high-risk HPV genotypes worldwide, others like -45 and -58 as well as co-infection cases are frequent between women of Northeastern Argentina, and a particular attention should be paid to this circumstance because it could be an epidemiological feature of regional importance and a useful information for a future vaccination program.

Human papillomavirus status and cervical abnormalities in women from public and private health care in Rio de Janeiro State, Brazil

This article reports the HPV status and cervical cytological abnormalities in patients attended at public and private gynecological services from Rio de Janeiro State. It also comments the performance of each HPV DNA tests used. A set of 454 women from private health clinics was tested by routine Capture Hybrid II HPV DNA assay. Among these, 58.4% presented HPV and nearly 90% of them were infected by high risk HPV types. However, this group presented few premalignant cervical lesions and no invasive cervical cancer was registered. We also studied 220 women from low income class attended at public health system. They were HPV tested by polymerase chain reaction using My09/11 primers followed by HPV typing with E6 specific primers. The overall HPV prevalence was 77.3%. They also showed a high percentage of high squamous intraepithelial lesion-HSIL (26.3%), and invasive cervical carcinoma (16.3%). HPV infection was found in 93.1% and 94.4% of them, respectively. The mean ages in both groups were 31.5 and 38 years, respectively. In series 1, HPV prevalence declined with age, data consistent with viral transient infection. In series 2, HPV prevalence did not decline, independent of age interval, supporting not only the idea of viral persistence into this group, but also regional epidemiological variations in the same geographic area. Significant cytological differences were seen between both groups. Normal and benign cases were the most prevalent cytological findings in series 1 while pre-malignant lesions were the most common diagnosis in the series 2. HPV prevalence in normal cases were statistically higher than those from series 1 (p < 0.001), indicating a higher exposure to HPV infection. Women from both samples were referred for previous abnormal cytology. However, socio-demographic evidence shows that women from series 1 have access to treatment more easily and faster than women from series 2 before the development of pre-malignant lesions. These data provides baseline support for the role of social inequalities linked to high risk HPV infection leading to cervical cancer. Broadly screening programs and the development of safe and effective vaccines against HPV would diminish the toll of this disease that affect mainly poor women.

Molecular detection of HPV 16 and 18 in cervical samples of patients from Belo Horizonte, Minas Gerais, Brazil

PURPOSE: The aim of this study was to investigate the frequency of HPV infection and the types 16 and 18 in cervical samples from patients attended at two public health services of the city of Belo Horizonte, MG. METHODS: Cervical samples from 174 patients were collected for cytopathological and molecular tests. HPV infection was searched by PCR utilizing MY09 and MY11 primers or HPV 16 and HPV 18 specific primers. RESULTS: Amongst the 174 samples analyzed, 20.7% presented squamous intraepithelial and/or invasive lesions detected on cytopathological analysis and of those, 94.4% were infected by HPV. HPV 16 was found in 20% of the cases of low-grade squamous intraepithelial lesions and in 40% and 50% of high-grade squamous intraepithelial lesion and squamous invasive carcinoma, respectively. HPV 18 was detected in 6.7% of the low-grade lesion samples and in two HPV16 co-infected samples. In 50% of the cases of high-grade lesion, the HPV type was not determined. CONCLUSION: The HPV 16 was the virus type more frequently detected. However, more than 50% of the positive samples at the cytopathological analysis were negative for HPV 16 and 18, indicating that possibly other virus types are present in relative high frequencies in the studied population.

