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1.
Viruses ; 16(2)2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38400049

RESUMO

Dengue virus (DENV) is a prominent arbovirus with global spread, causing approximately 390 million infections each year. In Brazil, yearly epidemics follow a well-documented pattern of serotype replacement every three to four years on average. Araraquara, located in the state of São Paulo, has faced significant impacts from DENV epidemics since the emergence of DENV-1 in 2010. The municipality then transitioned from low to moderate endemicity in less than 10 years. Yet, there remains an insufficient understanding of virus circulation dynamics, particularly concerning DENV-1, in the region, as well as the genetic characteristics of the virus. To address this, we sequenced 37 complete or partial DENV-1 genomes sampled from 2015 to 2022 in Araraquara. Then, using also Brazilian and worldwide DENV-1 sequences we reconstructed the evolutionary history of DENV-1 in Araraquara and estimated the time to the most recent common ancestor (tMRCA) for serotype 1, for genotype V and its main lineages. Within the last ten years, there have been at least three introductions of genotype V in Araraquara, distributed in two main lineages (L Ia and L Ib, and L II). The tMRCA for the first sampled lineage (2015/2016 epidemics) was approximately 15 years ago (in 2008). Crucially, our analysis challenges existing assumptions regarding the emergence time of the DENV-1 genotypes, suggesting that genotype V might have diverged more recently than previously described. The presence of the two lineages of genotype V in the municipality might have contributed to the extended persistence of DENV-1 in the region.


Assuntos
Vírus da Dengue , Dengue , Humanos , Filogenia , Vírus da Dengue/genética , Dengue/epidemiologia , Brasil/epidemiologia , Genótipo
2.
Am J Trop Med Hyg ; 110(2): 228-233, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38109765

RESUMO

In situ and systemic evaluations of the immune responses of HIV-infected patients to mucosal leishmaniasis have been poorly described. We describe a recently diagnosed HIV-infected patient with mucosal leishmaniasis who was characterized by a CD4 count of 85 cells/mm3 and nasal septum destruction resulting from pruritic and ulcerated nasal mucosa with crust formation and progression over 2 years. In situ and systemic immune evaluations of T cell activation, memory, and exhaustion were conducted using cytofluorometric assays, and sequencing of the Leishmania species was performed. The immune profile of HIV-infected patient with mucosal leishmaniasis shows a mixed Th1/Th2 pattern and an activated and exhausted status.


Assuntos
Infecções por HIV , Leishmania , Leishmaniose Mucocutânea , Humanos , Leishmaniose Mucocutânea/diagnóstico , Leishmaniose Mucocutânea/tratamento farmacológico , Contagem de Linfócito CD4 , Imunidade , Infecções por HIV/complicações
3.
Curr Probl Cancer ; 47(4): 100996, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37467541

RESUMO

Gynecological and breast cancers affect women's health worldwide. Although chemotherapy is one of the principal treatments for cancer, it also has limitations owing to toxicity and tumor resistance to the drugs used. Thus, individualized treatment based on personal tumor characteristics is essential for improving therapeutic outcomes and patient survival. Chemoresistance and chemosensitivity tests can be useful for predicting tumor response and guiding chemotherapy choices. This methodology has already been applied to breast, ovarian, cervical, and endometrial cancers, identifying successfully which drugs cause resistance and sensitivity responses for each individual person, influencing their progression-free survival and overall response. In addition, more recent techniques, such as organoids and patient-derived xenografts, can also recapitulate patients' tumor characteristics and contribute to chemo response evaluation. Therefore, this review compiles information on chemoresistance and chemosensitivity tests performed in gynecologic and breast cancers and their main results for women's health improvement.


