The role of transforming growth factor ß in cervical carcinogenesis.

Human papillomavirus (HPV) is involved in virtually all cases of cervical cancer. However, HPV alone is not sufficient to cause malignant development. The effects of chronic inflammation and the interaction of immune components with the microenvironment infected with the high-risk HPV type (HR) may contribute to cancer development. Transforming growth factor ß (TGFB) appears to play an important role in cervical carcinogenesis. Protein and mRNA levels of this cytokine gradually increase as normal tissue develops into malignant tissue and are closely related to the severity of HPV infection. At the onset of infection, TGFB can inhibit the proliferation of infected cells and viral amplification by inhibiting cell growth and downregulating the transcriptional activity of the long control region (LCR) of HPV, thereby reducing the expression of early genes. When infected cells progress to a malignant phenotype, the response to the cell growth inhibitory effect of TGFB1 is lost and the suppression of E6 and E7 expression decreases. Subsequently, TGFB1 expression is upregulated by high levels of E6 and E7 oncoproteins, leading to an increase in TGFB1 in the tumor microenvironment, where this molecule promotes epithelial-to-mesenchymal transition (EMT), cell motility, angiogenesis, and immunosuppression. This interaction between HPV oncoproteins and TGFB1 is an important mechanism promoting the development and progression of cervical cancer.

Experimental Granulomatous Amebic Encephalitis Caused by Acanthamoeba castellanii.

Acanthamoeba genus can affect humans with diseases such as granulomatous amebic encephalitis (GAE), a highly lethal neuroinfection. Several aspects of the disease still need to be elucidated. Animal models of GAE have advanced our knowledge of the disease. This work tested Wistar rats (Rattus norvegicus albinus) as an animal model of GAE. For this, 32 animals were infected with 1 × 106A. castellanii trophozoites of the T4 genotype. Ameba recovery tests were carried out using agar plates, vascular extravasation assays, behavioral tests, and histopathological technique with H/E staining. Data were subjected to linear regression analysis, one-way ANOVA, and Tukey's test, performed in the GraphPad Prism® 8.0 program, with a significance level of p < 0.05. The results revealed the efficiency of the model. Amebae were recovered from the liver, lungs, and brain of infected animals, and there were significant encephalic vascular extravasations and behavioral changes in these animals, but not in the control animals. However, not all infected animals showed positive histopathology for the analyzed organs. Nervous tissues were the least affected, demonstrating the role of the BBB in the defense of the CNS. Supported by the demonstrated evidence, we confirm the difficulties and the feasibilities of using rats as an animal model of GAE.

Different bacterial cargo in apoptotic cells drive distinct macrophage phenotypes.

The removal of dead cells (efferocytosis) contributes to the resolution of the infection and preservation of the tissue. Depending on the environment milieu, macrophages may show inflammatory (M1) or anti-inflammatory (M2) phenotypes. Inflammatory leukocytes are recruited during infection, followed by the accumulation of infected and non-infected apoptotic cells (AC). Efferocytosis of non-infected AC promotes TGF-ß, IL-10, and PGE2 production and the polarization of anti-inflammatory macrophages. These M2 macrophages acquire an efficient ability to remove apoptotic cells that are involved in tissue repair and resolution of inflammation. On the other hand, the impact of efferocytosis of infected apoptotic cells on macrophage activation profile remains unknown. Here, we are showing that the efferocytosis of gram-positive Streptococcus pneumoniae-AC (Sp-AC) or gram-negative Klebsiella pneumoniae-AC (Kp-AC) promotes distinct gene expression and cytokine signature in macrophages. Whereas the efferocytosis of Kp-AC triggered a predominant M1 phenotype in vitro and in vivo, the efferocytosis of Sp-AC promoted a mixed M1/M2 activation in vitro and in vivo in a model of allergic asthma. Together, these findings suggest that the nature of the pathogen and antigen load into AC may have different impacts on inducing macrophage polarization.

Metalloproteinase 9 immunostaining profile is positively correlated with tumor grade, extraprostatic extension and biochemical recurrence in prostate cancer.

