Janaina Coser

Prevalence and genotypic diversity of cervical human papillomavirus infection among women from an urban center in Brazil.

Human papillomavirus (HPV) infection is a common viral sexually transmitted infection and the main cause of cervical cancer in women worldwide. Epidemiological data on the prevalence of HPV in a given population is essential for the establishment of effective prevention strategies. The aim of this study was to determine HPV prevalence in women who attended a public health service within an urban center in Brazil. Cervical samples were collected from 337 women recruited from a primary public health care clinic in the city of Cruz Alta located in Rio Grande do Sul, the southernmost State of Brazil. Samples were analyzed for HPV DNA and with Pap smear screening tests. HPV was detected in 114 (34%) women. HPV type analysis revealed that 95 (83.3%) of those represented infections with a single genotype, while 19 (16.7%) were mixed genotype infections. High- and low-risk HPV genotypes were detected in 83 (72.8%) and 48 (42.1%) samples, respectively. Furthermore, a great diversity of HPV genotypes was observed (18 high-risk, 12 low-risk, and 1 indeterminate). The most commonly identified low-risk types were candHPV62 (7.9%) and 61 (5.3%), while the most common high-risk types were 16 and 33 (8.8% each). Abnormal cytology was observed in 10 (3.0%) women, 9 of which were infected with HPV. Of the remaining 327 women with normal cytology results, 107 (32.7%) were positive for HPV DNA. HPV infection was correlated with younger age (less than 40 years), a first Pap smear, and other vaginal infections.

Cervical human papillomavirus infection and persistence: a clinic-based study in the countryside from South Brazil

Human papillomavirus (HPV) infection is common in sexually active women and viral persistence may cause intraepithelial lesions and eventually progress to cervical cancer (CC). The present study aimed to investigate epidemiological factors related to HPV infection and to evaluate viral persistence and CC precursor lesions frequencies in women from a city in the countryside of South Brazil. Three hundred women were recruited from a primary public health care clinic. The patients were interviewed and underwent sampling with cervical brushes for HPV-DNA detection/typing by a PCR-based assay and cytological analysis by Pap smear test. HPV was detected in 47 (15.7%) women. HPV infection was significantly associated with young age (<30 years) and low socio-economic status. Seventeen (5.7%) women presented cytological abnormalities, three of them with precursor CC intraepithelial lesions. A subgroup of 79 women had been previously analyzed and thirteen (16.4%) were persistently infected, two with precursor CC intraepithelial lesions and high-risk HPV types infection (both of them without cervical abnormalities in the first exam). In conclusion, HPV infection was associated with young age (<30 years) and low family income; viral persistence was low (16.4%) but related to CC precursor lesions; and HPV-DNA high risk types detection would help to screen CC in the population.

Relação entre os achados da inspeção visual e o exame citológico do colo do útero

Introduction: The main strategy for the control and screening of cervical cancer (CCU) is cytopathological examination. Objective: To describe the cytological result, relating it to the information of the visual inspection of the cervix. Methodology: Cytological samples collected from women attended at the Primary Health Care were analyzed by the Papanicolaou method. Results: 34 women, aged 19-67 years, participated in the study. Of these, 8.28% were representative of JEC cells; 7.14% presented pathogenic agents and reactive inflammatory changes. One woman, whose cervix was identified as “altered” in the exam requisition, presented a suggestive result of ASC-US. For another woman, with a LSIL cytologic result, the cervix was identified as “normal” in the examination request. Conclusion: This study demonstrates that observation of the visual aspects of the cervix during visual inspection of the pap smear is an important tool for screening the CCU.

