Long COVID neuropsychological follow-up: Is cognitive rehabilitation relevant?

BACKGROUND: Duration of neuropsychological disorders caused by long COVID, and the variables that impact outcomes, are still largely unknown. OBJECTIVE: To describe the cognitive profile of patients with long COVID post-participation in a neuropsychological rehabilitation program and subsequent reassessment and identify the factors that influence recovery. METHODS: 208 patients (mean age of 48.8 y.o.), mostly female, were reevaluated 25 months after their first COVID infection and 17 months after their initial evaluation. Patients underwent subjective assessment, Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), Phonemic Verbal Fluency and Clock Drawing Tests (NEUPSILIN) for executive functions, Hospital Anxiety and Depression Scale (HADS) and WHOQol-Bref. RESULTS: We noted a discrete improvement of neuropsychological symptoms 25 months after the acute stage of COVID-19; nonetheless, performance was not within the normative parameters of standardized neuropsychological testing. These results negatively impact QoL and corroborate patients' subjective assessments of cognitive issues experienced in daily life. Improvement was seen in those who participated in psychoeducational neuropsychological rehabilitation, had higher levels of education, and lower depression scores on the HADS. CONCLUSION: Our data reveal the persistence of long-term cognitive and neuropsychiatric disorders in patients with long COVID. Neuropsychological rehabilitation is shown to be important, whether in-person or online.

A new cyclodipeptide from Tetragonisca angustula honey active against Neospora caninum and in silico study.

A new cyclic natural compound formed by succinic acid and two alanine amino acid units was isolated from the Tetragonisca angustula honey extract. The chemical structure of 1 was established based on spectroscopic data analysis, including one- (1H and 13C NMR) and two-dimensional NMR techniques (1H-1H-COSY, HSQC and HMBC). A primary culture model previously infected with Neospora caninum was used to evaluate 1 for two time intervals (24 and 72 h), showing a reduction (40-56%) of the number of tachyzoites in the first 24 h and until 72 h, a dose-dependent reduction in parasite proliferation (25-50%). Glial cells treated with 1 did not demonstrate toxicity at concentrations up to 25 ug/mL. Treated and infected cultures showed an increase in NO when compared to control cells in 24 h and 72 h. In silico studies suggest that the new compound may affect DNA synthesis and impair -protein production.

Efetividade da máquina de perfusão hipotérmica versus armazenamento estático para preservação do rim de doador falecido: revisão rápida / Effectiveness of hypothermic machine perfusion versus cold static storage for deceased donor kidney preservation: rapid review

Tecnologia: máquina de perfusão hipotérmica. Indicação: Transplante renal de doador falecido. Pergunta: Qual a efetividade da máquina de perfusão hipotérmica (HMP) para a preservação do rim de doador falecido, quando comparada ao armazenamento estático a frio (SCS)? Objetivo. Avaliar a efetividade da máquina de perfusão hipotérmica na preservação do rim de doador falecido, em comparação com o armazenamento estático a frio. Métodos: Revisão de revisões sistemáticas (overview) do tipo revisão rápida. Foi realizado um levantamento bibliográfico nas bases de dados: PubMed, Embase, BVS, Epistemonikos, Cochrane Library e em bases de registro de protocolos de revisões sistemáticas e ensaios clínicos, utilizando descritores e estratégias de busca predefinidas. A avaliação da qualidade metodológica dos estudos incluídos foi feita através da ferramenta AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews Version 2). Resultados: Duas revisões sistemáticas atenderam aos critérios de elegibilidade e foram incluídas na análise. Uma delas apresentou alto nível de qualidade metodológica. Conclusão: O uso da HMP para a preservação de rins de doadores falecidos foi associado a melhores desfechos clínicos relacionados à função retardada e à sobrevida do enxerto e foi considerado custo-efetivo, quando comparado ao SCS. Faz-se necessária a geração de evidências mais robustas acerca dos custos e benefícios do uso desta tecnologia no âmbito do SUS