Falsos Negativos em Citologia Cervical. A Propósito de um Caso Clínico

A redução na incidência e morbimortalidade do cancro do colo invasivo deveu-se, e deve-se, ao diagnóstico e terapêutica das lesões precursoras do cancro cervical, contribuindo para este objectivo a implementação de métodos e programas de rastreio eficazes com citologia cervical. É do conhecimento geral que a citologia cervical é um método de rastreio eficaz mas apresenta limitações. Os falso negativos podem atingir mais de 50%, uma taxa de 5 a 10% é considerada aceitável pela maioria dos autores. Taxas inferiores a 5% são apresentados nas melhores séries. Como a citologia é um exame de rastreio e não um teste diagnóstico, se a sintomatologia e/ou a clínica sugerirem patologia, a investigação deverá prosseguir, mesmo na presença de citologia negativa. O caso clínico que se apresenta ilustra e pede atenção para a problemática dos resultados falsamente negativos da citologia cervical.

Epstein Barr virus detection in cervical samples of women living with human immunodeficiency virus

Epstein Barr Virus (EBV) is transmitted commonly by saliva, but it has been found in genital secretions, which suggests sexual transmission and led researchers to connect EBV and cervical neoplasia. People living with human immunodeficiency virus (HIV) are reported to be at high risk of acquiring genital infections and cervical lesions. To verify the presence of EBV in the genital tract and/or it could affect cervical changes, we analyzed cervical smears from 85 HIV seropositive women for EBV DNA determination. EBV was only detected in two (2.3%) samples. The present study provides neither evidence for EBV as sexually transmitted infection nor discards this possibility.

Neurogenic Thoracic Outlet Syndrome Associated with Cervical Rib

A true neurogenic thoracic outlet syndrome (TOS) associated with a cervical rib is considered extremely rare. The authors present their experience with 5 cases of true neurogenic TOS associated with a cervical rib. All patients were female and had a cervical rib confirmed radiographically pre-operatively. Average age was 34,8 years. Although all patients had been treated with several combinations of diverse drugs and a rehabilitation program before referral to surgery, all described their pain as intense and debilitating before surgical treatment. All patients had pre-operative electromyographic abnormalities. Patients were operated on via a supraclavicular approach and the cervical rib was resected. No intra-operative or postoperative complications were noted. Two years postoperatively, all patients mentioned improvement. However, only 2 were symptomless, and on no medication. In one patient there was significant improvement, and in the remaining 2 patients some residual pain persisted that had to be dealt with pharmacologically. All patients were able to resume their daily life activities. Recovery was poorer in the 2 patients that had been referred to surgery after a longer period of time since the beginning of symptoms.

AN UPWARD TREND IN DNA P16INK4A METHYLATION PATTERN AND HIGH RISK HPV INFECTION ACCORDING TO THE SEVERITY OF THE CERVICAL LESION

SUMMARY High-risk human papillomavirus (hr-HPV) infection is necessary but not sufficient for cervical cancer development. Recently, P16INK4A gene silencing through hypermethylation has been proposed as an important cofactor in cervical carcinogenesis due to its tumor suppressor function. We aimed to investigate P16INK4A methylation status in normal and neoplastic epithelia and evaluate an association with HPV infection and genotype. This cross-sectional study was performed with 141 cervical samples from patients attending Hospital Moncorvo Filho, Rio de Janeiro. HPV detection and genotyping were performed through PCR and P16INK4A methylation by nested-methylation specific PCR (MSP). HPV frequency was 62.4% (88/141). The most common HPV were HPV16 (37%), HPV18 (16.3%) and HPV33/45(15.2%). An upward trend was observed concerning P16INK4A methylation and lesion degree: normal epithelia (10.7%), low grade lesions (22.9%), high grade (57.1%) and carcinoma (93.1%) (p < 0.0001). A multivariate analysis was performed to evaluate an association between methylation, age, tobacco exposure, HPV infection and genotyping. A correlation was found concerning methylation with HPV infection (p < 0.0001), hr-HPV (p = 0.01), HSIL (p < 0.0007) and malignant lesions (p < 0.0001). Since viral infection and epigenetic alterations are related to cervical carcinoma, we suggest that P16INK4A methylation profile maybe thoroughly investigated as a biomarker to identify patients at risk of cancer.

