Ineffectiveness of information and access to health services: vulnerability to human papillomavirus.

AIM: To examine situations of vulnerability to human papillomavirus in the social representations of young women. BACKGROUND: Human papillomavirus is one of the most frequent sexually transmitted infections among women and constitutes a serious health problem among youth. This problem is embedded in psychosocial issues that promote situations of vulnerability and affect attitudes and behaviour in relation to prevention. METHODS: Qualitative study based on the theory of social representations, conducted among 64 female students in a high school in the city of Rio de Janeiro, Brazil. The study used personal semi-structured interviews, with a lexical analysis by Alceste 2010 software. FINDINGS: The inefficacy of information on the human papillomavirus pointed out individual and social vulnerabilities, and showed relationships between the difficulty of access and the perception of low quality in public health services, which also promotes institutional vulnerability. DISCUSSION: The representation of vulnerability to human papillomavirus infection is associated, not only with individual behaviours related to sexuality and gender identity but also to social and institutional conditions involving insufficient information and low quality of and ineffective access to public health services. CONCLUSION: Situations of vulnerability of young women to human papillomavirus infection influence ways of thinking and acting, when they generate feelings and behaviours that put them at risk. The social representations provided knowledge about how the participants appropriated consensual and reified universes in relation to vulnerability, influencing care and awareness of prevention. IMPLICATION FOR NURSING AND HEALTH POLICY: Situations of vulnerability, whether individual, social or institutional, warrant the attention of nurses and should be prioritized as public health policy goals to reduce the number of cases of human papillomavirus infection among younger women.

Evaluation of staff, patient and foetal radiation doses due to endoscopic retrograde cholangiopancreatography (ERCP) procedures in a pregnant patient.

The use of endoscopic retrograde cholangiopancreatography (ERCP) in pregnant patients is not rare. Most studies on the safety and efficacy of these procedures report short- and long-term pregnancy outcomes and but not foetal absorbed doses. This investigation reports on an ERCP procedure for a 40-y-old woman who was 32-34 weeks pregnant. Thermoluminescent dosemeters (TLD 100) were used to measure doses received by the patient and the staff. Additionally, Monte Carlo calculations were performed using a 3D computational phantom representing a 9-month pregnant patient to estimate the foetal absorbed dose. The results show that the spleen of the mother received the largest absorbed dose of 12.18 mGy since it was closer to the source than other internal organs. For the foetus and uterus, the lowest absorbed dose was found to be 0.01 mGy to the foetal brain, while the largest absorbed dose was estimated to be 0.13 mGy to the placenta.

Ocorrência de cryptosporidium spp. em animais exóticos de companhia no Brasil / Occurrence of cryptosporidium spp. in exotic animals raised as pets in Brazil

A infecção por algumas espécies ou genótipos de Cryptosporidium representa um risco em potencial para a saúde pública, principalmente por causa de morbidade e mortalidade em crianças de zero a cinco anos de idade e em pacientes imunodeprimidos. Embora existam alguns relatos de infecção por Cryptosporidium em animais de companhia, sua participação na epidemiologia da criptosporidiose humana é incerta, e a literatura sobre esse tema ainda é bastante escassa. O objetivo deste estudo foi determinar a ocorrência e realizar a classificação molecular de Cryptosporidium spp. em amostras fecais de animais exóticos criados como animais de estimação no Brasil. Um total de 386 amostras de seis espécies de animais foi colhido e armazenado em solução de dicromato de potássio 5% a 4°C. Os oocistos foram purificados por centrífugo-sedimentação em água/éter, seguindo-se a extração de DNA genômico e a realização da nestedPCR para amplificação de fragmento parcial do gene da subunidade 18S do rRNA. Positividade para Cryptosporidium spp. foi observada em 11,40% (44/386) das amostras. O sequenciamento de fragmentos amplificados permitiu a identificação de Cryptosporidium tyzzeri em camundongos,Cryptosporidium murisem camundongos, hamster e chinchila, Cryptosporidium parvumem chinchila, Cryptosporidiumgenótipo hamsterem hamstere Cryptosporidium sp. em porquinho-da-índia. Os resultados deste estudo mostram que há uma variedade de espécies de Cryptosporidium presentes em animais exóticos de companhia no Brasil. Os dados sugerem que esses animais podem participar da epidemiologia da criptosporidiose humana, particularmente por seu estreito convívio.