Polymorphisms in Genes Related to Cervical Cancer in A Brazilian Population: A Case-Control Study

To the editor: Cervical cancer (CC) is the fourth most common cancer in women, with approximately 528,000 new cases in the world each year, 80% of them in developing countries [1]. It is well recognized that persistent infection of human papillomavirus (HPV) is the main cause of precursor lesions that progress to CC, but only a small proportion of these HPV infected women develop the disease. In this sense, polymorphisms in human genes have also been associated with CC [2]. Genome-wide studies investigated the association of human single nucleotide polymorphisms (SNPs) with HPV persistent infection, progression to cervical intraepithelial neoplasia (CIN) and CC in Latin American women [3, 4]. More than seven thousand SNPs were investigated in genes related to immune response, DNA repair, viral replication and entry into the host cell. Association to persistent HPV progression to CIN and CC was observed with SNPs in genes of DNA repair (EXO1, CYBA, FANCA, XRCC1, GTF2H4, DUT, FLJ35220, and DMC1), immune response (IRF) and virus entry into the cell (SULF1 and OAS3) [3, 4]. The present case-control study evaluated the frequency of nine SNPs (all of them previously demonstrated to have significant association with HPV persistence and/or cancer) and the association with CC in a population in South Brazil. The selected SNPs were located in genes of DNA repair (rs4149963 in EXO1, rs3784621 in DUT, rs4603608 in FLJ35220 and rs2239359 in FANCA), immune response (rs7251 in the IRF), and virus entry into the host cell (rs4737999, rs10108002, rs4284050 in SULF1, and rs12302655 in OAS3). The population sample of this study was 109 CC patients (mean age 50.3 ± 14.3 years; range 25–88 years), recruited during treatment at the Center of High Complexity in Oncology (Centro de Assistência de Alta Complexidade em Oncologia CACON), located in the city of Ijuí in the Brazil’s southernmost state (Rio Grande do Sul), from 2012 to 2016; and 220 controls (mean 49.5 ± 13.2 years; range 21–82 years) recruited at the Women’s Health Center (Centro de Saúde da Mulher), a primary public health care clinic located in the city of Cruz Alta (also in Rio Grande do Sul State, Brazil) from 2012 to 2013. This last women group was previously characterized in cross-sectional epidemiological study [5]. Biological samples were obtained from the mouth in the CC patients (cases) and from the endocervix in the healthy controls. Buccal and endocervical cells were obtained by exfoliation using cytobrush and after stored in a buffer solution (EDTA pH = 8.0 0.01 M, SDS 0.03 M) at −20 °C until analysis. Total DNA was extracted from peripheral blood cells by silica adsorption method. EXO1 (rs4149963), DUT (rs3784621), FLJ35220 (rs4603608), FANCA (rs2239359), IRF3 (rs7251), SULF1 (rs4737999, rs10108002 and rs4284050) and OAS3 (rs12302655) SNPs were genotyped using TaqMan® specific SNP genotyping assays (Life Technologies Co, Carlsbab, CA, USA). Allelic discrimination real-time polymerase chain reactions (PCR) were performed on the StepOnePlusTM system according to conditions informed by this manufacturer. Thermal cycling conditions were: 10 min at 95 °C followed by 45 cycles of 15 s at 95 °C and 1 min at 60 °C. Allelic discrimination was performed by measuring end-point fluorescence using * Jonas Michel Wolf jonasmwolf@gmail.com

In vitro Assessment of the Antioxidant Effect of Cunila microcephala Benth Infusion (Poejo) on Erythrocytes from Individuals with HIV/AIDS

The aim of the present study is to investigate in vitro antioxidant activity of Cunila microcephala Benth infusion (Poejo) in erythrocytes from individuals with HIV/AIDS. Erythrocytes were used from seventeen patients of both sexes, with HIV/AIDS, receiving antiretroviral therapy and the control group consisted of erythrocytes of HIV/AIDS free individuals belonging to both sexes. The erythrocytes were treated in vitro for an hour with infusions of Poejo at the following concentrations: 1, 5, 10, 25 and 50 g/L After treatment, the levels of thiobarbituric acid reactive substances (TBARS), carbonylated proteins (CPs), and reduced glutathione (GSH) were measured. A reduction in lipoperoxidation and protein carbonylation was observed after treatment with poejo tea at the concentrations of 5, 10, 25 and 50g/L. In addition, a reduction of GSH at such concentrations was observed. Poejo infusion appears to perform an antioxidant activity in lipid oxidation and in the protein carbonylation found in individuals with HIV/AIDS.