Cerclage Cervical na Gravidez

Os autores efectuam uma revisão de 78 cerclages do colo uterino realizadas na Maternidade Dr. Alfredo da Costa, num período de oito anos (1991-1998). A técnica utilizada foi a de Mc Donald, com excepção de um caso em que se utilizou a técnica de Shirodkar. No passado obstétrico destas 78 grávidas houve 181 gravidezes anteriores com uma sobrevida fetal de 17%. Após a cerclage, a sobrevida fetal foi de 83%, com um prolongamento médio da gestação de 17 semanas. O resultado final da gravidez foi de 8% de abortos, 37% partos pré-termo (PPT) e 55% de partos de termo (PT).

Contribuição para a adaptação cultural do Neck Disability Index e caraterização da prática de fisioterapia em pacientes com dor crónica cervical

RESUMO: Objetivo: Este trabalho teve como objetivo contribuir para o processo de adaptação cultural do Neck Disability Index (NDI), através da análise da sua unidimensionalidade e do estudo da sua fiabilidade (consistência interna e fiabilidade teste-reteste), validade de constructo e poder de resposta. De igual forma pretendeu-se caraterizar a intervenção realizada pela fisioterapia e os resultados obtidos em pacientes com Dor Cervical Crónica (DCC). Introdução: A dor cervical é um problema cada vez mais comum nos países industrializados, constituindo uma das três condições mais frequentemente reportadas por queixas de origem músculo-esquelética. A sua incidência é um fenómeno em crescimento, com custos implicados para a sociedade. Desta forma reconhece-se a importância de um instrumento que monitorize a evolução da incapacidade funcional associada à DCC. O NDI é atualmente o instrumento de avaliação mais recomendado para avaliar a incapacidade funcional associada à dor cervical. Foi traduzido e adaptado à língua portuguesa, mas à data não foi realizada nenhuma avaliação das suas propriedades psicométricas. Por outro lado, apesar de a literatura referir que os serviços de Fisioterapia são extremamente procurados por indivíduos com DCC, em Portugal, a informação sobre a sua prática nesta condição clínica é escassa ou mesmo inexistente. Assim, e sendo a incapacidade nas atividades funcionais uma das variáveis de maior impacto da DCC e ao mesmo tempo um dos resultados principais da intervenção da Fisioterapia, importa por um lado possuir instrumentos capazes de avaliar o nível de incapacidade funcional e a sua mudança, e por outro, aferir qual a intervenção realizada pela Fisioterapia e quais os resultados obtidos. Metodologia: Realizou-se um estudo de coorte prospetivo com uma amostra de conveniência, do tipo não probabilístico, constituída por 88 pacientes com DCC de origem músculo-esquelética e causa não traumática referenciados para 6 serviços de fisioterapia / medicina física e de reabilitação de clínicas e centros de reabilitação, sendo elegíveis todos os pacientes que cumprissem os critérios de inclusão e exclusão estabelecidos. Os pacientes foram avaliados em três momentos pré-definidos: antes do início das sessões de fisioterapia ou na 1ª semana de tratamento; 4 a 7 dias após a 1ª avaliação; e 7 semanas após o início da fisioterapia. Para verificação da unidimensionalidade do NDI, procedeu-se a uma Análise Fatorial Exploratória. As propriedades psicométricas do NDI avaliadas foram a Fiabilidade (consistência interna e fiabilidade teste-reteste), a Validade de Constructo e o Poder de Resposta. Posteriormente procedeu-se à caraterização da prática da fisioterapia quanto às modalidades utilizadas, número de sessões de tratamento e duração do episódio de cuidados. Adicionalmente descreveu-se os resultados obtidos após a intervenção da fisioterapia ao nível da dor e incapacidade. Resultados: os resultados obtidos foram positivos e significativos, com a confirmação da unidimensionalidade do NDI, sendo que em todos os critérios seguidos o fator mínimo retido foi de um. Na avaliação da consistência interna o valor obtido foi acima do mínimo aceitável (α Cronbach = 0,77), enquanto o valor de fiabilidade teste-reteste foi elevado (CCI =0,95). De igual forma, os resultados foram positivos para a validade de constructo, obtendo-se uma associação positiva do NDI com a Escala Numérica da dor (END). O valores de poder de resposta reportaram uma Área Abaixo da Curva de 0,63 (IC 95%=0,51-0,75), com valor de Diferença Mínima Clinicamente importante de 5,5 pontos (sensibilidade = 69,6%; especificidade = 43,6%). Relativamente á intervenção de fisioterapia em casos de DCC verificou-se que as características da prática da fisioterapia reportadas neste relatório são de difícil comparação ou análise dada a escassez ou inexistência de trabalhos publicados sobre este assunto em pacientes com DCC. No entanto, neste estudo, encontraram-se reduções significativas na intensidade da dor e incapacidade funcional após a intervenção de fisioterapia (z= -7,16; p<0,001 e t= 10,412, p<0,05, respetivamente). Conclusão: Os resultados do presente estudo revelam que o NDI-VP possui uma boa Fiabilidade, Validade de Constructo e Poder de Resposta. Revela ainda que a intervenção da fisioterapia em casos de DCC, apesar da escassez de trabalhos publicados, proporciona uma redução significativa dos níveis de dor e incapacidade em pacientes com DCC.