Technology: hypothermic machine perfusion. Indication: Deceased donor kidney transplantation. Question: How effective is hypothermic machine perfusion (HMP) for preserving deceased donor kidneys compared to static cold storage (SCS)? Objective: To evaluate the effectiveness of the hypothermic machine perfusion in preserving the deceased donor kidney, compared to static cold storage. Methods: Rapid review of systematic reviews (overview). A bibliographic survey was carried out in the databases: PubMed, Embase, VHL, Epistemonikos, Cochrane Library and in databases of systematic review protocols and clinical trials, using predefined descriptors and search strategies. The assessment of the methodological quality of the included studies was performed using the AMSTAR-2 tool (Assessing the Methodological Quality of Systematic Reviews Version 2). Results: Two systematic reviews met the eligibility criteria and were included in the analysis. One of them performed a high level of methodological quality. Conclusion: The use of HMP for the preservation of deceased donor kidneys was associated with better clinical outcomes related to delayed graft function and graft survival and was considered cost-effective. It is necessary to generate more evidence about the costs and benefits of using this technology within the Brazilian Unified System of Healthcare (SUS)

Differential Gene Expression Associated with Soybean Oil Level in the Diet of Pigs.

The aim of this study was to identify the differentially expressed genes (DEG) from the skeletal muscle and liver samples of animal models for metabolic diseases in humans. To perform the study, the fatty acid (FA) profile and RNA sequencing (RNA-Seq) data of 35 samples of liver tissue (SOY1.5, n = 17 and SOY3.0, n = 18) and 36 samples of skeletal muscle (SOY1.5, n = 18 and SOY3.0, n = 18) of Large White pigs were analyzed. The FA profile of the tissues was modified by the diet, mainly those related to monounsaturated (MUFA) and polyunsaturated (PUFA) FA. The skeletal muscle transcriptome analysis revealed 45 DEG (FDR 10%), and the functional enrichment analysis identified network maps related to inflammation, immune processes, and pathways associated with oxidative stress, type 2 diabetes, and metabolic dysfunction. For the liver tissue, the transcriptome profile analysis revealed 281 DEG, which participate in network maps related to neurodegenerative diseases. With this nutrigenomics study, we verified that different levels of soybean oil in the pig diet, an animal model for metabolic diseases in humans, affected the transcriptome profile of skeletal muscle and liver tissue. These findings may help to better understand the biological mechanisms that can be modulated by the diet.

Effect of dietary soybean oil inclusion on liver-related transcription factors in a pig model for metabolic diseases.

Dietary fatty acids (FA) are components of the lipids, which contribute to membrane structure, energy input, and biological functions related to cellular signaling and transcriptome regulation. However, the consumers still associate dietary FA with fat deposition and increased occurrence of metabolic diseases such as obesity and atherosclerosis. Previous studies already demonstrated that some fatty acids are linked with inflammatory response, preventing metabolic diseases. To better understand the role of dietary FA on metabolic diseases, for the first time, a study to identify key transcription factors (TF) involved in lipid metabolism and inflammatory response by transcriptome analysis from liver samples of animal models was performed. The key TF were identified by functional enrichment analysis from the list of differentially expressed genes identified in liver samples between 35 pigs fed with 1.5% or 3.0% soybean oil. The functional enrichment analysis detected TF linked to lipid homeostasis and inflammatory response, such as RXRA, EGFR, and SREBP2 precursor. These findings demonstrated that key TF related to lipid metabolism could be modulated by dietary inclusion of soybean oil. It could contribute to nutrigenomics research field that aims to elucidate dietary interventions in animal and human health, as well as to drive food technology and science.

Activation of the Kynurenine Pathway and Production of Inflammatory Cytokines by Astrocytes and Microglia Infected With Neospora caninum.