Metastasis is the main problem in the treatment of prostate cancer (PCa), and for it to occur, proteolytic enzymes must remodel the extracellular matrix (ECM) surrounding the tumor. The most important group of enzymes with this action include the matrix metalloproteinases (MMPs), which act on various substrates cleaving ECM components. The present study aimed to evaluate the protein immunostaining profiles of matrix metalloproteinase 2 (MMP-2) and 9 (MMP-9) in PCa Brazilian patients using the indirect immunohistochemical methodology. The tissue samples (n = 178), 60 from malignant tumor, 58 from adjacent non-tumor, and 60 from ECM, were evaluated according to the immunostaining intensity. The malignant tumor cytoplasmic MMP-2 immunostaining was more intense than in ECM (p = 0.001), but it did not correlate with any clinical-pathological parameter. The MMP-9 staining was similar in tumor cytoplasm, adjacent non-tumor cytoplasm and ECM, but showed significant positive correlations with ISUP grade (p = 0.044; Tau=0.249), extraprostatic extension (p = 0.025; Tau=0.309), and biochemical recurrence (p = 0.048; Tau=0.306). A significant positive correlation was also observed between MMP-2 and MMP-9 in all cell compartments analyzed. Although further research is warranted to elucidate the precise mechanisms underlying these observations, our findings suggest MMP-9 as a promising candidate marker for tissue invasion that could be used in predicting the progression and prognosis of PCa.

Evaluation of oxidative stress level: reactive oxygen species, reduced glutathione, and D-dimer in patients hospitalized due to COVID-19.

Elevated D-dimer levels at hospital admission may also indicate a higher likelihood of progressing to a severe or critical state. This study aimed to assess reactive oxygen species (ROS), non-enzymatic antioxidant reduced glutathione (GSH), and D-dimer levels in COVID-19 patients upon admission, examining their association with mortality outcomes. Data was collected from the medical records of 170 patients hospitalized in a referral hospital unit between March 2020 and December 2021. Patients were divided into two groups: the ward bed group (n = 87), comprising 51% with moderate clinical conditions, and the intensive care unit (ICU) group (n = 83), comprising 49% with severe conditions. The mean age was 59.4 years, with a male predominance of 52.4%. The overall death rate was 43%, with 30.6% in the moderate group and 69.4% in the severe group. The average time from symptom onset to hospitalization was 6.42 days. Results showed that non-survivors had high D-dimer and ROS counts, longer ICU stays, and worse saturation levels at admission. In conclusion, elevated ROS and D-dimer levels may contribute to worse outcomes in critically ill patients, potentially serving as specific and sensitive predictors of poor outcomes upon admission.

Allelic variants and immunostaining profile in CXCL12/CXCR4 axis: An investigation of association with prognosis in prostate cancer.

Prostate cancer (PCa) is the malignant neoplasm that most commonly affects men and is an important cause of death. It can be detected by changes in serum levels of Prostate Specific Antigen (PSA) and digital rectal examination, but often symptoms do not appear until advanced stages and metastases. The C-X-C Motif Chemokine Ligand 12/C-X-C Motif Chemokine Receptor 4 (CXCL12/CXCR4) axis acts in cell migration and may be involved in the metastatic process. In this context, the aim of this study was to evaluate the allelic variants rs1801157 (CXCL12) and rs2228014 (CXCR4) and the immunostaining of CXCR4 protein as candidates for prognostic markers in PCa. Samples (n = 60) were divided according to prognostic parameters (with and without metastasis at diagnosis) in tree groups: better prognosis, worse prognosis with metastasis at diagnosis and worse prognosis without metastasis at diagnosis, and immunostaining was evaluated by indirect immunohistochemistry, considering tumoral and adjacent tissues from the same patient (n = 120). A significant association was found between the C allele of rs2228014 (CXCR4) and the extraprostatic extension. For CXCR4 immunostaining a weak labeling and a cytoplasmic localization predominated, as well as a significant difference between malignant versus adjacent tissue, with higher protein expression in the malignant tissue. A significant association was found between CXCR4 tumor immunostaining with TNM staging (T2b-T2c) and PSA level (> 20 ng/mL). None of the allelic variants affected CXCR4 immunostaining. Prognostic groups did not differ in allelic variant frequency or immunostaining profile. Findings suggest that CXCR4 receptor may be one of the ways to worsen the prognosis of prostatic cancer.

APOBEC3A/B Polymorphism Is Not Associated with Human Papillomavirus Infection and Cervical Carcinogenesis.

The persistence of a high-risk Human papillomavirus (HPV-HR) infection of the cervix results in different manifestations of lesions depending on the immunologic capacity of the host. Variations in apolipoprotein B mRNA editing enzyme catalytic polypeptide (APOBEC)-like genes, such as the APOBEC3A/B deletion hybrid polymorphism (A3A/B), may contribute to cervical malignancy in the presence of HPV. The aim of this study was to investigate the association between the A3A/B polymorphism and HPV infection and the development of cervical intraepithelial lesions and cervical cancer in Brazilian women. The study enrolled 369 women, who were categorized according to the presence of infection and subdivided according to the degree of intraepithelial lesion and cervical cancer. APOBEC3A/B was genotyped by allele-specific polymerase chain reaction (PCR). As for the A3A/B polymorphism, the distribution of genotypes was similar between groups and among the analyzed subgroups. There were no significant differences in the presence of infection or development of lesions, even after exclusion of confounding factors. This is the first study to show that the A3A/B polymorphism is not associated with HPV infection and the development of intraepithelial lesions and cervical cancer in Brazilian women.