Lesão anal por papilomavírus humano em mulher vivendo com HIV/aids

*** Anal lesion caused by human papillomavirus in a woman living with HIV/AIDS *** AIMS: To describe a case of anal lesion caused by human papillomavirus (HPV) infection in a woman living with HIV/AIDS. CASE DESCRIPTION: A 35-year-old woman, diagnosed with HIV five years ago, reported pruritus ani, anal bleeding, painful defecation, and presence of small warts in the perianal region. The patient was seen at a specialized care center and was subjected to clinical examination with visual inspection, which revealed perianal condyloma. Histopathological examination confirmed the presence of moderate to severe dysplasia associated with HPV-compatible changes. The anal lesion was excised. At the onset of the symptoms, the patient was not on antiretroviral therapy and her HIV viral load was at its highest (2,951 copies/mL) compared with her previous laboratory tests. She had gone through emotional stress and presented with recurrent genital herpes simplex virus infections. These factors may have predisposed her to the development of anal condyloma. CONCLUSIONS: Since HIV infection may alter the history of HPV infection, it is important that screening strategies include cytological analysis of both the cervix and the anal region.

Malnutrition risk and hospitalization in elderly assisted in Primary Care

Abstract The aim of this study was to investigate the association of malnutrition risk and single items of the Mini Nutritional Assessment (MNA®) with hospitalization in the last 12 months in the elderly assisted in primary care. A cross-sectional study was conducted with the evaluation of 1229 elderly persons assisted in Family Health Strategies in seven cities of South Brazil. Malnutrition risk was evaluated using the MNA®, and hospitalization was determined by one question of the Probability of Repeated Admission (PRA) instrument. Most of the elderly were women (61.7%), with a mean age of 71.7 ± 7.7 years. The malnutrition risk rate was 23.3% and hospitalization was 32.9%. The frequency of malnutrition and risk of malnutrition was two times greater among the elderly who were hospitalized (36.8 versus 18.6% - P < 0.001). There was a significant association between hospitalization and 11 (64.7%) of the 17 items on the MNA® evaluated (P < 0.05). Of these, seven items were independently associated with hospitalization by multivariate analysis. We observed an association of malnutrition risk and most of the single MNA® items as well, with hospitalization in the elderly assisted in primary care.

NÍVEL DE ATIVIDADE FÍSICA E RISCO DE QUEDAS EM IDOSOS DA COMUNIDADE

A proposta deste estudo foi verificar a associacao entre o risco de quedas de 127 idosos da comunidade e o nivel de atividade fisica. O risco de quedas foi avaliado atraves dos instrumentos Fall Risk Score de Downton , teste Timed Up and Go (TUG) e o Teste de Alcance Funcional (TAF) e o nivel de atividade fisica utilizando o Questionario Internacional de Atividade Fisica ( IPAQ ) versao curta. A maioria dos idosos entrevistados (88,7%) foram classificados como ativos ou muito ativos e sem risco de quedas (TUG 89,8%, TAF 97,6%, Downton 64,5%). A relacao entre o nivel de atividade fisica e risco de quedas atraves dos testes TUG e Downton mostrou-se significativa, estando os idosos mais ativos com menor risco de quedas e todos os instrumentos que avaliaram este risco apresentaram associacao significativa entre si demonstrando que a atividade fisica pode reduzir o risco de quedas, minimizando perdas funcionais do envelhecimento. Descritores: Envelhecimento; Fatores de Risco; Acidentes por Quedas; Estilo de Vida.