In the central nervous system, astrocytes and microglia contribute to homeostasis, regulating the immune response to infectious agents. Neospora caninum is an obligate intracellular protozoan that infects different animal species and it is encysted in their nervous tissue while triggering an immune response modulated by glia. This study aimed to evaluate the infection of primary cultures of rat glial cells by N. caninum through the catabolites of tryptophan, the expression of inflammatory mediators and the integrity of neural tissue. Infection with this coccidium resulted in morphological and functional changes, particularly astrogliosis and microgliosis, and increased the expression of the inflammatory mediators TNF, IL1ß, IL-10, and arginase, as well as mRNA for CCL5 and CCL2, molecules involved in the CNS chemotaxis. The infection with N. caninum in glial cells also triggered the activation of the tryptophan pathway, characterized by increased kynurenine 2,3 monooxygenase (KMO) mRNA expression, and by the production of the excitotoxin quinolinic acid (QUIN). Moreover, glia-neuron co-cultures, when exposed to the secretome derived from N. caninum infected glial cells, presented greater neurons distribution and formation of neurite extensions, associated to morphological changes in astrocytes compatible with neuro-preservation. Considering that the tryptophan catabolism is associated to immune response, these findings suggest that glial activation in N. caninum infection should be responsible for modulating the inflammatory status in an attempt to restore the nervous system homeostasis, since excessive inflammatory response can cause irreversible damage to tissue preservation.

Hydroxycinnamic acid-spermidine amides from Tetragonisca angustula honey as anti-Neospora caninum: In vitro and in silico studies.

Tetragonisca angustula honey was fractioned in a SiO2 column to furnish three fractions (A-C) in which four hydroxycinnamic acid-Spermidine amides (HCAAs), known as N', N″, N‴-tris-p-coumaroyl spermidine, N', N″-dicaffeoyl, N‴-coumaroyl spermidine, N', N″, N‴-tris-caffeoyl spermidine and N', N″-dicaffeoyl and N‴-feruloyl spermidine were identified in the fractions B and C by electrospray ionization tandem mass spectrometry. A primary culture model previously infected with Neospora caninum (72 h) was used to evaluate the honey fractions (A-C) for two-time intervals: 24 and 72 h. Parasitic reduction ranged from 38% on fraction C (12.5 µg/ml), after 24 h, to 54% and 41% with fractions B and C (25 µg/ml) after 72 h of treatment, respectively. Additionally, HCAAs did not show any cell toxicity for 24 and 72 h. For infected cultures (72 h), the active fractions B (12.5 µg/ml) and C (25 µg/ml) decreased their NO content. In silico studies suggest that HCAAs may affect the parasite's redox pathway and improve the oxidative effect of NO released from infected cells. Here, we presented for the first time, that HCAAs from T. angustula honey have the potential to inhibit the growth of N. caninum protozoa.

Viral load and high prevalence of HR-HPV52 and 58 types in black women from rural communities.

BACKGROUND: The high-risk human papillomavirus (HR-HPV) infection is the main cause of cervical cancer development, and the most common types were included in the last approved nonavalent vaccine (9vHPV). Geographical, socioeconomic and ethnic barriers in developing countries challenge primary and secondary prevention measures of cervical cancer. We aimed to determine the prevalence of HPV infection and the viral load of HR-HPV 9vHPV-related types black women resident in rural semi-isolated communities. METHODS: A descriptive study was conducted with 273 cervical samples of women from rural communities of Southeastern Brazil. Viral DNA was amplified by PCR, the genotype was identified by Reverse Line Blot (RLB) and Restriction Fragment Length Polymorphism (RFLP), and real-time PCR was applied to determine the viral load. RESULTS: HPV frequency was 11.4% (31/273), associated with the presence of cytological abnormalities (32.3%; p < 0.001). Thirty-one distinct genotypes were detected; HR-HPV occurred in 64.5% (20/31) of the samples and the most prevalent type were HPV52 > 58, 59. Multiple infections occurred with up to nine different genotypes. The viral load of HR-HPV 9vHPV-related types was higher in lesions than in normal cytology cases (p = 0.04); "high" and "very high" viral load occurred in HSIL and LSIL, respectively (p = 0.04). CONCLUSIONS: We highlight that despite the low HPV frequency in the black rural women population, the frequency of HR-HPV was high, particularly by the HR-HPV52 and 58 types. Moreover, the HR-HPV viral load increased according to the progression from normal to lesion, being a potential biomarker to identify those women at higher risk of developing cervical lesions in this population.

Improving outcomes for people with mild cognitive impairment: An Australian mixed-methods pilot study.