Involvement of CXCL12/CXCR4 axis in colorectal cancer: a mini-review.

Migration of metastatic tumor cells is similar to the traffic of leukocytes and has been reported that can be guided by chemokines and their receptors, through the circulation to distant organs. The chemokine CXCL12 and its receptor CXCR4 play an essential role in hematopoietic stem cell homing and the activation of this axis supports malignant events. Binding of CXCL12 to CXCR4 activates signal transduction pathways, with broad effects on chemotaxis, cell proliferation, migration and gene expression. Thus, this axis serves as a bridge for tumor-stromal cell communication, creating a permissive microenvironment for tumor development, survival, angiogenesis and metastasis. Evidence suggests that this axis may be involved in the colorectal cancer (CRC) carcinogenesis. Therefore, we review emerging data and correlations between CXCL12/CXCR4 axis in CRC, the implications for cancer progression and possible therapeutic strategies that exploit this system.

General Health Questionnaire (GHQ12): new evidence of construct validity / Questionário de Saúde Geral (QSG-12): novas evidências de validade de construto

Abstract This study aimed to gather evidence on the adequacy of the General Health Questionnaire (GHQ-12) in Brazil, considering a random sample of Brazilian physicians. Specifically aimed: (1) to test the GHQ-12 bifactor structure compared to alternative models, (2) to check its factorial invariance regarding to gender and the diagnosis of mental and behavioral disorders, and (3) to know the association of this measure with indicators of poor health (e.g., suicidal thoughts, decreased libido, medication use). The study included 1,085 physicians with a mean age of 45.7 (SD = 10.6), mostly male (61.5%), married (72.6%) and Catholic (59.2%). They answered the GHQ-12, the Positive and Negative Suicidal Ideation Inventory, and demographic questions. The best fit model was the bifactor structure composed of anxiety and depression, in addition to a general dimension, which presented Cronbach's alpha, McDonald's ω and composite reliability higher than 0.70 just for a general fact. Psychological distress scores correlated with suicidal ideation and indicators of health and sexual satisfaction. This is a psychometrically suitable instrument that can be used in terms of its total, but its specific factors need to be used with caution.

Resumo Este estudo teve como objetivo reunir evidências sobre a adequação do Questionário de Saúde Geral (QSG-12) no Brasil, considerando uma amostra aleatória de médicos brasileiros. Especificamente, objetivou-se: (1) testar uma estrutura bifactor em comparação com modelos alternativos, (2) verificar invariância fatorial em relação ao gênero e ao diagnóstico de transtornos mentais e comportamentais, e (3) conhecer a associação com indicadores de saúde precária (por exemplo: pensamentos suicidas, diminuição da libido e uso de medicamentos). Participaram do estudo 1.085 médicos, com média de idade de 45,7 (DP = 10,6), maioria de sexo masculino (61,5%), casados ​​(72,6%) e católicos (59,2%). Eles responderam ao QSG-12, ao Inventário de Ideação Suicida Positiva e Negativa e a questões demográficas. O modelo de melhor ajuste foi a estrutura bifactor (composta por ansiedade, depressão e uma dimensão geral), que apresentou alfa de Cronbach, ômega de McDonald e confiabilidade composta superior a 0,70 apenas para o fato geral. Pontuações de sofrimento psicológico se correlacionaram a ideação suicida e indicadores negativos de saúde e satisfação sexual. O instrumento foi psicometricamente adequado e pode ser utilizado em termos de sua pontuação total, mas seus fatores específicos precisam ser utilizados com cautela.

Cinnamaldehyde supplementation acts as an insulin mimetic compound improving glucose metabolism during adolescence, but not during adulthood, in healthy male rats.

PURPOSE: Adolescence is a critical period of increased vulnerability to nutritional modifications, and adolescents may respond differently from adults to dietary intake and nutraceuticals. Cinnamaldehyde, a major bioactive compound of cinnamon, improves energy metabolism, as has been shown in studies conducted primarily in adult animals. We hypothesized that cinnamaldehyde treatment may have a higher impact on the glycemic homeostasis of healthy adolescent rats than on healthy adult rats. METHODS: Male adolescent (30 days) or adult (90 days) Wistar rats received cinnamaldehyde (40 mg/kg) for 28 days by gavage. The oral glucose tolerance test (OGTT), liver glycogen content, serum insulin concentration, serum lipid profile, and hepatic insulin signaling marker expression were evaluated. RESULTS: Cinnamaldehyde-treated adolescent rats showed less weight gain (P = 0.041), improved OGTT (P = 0.004), increased expression of phosphorylated IRS-1 (P = 0.015), and a trend to increase phosphorylated IRS-1 (P = 0.063) in the liver of adolescent rats in the basal state. None of these parameters was modified after treatment with cinnamaldehyde in the adult group. Cumulative food intake, visceral adiposity, liver weight, serum insulin, serum lipid profile, hepatic glycogen content, and liver protein expression of IRß, phosphorylated IRß, AKT, phosphorylated AKT, and PTP-1B in the basal state were similar between both age groups. CONCLUSION: In a healthy metabolic condition, cinnamaldehyde supplementation affects glycemic metabolism in adolescent rats while promoting no changes in adult rats.