Assuntos
Neoplasias da Mama , Neoplasias do Endométrio , Ginecologia , Humanos , Feminino , Neoplasias da Mama/tratamento farmacológico , Resistencia a Medicamentos Antineoplásicos , Mama
4.
Rev Bras Ginecol Obstet ; 45(5): 235-241, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37339642

RESUMO

OBJECTIVE: To evaluate the accuracy and patient acceptability toward self-sampling using a new device - SelfCervix® - for detecting HPV-DNA. METHODS: A total of 73 women aged 25-65 who underwent regular cervical cancer screening from March to October 2016 were included. Women performed self-sampling followed by a physician-sampling, and the samples were analyzed for HPV-DNA. After that, patients were surveyed about their acceptability of self-sampling. RESULTS: HPV-DNA detection rate of self-sampling presented high accuracy and was similar to physician-collection. Sixty-four (87.7%) patients answered the acceptability survey. Most patients (89%) considered the self-sampling comfortable, and 82.5% preferred self-sampling to physician-sampling. The reasons cited were time-saving and convenience. Fifty-one (79.7%) reported that they would recommend self-sampling. CONCLUSION: Self-sampling using the new Brazilian device SelfCervix® is not inferior in HPV-DNA detection rate compared with physician-collection, and patients are supportive of the method. Therefore, it might be an option to reach under-screened populations in Brazil.


OBJETIVO: Avaliar a acurácia e aceitabilidade da auto-coleta utilizando um novo coletor - SelfCervix® - para a detecção de DNA de HPV. MéTODOS: Foram incluídas no estudo 73 mulheres com idade entre 25­65 anos que realizaram seu rastreamento regular do câncer de colo do útero entre Março e Outubro de 2016. Estas mulheres realizaram a auto-coleta, seguida de coleta profissional e as amostras foram analisadas para a presença de DNA de HPV. Após, elas responderam um questionário sobre a experiência da auto-coleta. RESULTADOS: As taxas de detecção de DNA de HPV por auto-coleta foram altas e similares as da coleta profissional. Sessenta e quatro (87,7%) pacientes responderam o questionário de experiência. A maioria (89%) considerou a auto-coleta confortável, e 82,5% preferiram o método comparado a coleta profissional. As razões citadas foram economia de tempo e conveniência. Cinquenta e uma (79,7%) mulheres confirmaram que recomendariam a auto-coleta. CONCLUSãO: Auto-coleta utilizando o novo coletor desenvolvido no Brasil não é inferior na detecção de DNA de HPV quando comparada a coleta profissional, e apresenta uma boa aceitabilidade pelas mulheres. Desta maneira, pode ser uma opção para alcançar populações que não realizam o rastreamento padrão.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Brasil , Detecção Precoce de Câncer/métodos , Infecções por Papillomavirus/diagnóstico , Esfregaço Vaginal , Autocuidado , Papillomaviridae , Programas de Rastreamento , Aceitação pelo Paciente de Cuidados de Saúde
5.
Rev. bras. ginecol. obstet ; 45(5): 235-241, May 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1449738

RESUMO

Abstract Objective To evaluate the accuracy and patient acceptability toward self-sampling using a new device - SelfCervix® - for detecting HPV-DNA. Methods A total of 73 women aged 25-65 who underwent regular cervical cancer screening from March to October 2016 were included. Women performed self-sampling followed by a physician-sampling, and the samples were analyzed for HPV-DNA. After that, patients were surveyed about their acceptability of self-sampling. Results HPV-DNA detection rate of self-sampling presented high accuracy and was similar to physician-collection. Sixty-four (87.7%) patients answered the acceptability survey. Most patients (89%) considered the self-sampling comfortable, and 82.5% preferred self-sampling to physician-sampling. The reasons cited were time-saving and convenience. Fifty-one (79.7%) reported that they would recommend self-sampling. Conclusion Self-sampling using the new Brazilian device SelfCervix® is not inferior in HPV-DNA detection rate compared with physician-collection, and patients are supportive of the method. Therefore, it might be an option to reach under-screened populations in Brazil.