--------------- ABSTRACT:Objective: the aim of this study was to contribute for the process of cultural adaption of the Neck Disability Index (NDI), through the analysis of his unidimensionality and the study of his reliability (internal consistency and test-retest reliability), construct validity and responsiveness. At the same time it pretends to characterize the intervention performed by physical therapy and the results in patients with Chronic Neck Pain (CNP). Introduction: neck pain is a common problem in the industrialized countries, since is one of the three most reported conditions by complaints with musculoskeletal origin. His incidence is a growth phenomena that implicate great costs to society. Therefore the importance of an instrument that monitories the evolution of the functional disability associated to CNP is recognized. Nowadays, NDI is the instrument most recommended to evaluate functional disability associated to neck pain. It has been translated and adapted to portuguese but, till now, no evaluation of his psychometric proprieties has been completed. In the other hand, despite literature refers that physical therapy services are extremely searched by patients with neck pain, in Portugal, the information about practice in this clinical condition is very few or inexistent. Therefore, and since disability in the functional activities is one of the variables with most impact of CNP and, at the same time, one of the main results of physical therapy interventions, it’s important to have instruments capable of evaluate the level of functional disability and his change, and also calculate which intervention of physical therapy is most appropriate and his results. Methodology: it was used a prospective cohort study with a convenience sample, non-probabilistic, consisting of 88 patients with CNP of musculoskeletal origin and non-traumatic cause, referred to 6 physical therapy services of clinics and rehabilitation centers, and fulfilled the inclusion and exclusion criteria established. Patients were evaluated in three pre-defined moments: before the beginning of physical therapy or during the first week of treatment; 4 to 7 days after the first evaluation; and 7 weeks after beginning of physical therapy. To verify NDI unidimensionality, we run an Exploratory Factorial Analysis. NDI psychometric proprieties evaluated were reliability (internal consistency and test-retest reliability), construct validity and responsiveness. Subsequently, it was proceeded the characterization the practice of physical therapy regarding to the modalities used, the number of treatment sessions and duration of the episode of care. Additionally it was described the results obtained after the intervention of the physical therapy, the level of pain and the disability. Results: results were positive and significant, with the confirmation of the NDI unidimensionality, since in every followed criteria the minimal retained factor was one. In the evaluation of internal consistency the value was above the minimal accepted (α Cronbach = 0,77), and the test-retest reliability value was high (CCI =0,95). Results were positive to construct validity, with an positive association of the NDI with Numeric Rating Scale (NRS). Responsiveness values reported an Area Under Curve (AUC) of 0,63 (IC 95%=0,51-0,75) with a Minimal Important Detectable Change (MIDC) of 5,5 points (sensitivity = 69,9%; specificity = 43,6%). Regarding physical therapy interventions in CNP, it was verified that the physical therapy characteristics reported are difficult to compare or analyze since there are very few published studies about this topic. However, in this study, significant reductions were founded in pain intensity and functional disability after intervention(z= -7,16; p<0,001 and t= 10,412, p<0,05, respectively).Conclusion: present study results reveals that NDI has an good reliability, construct validity and responsiveness. It also reveals that physical therapy intervention in CNP, beside few studies published, result in a significant reduction of pain and disability levels in patients with CNP.