OBJECTIVE: This pilot study tested the feasibility and acceptability of an innovative functional task exercise program to ameliorate mild cognitive impairment. METHODS: The functional task exercise program was trialled on community-dwelling adults aged 60 years or older. The 10-week program was conducted in regional Australia and evaluated for acceptability and feasibility. Outcomes were assessed pre- and post- intervention and at three-month follow-up. Structured interviews were conducted with caregivers and participants at the end of the program. RESULTS: Acceptability was demonstrated, with approximately 80% of the 23 participants completing the program. Clinical improvements were demonstrated in several cognitive and functional measures using an uncontrolled pre-post test design. Qualitative findings suggest feasibility as the program was viewed positively by participants and caregivers. CONCLUSION: The functional exercise program was acceptable, was feasible and improved outcomes in an Australian context. Research is urgently needed to identify and treat people with mild cognitive impairment living in the community.

Sexually transmitted infections among women living with HIV in a Brazilian city.

BACKGROUND: Clinical improvements following highly active antiretroviral therapy (HAART) may increase high-risk behaviors resulting in sexually transmitted infections (STI). Optimism related to the success of HAART in slowing disease progression, reducing viral load, and improving health status might be important factors for increasing sexual risk behaviors such as less use of condoms. OBJECTIVE: To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B and C, high-risk HPV, and cervical cytological abnormalities among women living with HIV (WLHIV) who attended a Reference Center for STI/AIDS in Brazil. METHODS: A cross-sectional study was conducted among 151 WLHIV attending an STI Clinic in Vitória city, Brazil. A structured questionnaire, including demographic, behavioral, and clinical information, was used for data collection. Serological tests for HIV, syphilis, hepatitis C and B, CD4 counts, and viral load determination were performed. Cervical samples were collected for cytology and real-time PCR for HPV,Chlamydia, and Neisseria gonorrhoeae. RESULTS: In this study, 59% of women had at least one diagnosed STI at the time of the first clinic visit; 31% had clinical forms of anogenital HPV, 10% syphilis, 8%Neisseria gonorrhoeae, 5.0% trichomoniasis, 3% Chlamydia trachomatis, 1% hepatitis B, and 1% hepatitis C; 6.7% of the women presented with cervical cytological abnormalities. Furthermore, 46.3% of women had HR-HPV, and 17.6% had HPV 16/18. Only 5% of the women had a CD4 count <200 cells/mm3, 61.6% had undetectable HIV viral load, and 81.3% were currently on HAART. CONCLUSION: A high prevalence of STI and HR-HPV infections were observed among HIV-infected women in this investigation. Prevention programs need to focus on counseling WLHIV and their regular partners with focused interventions such as couples counseling and education programs.

Sexually transmitted infections among women living with HIV in a Brazilian city

ABSTRACT Background: Clinical improvements following highly active antiretroviral therapy (HAART) may increase high-risk behaviors resulting in sexually transmitted infections (STI). Optimism related to the success of HAART in slowing disease progression, reducing viral load, and improving health status might be important factors for increasing sexual risk behaviors such as less use of condoms. Objective: To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B and C, high-risk HPV, and cervical cytological abnormalities among women living with HIV (WLHIV) who attended a Reference Center for STI/AIDS in Brazil. Methods: A cross-sectional study was conducted among 151 WLHIV attending an STI Clinic in Vitória city, Brazil. A structured questionnaire, including demographic, behavioral, and clinical information, was used for data collection. Serological tests for HIV, syphilis, hepatitis C and B, CD4 counts, and viral load determination were performed. Cervical samples were collected for cytology and real-time PCR for HPV, Chlamydia, and Neisseria gonorrhoeae. Results: In this study, 59% of women had at least one diagnosed STI at the time of the first clinic visit; 31% had clinical forms of anogenital HPV, 10% syphilis, 8%Neisseria gonorrhoeae, 5.0% trichomoniasis, 3% Chlamydia trachomatis, 1% hepatitis B, and 1% hepatitis C; 6.7% of the women presented with cervical cytological abnormalities. Furthermore, 46.3% of women had HR-HPV, and 17.6% had HPV 16/18. Only 5% of the women had a CD4 count <200 cells/mm3, 61.6% had undetectable HIV viral load, and 81.3% were currently on HAART. Conclusion: A high prevalence of STI and HR-HPV infections were observed among HIV-infected women in this investigation. Prevention programs need to focus on counseling WLHIV and their regular partners with focused interventions such as couples counseling and education programs.