Infection by some species or genotypes of Cryptosporidium represents a potential risk to public health, mainly because of the morbidity and mortality in children from zero to five years of age and in immunocompromised patients. Although there are some reports of Cryptosporidium infection in animals raised as pets, their participation in the epidemiology of human cryptosporidiosis is uncertain and studies on this topic are still scarce. The aim of this study was to determine the occurrence, as well as to perform the molecular classification of Cryptosporidium spp. in faecal samples of exotic animals raised as pets in Brazil. A total of 386 faecal samples from six species of animals was collected and stored in a solution 5% potassium dichromate at 4°C. The oocysts were purified by centrifugal sedimentation in water-ether, followed by genomic DNA extraction and the performance of the nested-PCR to amplify a partial fragment of 18S rRNA gene. Positivity for Cryptosporidium spp. was obtained in 11.40% (44/386) of samples. The sequencing of the amplified fragments allowed the identification of Cryptosporidium tyzzeri in mice, Cryptosporidium muris in mice, hamster and chinchilla, Cryptosporidium parvum in chinchilla, Cryptosporidium hamster genotype in hamster and Cryptosporidium sp. in guinea pig. The results of this study show that there is a variety of species of Cryptosporidium present in exotic animals raised as pets in Brazil. The data suggest that these animals may have zoonotic potential and participate in the epidemiology of human cryptosporidiosis.

Modulation of the effects of lung immune response on bone marrow by oral antigen exposure.

Allergic airway inflammation is attenuated by oral tolerization (oral exposure to allergen, followed by conventional sensitization and challenge with homologous antigen), which decreases airway allergen challenge-induced eosinophilic infiltration of the lungs and bone marrow eosinophilia. We examined its effects on bone marrow eosinophil and neutrophil production. Mice of wild type (BP-2, BALB/c, and C57BL/6) and mutant strains (lacking iNOS or CD95L) were given ovalbumin (OVA) or water (vehicle) orally and subsequently sensitized and challenged with OVA (OVA/OVA/OVA and H2O/OVA/OVA groups, resp.). Anti-OVA IgG and IgE, bone marrow eosinophil and neutrophil numbers, and eosinophil and neutrophil production ex vivo were evaluated. T lymphocytes from OVA/OVA/OVA or control H2O/OVA/OVA donors were transferred into naïve syngeneic recipients, which were subsequently sensitized/challenged with OVA. Alternatively, T lymphocytes were cocultured with bone marrow eosinophil precursors from histocompatible sensitized/challenged mice. OVA/OVA/OVA mice of the BP-2 and BALB/c strains showed, relative to H2O/OVA/OVA controls, significantly decreased bone marrow eosinophil counts and ex vivo eosinopoiesis/neutropoiesis. Full effectiveness in vivo required sequential oral/subcutaneous/intranasal exposures to the same allergen. Transfer of splenic T lymphocytes from OVA/OVA/OVA donors to naive recipients prevented bone marrow eosinophilia and eosinopoiesis in response to recipient sensitization/challenge and supressed eosinopoiesis upon coculture with syngeneic bone marrow precursors from sensitized/challenged donors.

Consumo, digestibilidade dos nutrientes e parâmetros ruminais em bovinos alimentados com silagem de capim-mombaça / Intake, digestibilities of the nutrients, and ruminal variables in cattle fed mombaça-grass silage

Avaliaram-se o consumo, a digestibilidade aparente total e parcial dos nutrientes, o pH e a concentração de amônia ruminal em bovinos alimentados com silagem de capim-mombaça e concentrado nas seguintes proporções: 80:20, 65:35, 50:50 e 35:65, com base na matéria seca. Foram utilizados quatro animais Holandês x Zebu, com peso corporal médio inicial de 229kg, canulados no rúmen e abomaso, e distribuídos em quadrado latino 4x4. Os consumos de matéria seca (MS), matéria orgânica (MO), proteína bruta (PB), extrato etéreo (EE) e carboidratos totais (CHOT), expressos em kg/dia, e a digestibilidade parcial dos carboidratos não fibrosos (CNF) apresentaram comportamento linear crescente, com resposta platô nos níveis de concentrado de 54,1; 54,8; 52,9; 62,2; 55,2 e 52,7 por cento. O consumo dos demais nutrientes, exceto da fibra em detergente neutro (FDN), e as digestibilidades aparente total de MS, MO e CNF e a parcial de MO aumentaram linearmente com o incremento do concentrado nas dietas. Não foram encontradas diferenças no consumo e nas digestibilidades aparente total e parcial da FDN. Para concentração de amônia e pH ruminal, observou-se efeito quadrático de tempo de amostragem, com valores máximos de 24,76mg/dL e 6,53 em 2,8 e 3,5 horas após a alimentação, respectivamente.