Linfonodo pulmonar na paracoccidioidomicose aguda infantil (relato de um caso)

Observou-se a evolução de um linfonodo pulmonar na paracoccidioidomicose (PCM) aguda infantil. Doente, masculino, 6 anos, branco, natural de Curitiba (PR), procedente de Guaratinguetá (SP), que há 3 meses desenvolveu quadro gripal, febre diária, bimodal, prolongada, precedida de calafrio, acompanhada de sudorese inodora, cefaléia frontal e anorexia. Diagnosticado e tratado como pneumonia por cinco dias, sem melhora do quadro. Há 2 meses, apresentou dor óssea nos braços e articulações do pé, com edema inflamatório e emagrecimento de 6 kg em 3 meses. Exame físico revelou: peso 20 kg; estatura 120 cm; P. A. 90/60 mmHg; facies atípica, hipoativo, palidez cutâneo-mucosa (+ +), hipotrofia muscular, adenopatiageneralizada, sopro sistólico suave em foco aórtico acessório e hepatesplenomegalia. Imunodifusão com exoantígeno glicoprotéico 43 kdpositiva (1/32). A biópsia de gânglio revelou Paracoccidioides brasiliensis. A radiologia demonstrou na primeira consulta, discreto infiltrado intersticial bilateral com linfoadenomegaliapara-hilar que desaparecu em 30 dias. Observou- se, ainda, massa tumoral mediastínica superior, hiperplasia do sistema fagocítico mononuclear e lesões osteolíticas nos 60 dias iniciais da evolução.

Analysis of molecular biology techniques for the diagnosis of human papillomavirus infection and cervical cancer prevention

The objective of the present study was to evaluate the usefulness of molecular methodologies to access human papillomavirus genome in the genital tract. Samples from 136 women aged 17 to 52 years old obtained from the Dr. Sérgio Franco Laboratories between 2000 and 2001, were analyzed by the hybrid capture assay and amplified by PCR with generic primers MY09/MY11 and specific primers for types 16, 18, 31, 33, 35, 58. Viral genome was detected in 71.3% of the samples by hybrid capture and 75% by amplification. When cytopathology was used as a reference method for screening lesions, hybrid capture (p=0) and amplification (p=0.002) presented positive association. The 3 methods showed absolute agreement when cytopathology confirmed papillomavirus infection and high grade intraepithelial lesion. Disagreements occurred for 10 cases: seven inflammatory cases positive by PCR and negative for hybrid capture and 3 low squamous intraepithelial lesions positive for hybrid capture but negative for amplification. In conclusion, hybrid capture was shown to be sensitive and specific enough for use in clinical routines. Moreover, the evaluation of viral load values obtained by this method were shown to be related to the severity of the lesion and merit further studies to analyze the possible association with risk of progression to malignancy.

Febre do viajante associada com adenite cervical e sororreatividade para Bartonella sp em paciente brasileira, após retorno da África do Sul

Um grande número de viajantes visita anualmente, por estudo, turismo ou trabalho o continente africano. Um caso de adenomegalia cervical e hepatoesplenomegalia associado à febre de duas semanas de duração com teste sorológico positivo para Bartonella sp em uma paciente de 22 anos do sexo feminino que retornou da África do Sul após realização de trabalho de campo com primatas em área silvestre é apresentado.