Prevalence of drug use and family relationships among school adolescents in Cuiabá, MT, Brazil: a cross-sectional study, 2015. / Prevalência do uso de drogas e relações familiares entre adolescentes escolares de Cuiabá, Mato Grosso: estudo transversal, 2015.

OBJECTIVE: to analyze prevalence and factors associated with lifetime drug use in adolescents. METHODS: this was a cross-sectional study carried out in 2015 with elementary and high school students in Cuiabá, MT, Brazil, aged 10-19; drug use (except alcohol and tobacco) was analyzed according to sociodemographic, school and family variables; data were submitted to descriptive analysis and Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS: drug use prevalence was 23.5% (95%CI 20.8;26.4) and was associated with unsatisfactory family relationships (PR=1.43; 95%CI 1.08;1.91) and non-authoritative parenting style (PR=1.67; 95%CI 1.14;2.44). CONCLUSION: prevalence of drug use among adolescents was associated with unsatisfactory family relationships, especially when conflicts were between parents and when parenting style was non-authoritative.

Wide genetic heterogeneity and low antimicrobial resistance of enteroaggregative Escherichia coli isolates from several rural communities.

Enteroaggregative Escherichia coli (EAEC), a highly heterogeneous pathotype of E. coli classified as typical and atypical, are an emerging cause of acute and persistent diarrhea. We aimed to investigate whether population living in rural geographic areas, impacts in the heterogeneity, dissemination and antimicrobial susceptibility of EAEC strains. EAEC isolates (n=73) were analysed for the presence of 23 putative virulence factors, plasmid and antimicrobial resistance profiles, biofilm formation, pulsedfield gel electrophoresis (PFGE) and by multilocus sequence typing (MLST). The agg3A, agg4A, agn43, aap, shf, astA, pet, pic/set1A and sat genes, biofilm forming and antimicrobial resistance were statistically associated with typical EAEC. A low frequency of all isolates was resistant or showed a multidrug-resistance profile. No isolate showed the same plasmid profile. In total, 58 different pulsotypes were observed. Sixteen isolates analysed by MLST belonged to 15 different sequence types (ST) and showed a different PFGE pattern and virulence-gene profile. The fact that the communities are semi-isolated did not impact on the peculiar heterogeneity of EAEC, being characterized as epidemiologically independent strains.

Prevalência do uso de drogas e relações familiares entre adolescentes escolares de Cuiabá, Mato Grosso: estudo transversal, 2015 / Prevalencia del uso de drogas psicoactivas y relaciones familiares entre los adolescentes escolares de Cuiabá, Mato Grosso, Brasil: estudio transversal, 2015 / Prevalence of drug use and family relationships among school adolescents in Cuiabá, MT, Brazil: a cross-sectional study, 2015

Objetivo: analisar a prevalência e fatores associados ao uso de drogas na vida em adolescentes escolares. Métodos: estudo transversal realizado em 2015, entre estudantes da educação básica de Cuiabá, MT, Brasil, com 10-19 anos; analisou-se o uso de drogas (exceto álcool e tabaco) na vida, segundo variáveis sociodemográficas, escolares e familiares; os dados foram submetidos a análise descritiva e regressão de Poisson para estimativa de razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Resultados: a prevalência de uso de drogas foi de 23,5% (IC95% 20,8;6,4) e foi associada a relacionamento insatisfatório entre os pais (RP=1,43; IC95%1,08;1,91) e estilo parental não autoritativo (RP=1,67; IC95%1,14;2,44). Conclusão: a prevalência do uso de drogas entre os adolescentes mostrou-se associada a relações familiares insatisfatórias, especialmente quando os conflitos eram entre os pais e quando o estilo parental era não autoritativo.