Resumo Objetivo Avaliar a acurácia e aceitabilidade da auto-coleta utilizando um novo coletor - SelfCervix® - para a detecção de DNA de HPV. Métodos Foram incluídas no estudo 73 mulheres com idade entre 25-65 anos que realizaram seu rastreamento regular do câncer de colo do útero entre Março e Outubro de 2016. Estas mulheres realizaram a auto-coleta, seguida de coleta profissional e as amostras foram analisadas paraa presença de DNA de HPV. Após, elas responderam um questionário sobre a experiência da auto-coleta. Resultados As taxas de detecção de DNA de HPV por auto-coleta foram altas e similares as da coleta profissional. Sessenta e quatro (87,7%) pacientes responderam o questionário de experiência. A maioria (89%) considerou a auto-coleta confortável, e 82,5% preferiram o método comparado a coleta profissional. As razões citadas foram economia de tempo e conveniência. Cinquenta e uma (79,7%) mulheres confirmaram que recomendariam a auto-coleta. Conclusão Auto-coleta utilizando o novo coletor desenvolvido no Brasil não é inferior na detecção de DNA de HPV quando comparada a coleta profissional, e apresenta uma boa aceitabilidade pelas mulheres. Desta maneira, pode ser uma opção para alcançar populações que não realizam o rastreamento padrão.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Displasia do Colo do Útero , Programas de Rastreamento , Detecção Precoce de Câncer , Papillomaviridae
6.
Rev. Bras. Cancerol. (Online) ; 69(3)jul-set. 2023.
Artigo em Inglês | LILACS, Sec. Est. Saúde SP | ID: biblio-1512597

RESUMO

Introduction: Acute lymphocytic leukemia (ALL) is the most common cancer type in children and accounts for 80% of pediatric leukemias. Novel targets are necessary to improve survival rates for refractory and relapsed disease. There is accumulating evidence that Toll-like Receptor (TLR) signaling may be associated with outcomes in cancer however little has been described in leukemias. Objective: Analyze the expression and contribution of TLRs to the development of childhood ALL. Method: To evaluate the effect of specific TLR2, TLR3, and TLR4 agonists on the viability and proliferation of childhood ALL cell lines and to analyzed the mRNA expression of these types of TLR in bone marrow blast cells at diagnosis (D0) and induction (D35) in pediatric ALL patients. Results: Treatment with TLR agonists reduced the cell viability of Jurkat and Sup-B15 cell lines. Cell cycle distribution in Jurkat was altered, reducing polyploid cells and increasing sub-G1 phase. Conclusion: It was observed that the cell viability of the cell lines responded with different sensitivities to the agonists. The polyploidy associated with tumor malignancy was reduced, in addition to the increase in the sub-G1 phase indicating an increase in apoptosis. There were differences in TLR expression at D35 between groups at risk of the disease. Patients with high expression of TLR2 and low expression of TLR4 on D35 demonstrated a worse prognosis


Introdução: A leucemia linfoblástica aguda (LLA) é o tipo de câncer mais comum em crianças e representa 80% das leucemias pediátricas. Novos alvos são necessários para melhorar as taxas de sobrevivência para doença refratária e recidivante. Há evidências acumuladas de que a sinalização de receptores Toll-Like (TLR) pode estar associada a resultados em câncer, embora pouco tenha sido descrito em leucemias. Objetivo: Analisar a expressão e a contribuição dos TLR para o desenvolvimento da LLA infantil. Método: Avaliar o efeito de agonistas específicos de TLR2, TLR3 e TLR4 na viabilidade e proliferação de linhagens celulares de LLA infantil e analisar a expressão do RNAm desses tipos de TLR em células blásticas da medula óssea no diagnóstico (D0) e na indução (D35) em pacientes LLA pediátricos. Resultados: O tratamento com agonistas de TLR reduziu a viabilidade celular das linhagens celulares Jurkat e Sup-B15. A distribuição do ciclo celular em Jurkat foi alterada, reduzindo as células poliploides e aumentando a fase sub-G1. Houve aumento na expressão dos receptores entre D0 e D35 em amostras de pacientes. Conclusão: Observou-se que a viabilidade celular das linhagens celulares respondeu com diferentes sensibilidades aos agonistas. A poliploidia associada à malignidade tumoral foi reduzida, além de o aumento da fase sub-G1 indicar aumento da apoptose. Houve diferenças na expressão de TLR em D35 entre os grupos de risco da doença. Pacientes com alta expressão de TLR2 e baixa expressão de TLR4 no D35 demonstraram pior prognóstico.