S100, CD68, and MHC class II molecule expression in cervical high- and low-grade HPV-induced lesions

INTRODUCTION: Some human papillomavirus (HPV) types are involved in malignant processes in the cervical epithelium, with 99% of cases attributed to oncogenic HPV infection. This study aimed to detect S100, CD68, and major histocompatibility complex class II (MHC-II) molecules in cervical uterine epithelial samples in patients with high- and low-grade lesions induced by HPV. METHODS: Fifty-eight samples from patients who were confirmed positive or negative for high-risk oncogenic HPV DNA, had histopathological diagnosis of cervical intraepithelial neoplasia (CIN) of grades I, II, or III, or were negative for intraepithelial lesion or malignancy were subjected to immunohistochemistry reaction to S100 protein, CD68, and MHC-II (HLA-DR alpha chain). RESULTS: The presence of MHC-II predominated in samples exhibiting histopathological alterations (p < 0.05). S100 detection was more numerous in carcinoma samples (CIN III) (75%). Presence of this protein correlated significantly (p < 0.05) with histopathological findings and viral load. CONCLUSIONS: A small expression of CD68 was observed, which may be explained by the observation in our study having been made on random microscopic fields and not on specific areas. The findings, such as the presence of S100 protein and MHC-II expression in samples with histological alterations, could suggest that the immune system fails to control HPV replication at the early stages of infection. Further studies with larger prospective data are necessary to confirm this result.

Fatores de prognóstico para os resultados de sucesso da fisioterapia multimodal em utentes com dor cervical crónica