Objetivo: analizar la prevalencia y los factores asociados al uso de drogas en la vida en adolescentes escolares. Métodos: estudio transversal realizado en 2015 con estudiantes de la educación básica de Cuiabá, MT, Brasil, con 10-19 años; se analizó el uso de drogas (excepto alcohol y tabaco) en la vida, según variables sociodemográficas, escolares y familiares; los datos fueron sometidos al análisis descriptivo y la regresión de Poisson para estimación de razones de prevalencia (RP) e intervalos de confianza del 95% (IC95%). Resultados: la prevalencia del uso de drogas fue del 23,5% (IC95% = 20,8 a 26,4) y asociada a la relación insatisfactoria entre los padres (RP=1,43; IC95% = 1,08 a 1,91) y con estilo parental no autoritario (RP=1,67; IC95% = 1,14 a 2,44). Conclusión: la prevalencia del uso de drogas entre los adolescentes estuvo asociada a las relaciones familiares insatisfactorias, especialmente cuando los conflictos son entre los padres y cuando el estilo parental era no autoritario.

Objective: to analyze prevalence and factors associated with lifetime drug use in adolescents. Methods: this was a cross-sectional study carried out in 2015 with elementary and high school students in Cuiabá, MT, Brazil, aged 10-19; drug use (except alcohol and tobacco) was analyzed according to sociodemographic, school and family variables; data were submitted to descriptive analysis and Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). Results: drug use prevalence was 23.5% (95%CI 20.8;26.4) and was associated with unsatisfactory family relationships (PR=1.43; 95%CI 1.08;1.91) and non-authoritative parenting style (PR=1.67; 95%CI 1.14;2.44). Conclusion: prevalence of drug use among adolescents was associated with unsatisfactory family relationships, especially when conflicts were between parents and when parenting style was non-authoritative.

Forecasting the spatiotemporal variability of soil CO2 emissions in sugarcane areas in southeastern Brazil using artificial neural networks.

Carbon dioxide (CO2) is considered one of the main greenhouse effect gases and contributes significantly to global climate change. In Brazil, the agricultural areas offer an opportunity to mitigate this effect, especially with the sugarcane crop, since, depending on the management system, sugarcane stores large amounts of carbon, thereby removing it from the atmosphere. The CO2 production in soil and its transport to the atmosphere are the results of biochemical processes such as the decomposition of organic matter and roots and the respiration of soil organisms, a phenomenon called soil CO2 emissions (FCO2). The objective of the study was to investigate the use of neural networks with backpropagation algorithm to predict the spatial patterns of soil CO2 emission during short periods in sugarcane areas. FCO2 values were collected in three commercial crop areas in the São Paulo state, southeastern Brazil, registered through the LI-8100 system during the years 2008 (Motuca), 2010 (Guariba city), and 2012 (Pradópolis), in the period after the mechanical harvesting (green cane). A neural network multilayer perceptron with a backpropagation algorithm was applied to estimate the FCO2 in 2012, using data from 2008 and 2010 as training for the neural network. The neural network initially presented a mean absolute percentage error (MAPE) of 18.3852 and a coefficient of determination (R2) of 0.9188. Data obtained from the observed and estimated values of FCO2 present moderate spatial dependence, and it is observed from the maps of the spatial pattern of the CO2 flow that the results from the neural network show considerable similarity to the observed data. The model results identify the higher and lower characteristics in sample points of CO2 emissions and produce an overestimation of the range of spatial dependence (0.45 m) and an underestimation of the interpolated values in the field (R2 = 0.80; MAPE = 12.0591), when compared to the actual soil CO2 emission values. Therefore, the results indicate that the artificial neural network provides reliable estimates for the evaluation of FCO2 from data of the soil's physical and chemical attributes and describes the spatial variability of FCO2 in sugarcane fields, thereby contributing to the reduction of uncertainties associated with FCO2 accountings in these areas.

Anal HPV infection and correlates in HIV-infected patients attending a Sexually Transmitted Infection clinic in Brazil.