Introducción: La leucemia linfocítica aguda (LLA) es el tipo de cáncer más común en los niños y representa el 80 % de las leucemias pediátricas. Se necesitan nuevos objetivos para mejorar las tasas de supervivencia de la enfermedad refractaria y recidivante. Cada vez hay más pruebas de que la señalización del receptor Toll-Like (TLR) puede estar asociada con resultados en el cáncer, aunque se ha descrito poco en las leucemias. Objetivo: Analizar la expresión y la contribución de los TLR al desarrollo de la LLA infantil. Método: Evaluar el efecto de agonistas específicos de TLR2, TLR3 y TLR4 en la viabilidad y proliferación de líneas celulares de LLA infantil y analizar la expresión de ARNm de estos tipos de TLR en células blásticas de médula ósea en el momento del diagnóstico (D0) y la inducción (D35) en pacientes pediátricos con LLA. Resultados: El tratamiento con agonistas de TLR redujo la viabilidad celular de las líneas celulares Jurkat y sup-B15. Se alteró la distribución del ciclo celular en Jurkat, reduciendo las células poliploides y aumentando la fase sub-G1. Hubo un aumento en la expresión de los receptores entre D0 y D35 en muestras de pacientes. Conclusión: Se observó que la viabilidad celular de las líneas celulares respondía con distintas sensibilidades a los agonistas. Se redujo la poliploidía asociada con la malignidad del tumor, además de un aumento de la fase sub-G1 que indica un aumento de la apoptosis. Hubo diferencias en la expresión de TLR en D35 entre los grupos de riesgo de enfermedad. Los pacientes con alta expresión de TLR2 y baja expresión de TLR4 en D35 mostraron peor pronóstico


Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras B , Receptores Toll-Like , Linfoma
7.
Am J Trop Med Hyg ; 107(4): 785-788, 2022 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-36067991

RESUMO

The immunosuppressive effect of methotrexate has rarely been associated with reactivation of cutaneous leishmaniasis. Here we present a case of a cutaneous leishmaniasis patient with atypical clinical symptoms without splenomegaly but with cutaneous manifestations after treatment of rheumatoid arthritis with methotrexate and blood recovery of the parasite. Next-generation sequencing was used to identify Leishmania infantum chagasi in the patient's blood sample.


Assuntos
Artrite Reumatoide , Leishmania infantum , Leishmaniose Cutânea , Leishmaniose Visceral , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Humanos , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/parasitologia , Leishmaniose Visceral/tratamento farmacológico , Metotrexato/efeitos adversos
8.
Artigo em Inglês | MEDLINE | ID: mdl-36074449

RESUMO

In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.


Assuntos
Mpox , Infecções Sexualmente Transmissíveis , Adulto , Animais , Brasil , Diagnóstico Diferencial , Surtos de Doenças , Humanos , Masculino , Mpox/diagnóstico , Mpox/epidemiologia , Mpox/patologia , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia
10.
Travel Med Infect Dis ; 48: 102351, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35537676