Intake; total and partial digestibilities of nutrients; and ruminal pH and ammonia concentration were evaluated in beef cattle fed Mombaça-grass silage and concentrate at the following proportions: 80:20, 65:35, 50:50, and 35:65, in the dry matter basis. Four Holstein x Zebu steers, with average live weight of 229kg, fitted with ruminal and abomasal canullae, were used. The animals were allotted in a 4x4 latin square design. The intakes of dry matter (DM), organic matter (OM), crude protein (CP), ether extract (EE), and total carbohydrates (kg/day), as well the partials digestibilities of non fibrous carbohydrates (NFC) increased linearly with plateau at the concentrate levels of 54.1, 54.8, 52.9, 62.2, 55.2, and 52.7 percent. The intakes of others nutrients, except neutral detergent fiber (NDF), and the total apparent digestibilities of DM, OM, and NFC and the partial digestibility of OM increased linearly as the concentrate levels in the diets increased. No differences were found on the intake and the total and partial apparent digestibilities of NDF. The ruminal pH and ammonia concentration presented a quadratic affect in relation to the time of sampling, with maximum register at 2.8 and 3.5 hours after feeding, respectively, corresponding to pH 6.53 and 24.76mg/dL of ammonia.

Medo e/ou ansiedade com fator inibitório para a visita ao dentista / Fear and/or anxiety related to the avoidance of dental visits

Considerando que a ansiedade pode refletir no comparecimento do paciente ao consultório odontológico, este estudo exploratório propôs avaliar o medo e/ou ansiedade como um fator inibitório para a visita ao dentista por crianças pré-escolares. O estudo contou com a participação de 558 responsáveis por crianças com 5 anos de idade, de ambos os sexos, matriculadas em escolas públicas e particulares da cidade do Recife. Os dados foram coletados através da aplicação de um formulário em forma de entrevista, com questões referentes ao medo/ansiedade, tanto da criança quanto do responsável. Após a análise dos dados, pode-se constatar que, de acordo com relato dos responsáveis, uma parcela significativa (17 por cento) adiaria ou cancelaria a consulta odontológica da criança caso a mesma apresentasse ansiedade no dia da visita ao dentista. Foi observado, também, que, a maioria dos entrevistados afirmou sentir desconforto devido à presença do medo e/ou ansiedade em suas crianças, e 7,8 por cento informaram que já adiaram ou cancelaram a consulta odontológica do paciente infantil devido ao medo e/ou ansiedade apresentado pelo criança. Além disso, 23 por cento dos responsáveis afirmaram que já adiaram ou faltaram à sua própria consulta ao dentista por medo e/ou ansiedade. Sufere-se que o medo e/ou ansiedade pode ser um fator inibitório ao atendimento odontológico

Oral manifestation of sporotrichosis in AIDS patients.

A wide spectrum of oral lesions has been associated with human immunodeficiency viral infection (HIV), or AIDS. This report describes the case of an HIV-infected patient who developed a case of disseminated sporotrichosis whose first clinical sign was the presence of orofacial lesions. A histopathological study of this patient's biopsy specimens taken from the oropharyngeal lesions revealed a number of rounded and/or oval free-spore forms of Sporothrix schenkii, the identification of which was corroborated by culturing skin lesion exudate on Sabouraud's glucose agar. To the best of our knowledge to date, this is the first time a case of the oral manifestation of sporotrichosis in association with HIV infection has been described in the dental literature.

Oral manifestation of tertiary syphilis: case report.

This paper describes a case of benign tertiary syphilis represented by a solitary hypertrophic lesion on the dorsum surface of the tongue. The diagnosis was confirmed by serologic tests (VDRL and FTA-ABS). Histopathological analysis of biopsy specimens revealed, in the lamina propria, the presence of well-developed granulomas associated with necrotic areas (gummatous lesion). Currently, tertiary syphilis is rarely seen; however, this case emphasizes that it still exists and must be considered in the differential diagnosis of inflammatory oral lesions.