OBJECTIVE: To estimate the prevalence of anal HPV infection, genotype distribution, intraepithelial neoplasia (AIN) and correlates in a cohort of HIV-infected patients attending at Sexually Transmitted Infections (STI) clinic in Brazil. STUDY DESIGN: A descriptive analysis was performed which includes, demographic, behavioral and clinical data. Anal specimens from HIV-positive men and women were collected during a regular visit and they were used for cytology and histopathology tests, as well as for HPV molecular identification. RESULTS: A total of 223 patients (143 females and 80 males) were enrolled in the study and, HPV was identified in 68.6% of the sample. The frequency of HR-HPV, HPV16/18 and multiple HPV infection were similar in both groups. The upstream regulatory region (URR) sequencing was carried out in 38 samples identified as HPV16-positive, and European variants were the most frequent (69.2%), followed by Africans (25.6%) and Asiatic-Americans (5.1%). Having more than 20 sexual partners was associated with multiple HPV infection (p = 0.000) while, anal sex and the first intercourse before 15 years of age was a risk factor for any HPV infection (p = 0.001). Being MSM (men who have sex with men) was a risk factor for any HPV and multiple infections (p = 0.002). The CD4 count >500 cells/mm3 was a protective factor for the HPV16/18 (p = 0.048) and multiple infections (p = 0.023), and the undetectable viral load and HAART treatment were both protective for any HPV (p = 0.010), HR-HPV (p = 0.091) and multiple infections (p = 0.006). Abnormal anoscopy was found in 23.7% (53/223) of the total number of patients, and this was significantly associated with all types of investigated HPV infections (p<0.0001). CONCLUSIONS: In this study, anal HPV infection was common among young HIV-positive men and women, particularly in MSM. Anal cancer screening in patients at risk, such as those who are HIV-positive, and mainly those with anal HPV infection and a history of STI, will increase the likelihood of detecting anal intraepithelial neoplasia.

Human papillomavirus in foetal and maternal tissues from miscarriage cases.

Early miscarriage is still a concern, and viral infections are recognised as one of the causes of this adverse outcome. The causal relationship between HPV and miscarriage remains controversial. The aim of the study was to evaluate whether HPV infection indeed may occur in both the maternal and placental tissue in cases of miscarriage. Decidual and chorionic villi fragments (n = 118) were dissected from 81 miscarriage cases, 68 spontaneous and 13 intentional. HPV DNA was detected using the consensus primers MY09/11; in eight cases (9.9%, 8/81), seven of which (10.3%) were from spontaneous miscarriages and one (7.7%), was from an intentional miscarriage. The deciduas (4/8) and chorionic villi (5/8) were both infected with HPV. A reverse line blot was used to genotype HPV positive samples and revealed HPV6, 11, 58, 66 and 82. Although the results obtained cannot infer an association between HPV and pregnancy loss, it cannot be ruled out. Impact Statement What is already known on this subject? Miscarriages are considered to be the most common complication in pregnancy. Several possible causes of miscarriage have been considered, and the role of infections as one of those is confirmed, especially during the second trimester of pregnancy. The prevalence of HPV in conception products is still questionable. However, an HPV infection should not be ignored and its association with miscarriage must be considered. What the results of this study add? The present study reveals the presence of HPV in the foetal and maternal tissues of conception. What the implications are of these findings for clinical practice and/or further research? This issue deserves further investigation aiming to clarify the role of HPV in miscarriage cases; which are mainly related to the specific type and grade of tissues' abnormalities found co-topographically with a virus presence.

Caracterização dos resultados de exames citopatológicos do colo do útero entre 2014 e 2016 / Characterization of the results of citopatological examinations of the uterus coloss between 2014 and 2016 / Caracterización de los resultados de examenes citopatológicos del colo del útero entre 2014 y 2016

Objetivo: analisar resultados dos exames citopatológicos de colo do útero alterados de mulheres submetidas à colposcopia. Método: pesquisa descritiva, exploratória, com abordagem quantitativa e de cunho documental, realizada no periodo de 2014 a 2016 em Barra do Garças, Mato Grosso. A análise de dados foi realizada por meio da estatística descritiva simples. Resultados: foram analisados 218 registros, prevalecendo entre as mulheres abaixo de 25 anos e entre 25 a 35 anos lesão de baixo grau, 65,85%, e 38,46% respectivamente; 36 a 45 anos, 35,71% lesão de alto grau; 46 a 55 anos, 39,39% células escamosas atípicas de significado indeterminado, não podendo afastar lesão de alto grau; entre 56 a 64 anos, 27,77% células escamosas atípicas de significado indeterminado, possivelmente não neoplásicas e 27,77% lesão de alto grau e e entre 65 anos ou mais, 26, 31% células escamosas atípicas de significado indeterminado, não podendo afastar lesão de alto grau. Conclusão: a faixa etária de 25 a 35 anos foi a que mais apresentou número de alterações. Em todas as faixas etárias investigadas no estudo, notou-se que ocorreram encaminhamentos indevidos à colposcopia, pois muitos desses encaminhamentos não requeriam o seguimento imediato, contrariando os critérios e condutas preconizadas.