RESUMO

BACKGROUND: Only two naturally occurring human Sabiá virus (SABV) infections have been reported, and those occurred over 20 years ago. METHODS: We diagnosed two new cases of SABV infection using metagenomics in patients thought to have severe yellow fever and described new features of histopathological findings. RESULTS: We characterized clinical manifestations, histopathology and analyzed possible nosocomial transmission. Patients presented with hepatitis, bleeding, neurological alterations and died. We traced twenty-nine hospital contacts and evaluated them clinically and by RT-PCR and neutralizing antibodies. Autopsies uncovered unique features on electron microscopy, such as hepatocyte "pinewood knot" lesions. Although previous reports with similar New-World arenavirus had nosocomial transmission, our data did not find any case in contact tracing. CONCLUSIONS: Although an apparent by rare, Brazilian mammarenavirus infection is an etiology for acute hemorrhagic fever syndrome. The two fatal cases had peculiar histopathological findings not previously described. The virological diagnosis was possible only by contemporary techniques such as metagenomic assays. We found no subsequent infections when we used serological and molecular tests to evaluate close contacts.


Assuntos
Arenavirus do Novo Mundo , Infecção Hospitalar , Febre Amarela , Anticorpos Neutralizantes , Brasil/epidemiologia , Humanos
11.
Mol Cell Probes ; 61: 101791, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35051596

RESUMO

Leishmaniasis is a major public health problem worldwide. Although next generation sequencing technology has been widely used in the diagnosis of infectious diseases, it has been scarcely applied in identification of Leishmania species. The aim of this study was to compare the efficiency of MinION™ nanopore sequencing and polymerase chain reaction restriction fragment length polymorphism in identifying Leishmania species. Our results showed that the MinION™ sequencer was able to discriminate reference strains and clinical samples with high sensitivity in a cost and time effective manner without the prior need for culture.


Assuntos
Leishmania , Leishmaniose Cutânea , DNA de Protozoário , Proteínas de Choque Térmico HSP70/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Leishmania/genética , Leishmaniose Cutânea/diagnóstico , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição
12.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1406880

RESUMO

ABSTRACT In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.

14.
J Mol Neurosci ; 68(1): 49-57, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30887411

RESUMO

Changes in expression of histone deacetylases (HDACs), which epigenetically regulate chromatin structure, and mutations and amplifications of the EGFR gene, which codes for the epidermal growth factor receptor (EGFR), have been reported in glioblastoma (GBM), the most common and malignant type of brain tumor. There are likely interplays between HDACs and EGFR in promoting GBM progression, and HDAC inhibition can cooperate with EGFR blockade in reducing the growth of lung cancer cells. Here, we found that either HDAC or EGFR inhibitors dose-dependently reduced the viability of U87 and A-172 human GBM cells. In U87 cells, the combined inhibition of HDACs and EGFR was more effective than inhibiting either target alone in reducing viability and long-term proliferation. In addition, HDAC or EGFR inhibition, alone or combined, led to G0/G1 cell cycle arrest. The EGFR inhibitor alone or combined with HDAC inhibition increased mRNA expression of the signal transducer and activator of transcription 3 (STAT3), which can act either as an oncogene or a tumor suppressor in GBM. These data provide early evidence that combining HDAC and EGFR inhibition may be an effective strategy to reduce GBM growth, through a mechanism possibly involving STAT3.


Assuntos
Antineoplásicos/farmacologia , Neoplasias Encefálicas/metabolismo , Receptores ErbB/antagonistas & inibidores , Glioblastoma/metabolismo , Inibidores de Histona Desacetilases/farmacologia , Fator de Transcrição STAT3/genética , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Humanos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fator de Transcrição STAT3/metabolismo
15.
Mol Clin Oncol ; 8(6): 719-724, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29844902

RESUMO

Ewing Sarcoma (ES) is a highly aggressive bone and soft tissue childhood cancer. The development of resistance to chemotherapy is common and remains the main cause of treatment failure. We herein evaluated the expression of genes associated with chemotherapy resistance in ES cell lines. A set of genes (CCAR1, TUBA1A, POLDIP2, SMARCA4 and SMARCB1) was data-mined for resistance against doxorubicin and vincristine, which are the standard drugs used in the treatment of patients with ES. The expression of each gene in SK-ES-1 ES cells was reported before and after exposure to a drug resistance-inducing protocol. There was a significant downregulation of CCAR1 and TUBA1A in doxorubicin-resistant cells, with low expression of TUBA1A in vincristine-resistant cells. By contrast, POLDIP2 was significantly upregulated in cells resistant to either drug, and the expression of the SMARCB1 and SMARCA4 genes was upregulated in doxorubicin-resistant cells. These findings indicate that resistance to specific chemotherapeutic agents was accompanied by differential changes in gene expression in ES tumors.