RESUMO: Introdução: O conhecimento acerca da influência das características dos indivíduos com dor cervical crónica (DCC) no prognóstico dos resultados alcançados com a Fisioterapia é ainda inconsistente, sendo escassos os estudos desenvolvidos neste âmbito. Objetivo: Este relatório pretende determinar se um modelo baseado em fatores de prognóstico é capaz de prever os resultados de sucesso da Fisioterapia, a curto prazo, em utentes com DCC, ao nível da incapacidade funcional, intensidade da dor e perceção global de melhoria. Metodologia: Trata-se de estudo de coorte prospetivo com 112 participantes. Os utentes foram avaliados na primeira semana de tratamento e sete semanas após o início da intervenção. Os instrumentos utilizados foram o Neck Disability Index–Versão Portuguesa (NDI-PT) e a Escala Numérica da Dor (END) nos dois momentos de avaliação, um Questionário de Caracterização Sociodemográfica e Clínica da Amostra na baseline e a Patient Global Impression Change Scale–Versão Portuguesa (PGIC-PT) no follow-up. As características sociodemográficas e clínicas foram incluídas como potenciais fatores de prognóstico e estes foram definidos com base nas diferenças mínimas clinicamente importantes (DMCI) dos instrumentos NDIPT (DMCI≥6) e END (DMCI≥2) e no critério de pontuação ≥5 na PGIC-PT. A análise dos dados foi realizada através do método de regressão logística (backward conditional procedure) para identificar as associações entre os indicadores e as variáveis de resultado (p<0.05). Resultados: Dos 112 participantes incluídos no estudo, 108 completaram o follow-up (média de idade: 51.76±10.19). No modelo multivariado relativo à incapacidade funcional, os resultados de sucesso encontram-se associados a elevados níveis de incapacidade na baseline (OR=1.123; 95% IC 1.056–1.194) e a duração da dor inferior a 12 meses (OR=2.704; 95% IC 1.138–6.424). Este modelo explica 30.0% da variância da melhoria da funcionalidade e classifica corretamente 74.1% dos utentes (sensibilidade: 75.9%; especificidade: 72.0%). O modelo relativo à intensidade da dor identificou apenas a associação do outcome com níveis elevados de intensidade da dor na baseline (OR=1.321; 95% IC 1.047–1.668), explicando 7.5% da variância da redução da mesma e classificando corretamente 68.2% dos utentes (sensibilidade: 94.4%; especificidade: 16.7%). O modelo final referente à perceção global de melhoria apresentou uma associação com a intensidade da dor na baseline (OR=0.621; 95% IC 0.465–0.829), com a presença de cefaleias e/ou tonturas (OR=2.538; 95% IC 0.987–6.526) e com a duração da dor superior a 12 meses (OR=0.279; 95% IC 0.109–0.719). Este modelo explica 27.5% da variância dos resultados de sucesso para este outcome e classifica corretamente 73.1% dos utentes (sensibilidade: 81.8%; especificidade: 59.5%). Conclusões: Utentes com DCC com elevada incapacidade na baseline e queixas de dor há menos de 12 meses apresentam maior probabilidade de obter melhorias ao nível da incapacidade funcional. Elevados níveis de intensidade da dor na baseline predizem resultados de sucesso na redução da dor após sete semanas de tratamento. Utentes com DCC com baixos níveis de dor na baseline, com cefaleias e/ou tonturas e com queixas de dor há mais de 12 meses apresentam maior probabilidade de obter uma melhor perceção de melhoria.--------------- ABSTRACT:Introduction: The influence of the characteristics of individuals with chronic neck pain (CNP) on the prognosis of physiotherapy outcomes is still inconsistent, there being few studies developed in this context. Aim: This study seeks to determine whether a model based on prognostic factors can predict the short-term physiotherapy successful outcomes in CNP patients, regarding functional disability, pain intensity and perceived recovery. Methodology: This is a prospective cohort study with 112 participants. Patients were assessed during the first week of treatment and seven weeks after the start of the intervention. The instruments used were the Neck Disability Index–Portuguese Version (NDI-PT) and the Numerical Rating Scale (NRS) at both moments of assessment, a Sample Sociodemographic and Clinical Characterization Questionnaire at baseline and Patient Global Impression Change Scale–Portuguese Version (PGIC-PT) at the follow-up. The sociodemographic and clinical characteristics were included as potential predictors of successful outcomes, and these were defined on the basis of minimal clinically important differences (MCID) of NDI-PT (MCID≥6) and END (MCID≥2) and the criteria score ≥5 on the PGIC-PT. Data analysis was performed using logistic regression (backward conditional procedure) to identify associations between predictors and outcomes (p<0.05). Results: Of the 112 participants included in the study, 108 completed the follow-up (mean age: 51.76±10.19). In the multivariate model of functional disability, the successful outcomes are associated with high levels of disability at baseline (OR = 1.123; 95% CI 1.056-1.194), and pain duration shorter than 12 months (OR=2.704; 95% CI 1.138–6.424). This model explains 30.0% of the variance of improved functional capacity and correctly classifies 74.1% of the patients (sensitivity: 75.9%, specificity: 72.0%). The model for pain intensity solely identified an outcome association with high pain intensity at baseline (OR=1.321; 95% CI 1.047-1.668), explaining 7.5% of the variance of pain reduction and correctly classifying 68.2% of the patients (sensitivity: 94.4%, specificity: 16.7%). The final model of perceived recovery showed an association with pain intensity at baseline (OR=0.621; 95% CI 0465-0829), with the presence of headache and/or dizziness (OR=2.538; 95% CI 0.987-6.526) and the duration of pain over 12 months (OR=0.279; 95% CI 0.109-0.719). This model explains 27.5% of the variance of successful outcomes and correctly classifies 73.1% of the patients (sensitivity: 81.8%, specificity: 59.5%). Conclusions: Patients with CNP with high disability at baseline and complaints of pain for less than 12 months are more likely to obtain improvements in functional disability. High levels of pain intensity at baseline predict successful outcomes in pain reduction after seven weeks of treatment. Patients with CNP with low levels of pain at baseline, with headache and/or dizziness and with pain complaints for more than 12 months are more likely to get a better perceived recovery.