Objective: to analyze the results of cervical cytopathological exams altered in women submitted to colposcopy. Method: descriptive, exploratory research, with a quantitative and documentary approach, carried out in the period from 2014 to 2016 in Barra do Garças, Mato Grosso. Data analysis was performed using simple descriptive statistics. Results: 218 records were analyzed, prevailing among women under 25 years and between 25 and 35 years of low grade lesions, 65.85%, and 38.46%, respectively; 36 to 45 years, 35.71% high-grade injury; 46 to 55 years old, 39.39% atypical squamous cells of indeterminate significance, and can not rule out high grade lesions; between 56 and 64 years, 27.77% atypical squamous cells of indeterminate significance, possibly non-neoplastic and 27.77% high-grade lesion and and between 65 years and over, 26, 31% atypical squamous cells of indeterminate significance, high grade injury. Conclusion: the age group of 25 to 35 years was the one that presented the most number of alterations. In all the age groups investigated in the study, it was noticed that undue referrals to colposcopy occurred, since many of these referrals did not require immediate follow-up, contrary to the criteria and recommended guidelines.

Objetivo: analizar resultados de los exámenes citopatológicos de cuello del útero alterados de mujeres sometidas a la colposcopia. Método: investigación descriptiva, exploratoria, con abordaje cuantitativo y de cuño documental, realizado en el período de 2014 a 2016 en Barra do Garças, Mato Grosso. El análisis de datos fue realizado por medio de la estadística descriptiva simple. Resultados: se analizaron 218 registros, prevaleciendo entre las mujeres menores de 25 años y entre 25 a 35 años lesión de bajo grado, 65,85%, y 38,46% respectivamente; De 36 a 45 años, 35,71% lesión de alto grado; 46 a 55 años, 39,39% células escamosas atípicas de significado indeterminado, no pudiendo alejarse lesión de alto grado; entre 56 y 64 años, 27,77% de las células escamosas atípicas de significado indeterminado, posiblemente no neoplásicas y 27,77% lesión de alto grado y entre 65 años o más, 26, 31% células escamosas atípicas de significado indeterminado, no pudiendo alejarse lesión de alto grado. Conclusión: el grupo de edad de 25 a 35 años fue el que más presentó número de alteraciones. En todas las edades investigadas en el estudio, se notó que ocurrieron encaminamientos indebidos a la colposcopia, pues muchos de esos encaminamientos no requerían el seguimiento inmediato, contrariando los criterios y conductas preconizadas.

The high prevalence of HPV and HPV16 European variants in cervical and anal samples of HIV-seropositive women with normal Pap test results.

Human Immunodeficiency Virus (HIV)-seropositive women are more likely to have anogenital cancer, and high risk-HPV (HR-HPV) infection is the main associated factor. Between August 2013 and December 2015, we conducted a descriptive study to determine the HPV genotypes and HPV16 variants in cervical and anal samples of HIV-seropositive women with a normal Pap test. The viral DNA was amplified by PCR using the PGMY09/11 set of primers. Reverse line blot (RLB), restriction fragment length polymorphism (RFLP) and sequencing assays were used to determine the HPV genotypes. HPV16 variants were identified by gene sequencing. We found a high frequency of HR-HPV (60.3%; 76/126) at the anogenital site among HIV-seropositive women and without association with anal intercourse. HPV16 and European variant predominated among the HR-HPV. Mixed infections with at least three different HPV types were common, particularly at the anal site. CD4+ T-cell counts below 500 cells/mm3, a HIV viral load above 50 copies/mL and an age of 18 to 35 years old were all related to HPV anal infection. Our study showed a high frequency of HR-HPV in both cervical and anal sites of women with negative cytology belonging to a risk group for the development of anogenital cancer.