16.
Rev. bras. cir. cabeça pescoço (Online) ; 43(3): 127-131, jul.-set. 2014. tab
Artigo em Português | LILACS-Express | LILACS | ID: lil-733540

RESUMO

Introdução: O câncer de tireoide é a neoplasia endócrina de maior prevalência, e sua incidência vem aumentando nos últimos anos. Estudos anteriores sugeriram que o nível sérico de Hormônio Estimulante de Tireoide (TSH) é um fator de risco independente para o desenvolvimento de cânceres bem diferenciados de tireoide. Além disso, alguns desses estudos demonstraram que altos níveis de TSH estão relacionados a estágios mais avançados de doença. Objetivos: O objetivo do presente estudo é averiguar se os níveis de TSH, mesmo dentro da faixa da normalidade, se correlacionam com maior incidência e maior agressividade dos carcinomas bem diferenciados de tireoide. Métodos: Analisamos os dados de 1180 pacientes submetidos a tireoidectomia total pela equipe da Disciplina de Cirurgia de Cabeça e Pescoço do HC-FMUSP, sendo 57,9% devido a doenças benignas e 42,1% a neoplasias malignas de tireoide. Para cada paciente, adotamos os valores absolutos de TSH referentes à última coleta antes da cirurgia, e os resultados dos exames anatomopatológicos (AP). Resultados: A comparação dos níveis de TSH estratificado nos pacientes com doenças benignas e com neoplasias malignas demonstrou uma associação estatisticamente significativa (p < 0,0001), nos permitindo inferir que pacientes com valor de TSH sérico maior de 1,16 µIU/mL tem maior risco de serem portadores de câncer bem diferenciado de tireoide do que aqueles que tem níveis de TSH menor ou igual a este valor. Porém, quando comparamos o estadio final dos CBT com os níveis de THS estratificado não houve associação significativa (p = 0,585), e assim pelos nossos resultados não podemos afirmar que valores de TSH maiores de 1,16 µIU/mL estão associados a maior gravidade no câncer de tireoide.


Introduction: The thyroid cancer is the most common endocrine malignancy, and its incidence has increased in recent years. Previous studies have suggested that serum Thyroid Stimulating Hormone (TSH) is an independent risk factor for the development of well differentiated thyroid cancer. Furthermore, some of these studies showed that high TSH levels are related to more advanced stages of disease. Objective: The aim of the present study is to investigate if serum THS levels, even whitin the normal range, are related with higher incidence and increased aggressiveness of well-differentiated thyroid carcinomas. Methods: We analyzed data of 1180 patients who underwent total thyroidectomy by the Discipline of Head and Neck Surgery from Hospital das Clinicas of University of São Paulo (HC-FMUSP). 57.9% was due to benign diseases and 42,1% was due to malignant neoplasms. For each patient, we adopted the value of serum TSH reference to the last collection before surgery, and the results of the pathologic exams. Results: The comparison of the stratified TSH levels in the patients with benign diseases and malignant neoplasms showed a statistically significant association (p < 0,0001), allowing us to infer that patients with TSH levels higher than 1,16 µIU/mL have higher risk of being carriers of well differentiated thyroid cancer than those who TSH levels less than or equal to this value. But when we compared the final stage of CBT with the stratified TSH levels, there was no significant association (p = 0,585), and so by our results we cannot say that THS levels higher then 1,16 µIU/mL are associated with more advanced stage of disease.

17.
Pesqui. bras. odontopediatria clín. integr ; 10(2): 209-216, maio-ago. 2010.
Artigo em Português | LILACS | ID: lil-568481

RESUMO

Objetivo: Avaliar a atividade antimicrobiana de produtos fluoretados sobre cepas de referencia de Streptococcus mutans, Streptococcus oralis e Lactobacillus casei. Metodo: Comparou-se os produtos a base de diaminofluoreto de prata (Cariestop© a 12%, Cariostal© a 16% e o Cariestop© a 30%), gel acidulado (Flutop©) e espuma acidulada (Fluor Care©), sob a forma pura e em seis diluicoes (1:2 a 1:64), determinando-se a Diluicao Inibitoria Maxima (DIM) com a clorexidina (controle positivo). Para verificacao a DIM, utilizou-se o metodo da difusao em agar e a tecnica do agar recortado, posterior incubacao em microaerofilia por 48 horas, seguindo-se da mensuracao dos halos de inibicao. Os testes foram realizados em duplicata, procedendo-se a analise descritiva dos dados.Resultados: O Cariostal a 16% teve sua DIM de 25% sobre o S. mutans, evidenciando-se inibicao sobre o S. oralis na sua forma pura. Em relacao ao Cariestop a 30%, constatou-se que ele inibiu o S. mutans e o S. oralis na sua forma pura e na diluicao de ate 1:2, sendo o unico produto testado a formar halo de inibicao para o L. casei (forma pura). A espuma acida nao demonstrou atividade antimicrobiana sobre as cepas testadas enquanto o gel de fluorfosfato acidulado inibiu o crescimento de S. mutans e S. oralis apresentando a DIM de 50% sobre estas bacterias. Conclusao: A maioria dos cariostaticos apresentou atividade antimicrobiana sobre S. mutans e S. oralis. O gel demonstrou acao antimicrobiana sobre S. mutans e S. oralis, nao sendo evidenciado efeito sobre o L. casei enquanto tal atividade nao foi verificada para a espuma sobre as cepas testadas.


Objective: To evaluate the antimicrobial activity of fluoridated products on reference strains of Streptococcus mutans, Streptococcus oralis and Lactobacillus casei. Method: The antibacterial activity of products based on silver diamine fluoride at 12% (Cariestop©), 16% (Cariostal©) and30% (Cariestop©), acidulated phosphate fluoride gel (Flutop©) and acidulated phosphate fluoride foam (Fluor Care©) in their pure form and in 6 dilutions (1:2 to 1:64) was evaluated bydetermination of the maximum inhibitory dilution (MID), having chlorhexidine as the positive control. For determination of the MID, the agar difuusion method and the agar well techniquewere performed, followed by incubation in microaerophilia for 48 hours. The analysis of MID data was based on the measurement of the zones of bacterial growth inhibition (inmm) formed around the wells. All tests were performed in duplicate and the data were analyzed descriptively. Results: Cariostal© presented 25% MID against S. mutans, inhibited of S.oralis in its pure form. Cariestop© inhibited S. mutans and S. oralis in its a form and in dilutions up to 1:2,being the only product that formed an inhibition zone against L. casei (pure form). The acidulated phosphate fluoride foam did not show antimicrobial activity against the tested strains, thewhile acidulated phosphate fluoride gel inhibited the growth of S. mutans and S. oralis, presenting 50% MID against the bacteria Conclusion: Most cariostatic agents presented antimicrobial activity against S. mutans and S. oralis. The acidulated phosphate fluoride gel showed antimicrobial action against S. mutans and S. oralis, but had not effect against L. casei. The acidulated phosphate fluoride foam showed no antimicrobial activity against the tested strains.


Assuntos
Cárie Dentária/prevenção & controle , Fluoretos , Técnicas In Vitro , Produtos com Ação Antimicrobiana , Streptococcus mutans
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