Cross-Sectional Analysis of Human Papillomavirus Infection and Cytological Abnormalities in Brazilian Women.

The aim of this study was to determine the incidence of infections and cytological abnormalities and to investigate possible predisposing factors such as sociodemographic characteristics, sexual behavioral habits, and gynecological and obstetric backgrounds. Between 2013 and December 2016, a cross-sectional study was conducted among 429 consenting women, from whom cervical samples were tested for the presence of Human papillomavirus (HPV) by polymerase chain reaction (PCR). Susceptibility to HPV infection was assessed by binary logistic regression in light of possible predisposing factors, which were collected using a questionnaire. In our sample population, the prevalence of HPV infection was 49%; high-risk types had a higher prevalence of 89.1%. A larger proportion of HPV-infected women were under 25 years of age, were single, and had monthly incomes up to minimum wage. Multivariate binary logistic regression analysis showed that age younger than 25 years increased the odds of infection fivefold, while a monthly income of one to three minimum wages provided protection against HPV infection, even if the women were married or had a cohabiting partner. In the HPV-positive group, squamous intraepithelial lesions (SIL) occurred more frequently in women who earned up to one minimum wage monthly, but a monthly income of one to three minimum wages protected against the development of SIL. The results suggest that age, marital status, and monthly income are important cofactors for HPV infection and the development of SIL.

Severe and Moderate Primary Graft Dysfunction in Adult Heart Recipients.

INTRODUCTION: The aims of this study were to determine the incidence of severe and moderate primary graft dysfunction (PGD) in our center, to identify, retrospectively, donors' and recipients' risk factors for PGD development, and to evaluate the impact of PGD within 30 days after heart transplantation. METHODS: Donors' and recipients' medical records of 64 consecutive adult cardiac transplantations performed between January 2016 and June 2017 were reviewed. The International Society for Heart and Lung Transplantation (ISHLT) criteria were used to diagnose moderate and severe PGD. Associations of risk factors for combined moderate/severe PGD were assessed with appropriate statistical analyses. RESULTS: Sixty-four patients underwent heart transplantation in this period. Twelve recipients (18.7%) developed severe or moderate PGD. Development of PGD was associated with previous donor cardiopulmonary resuscitation and a history of prior heart surgery in the recipient (P=0.01 and P=0.02, respectively). The 30-day in hospital mortality was similar in both PGD and non-PGD patients. CONCLUSION: The use of the ISHLT criteria for PGD is important to identify potential risk factor. The development of PGD did not affect short-term survival in our study. More studies should be done to better understand the pathophysiology of PGD.

Tissue immunostaining of candidate prognostic proteins in metastatic and non-metastatic prostate cancer.

PURPOSE: Prostate cancer (PCa) lacks specific markers capable of distinguishing aggressive tumors from those with indolent behavior. Therefore, the aim of this study was to evaluate the immunostaining of candidate proteins (PTEN, AKT, TRPM8, and NKX3.1) through the immunohistochemistry technique (IHC) on patients with metastatic and non-metastatic PCa. METHODS: Tissues from 60 patients were divided into three groups categorized according to prognostic parameters: better prognosis (n = 20), worse prognosis (n = 23), and metastatic (n = 17). Immunostaining was analyzed by a pathologist and staining classifications were considered according to signal intensity: (0) no staining, (+) weak, and (++ and +++) intermediate to strong. RESULTS: AKT protein was associated (p = 0.012) and correlated (p = 0.014; Tau = - 0.288) with the prognostic groups. The immunostaining for TRPM8 (p = 0.010) and NKX3.1 (p = 0.003) proteins differed between malignant tumor and non-tumoral adjacent tissue as well as for proteins in cellular locations (nucleus and cytoplasm). TRPM8 was independently associated with the ISUP grade ≥ 4 (p = 0.024; OR = 8.373; 95% CI = 1.319-53.164). The NKX3.1 showed positive and predominantly strong immunostaining in all patients in both tumoral and non-tumoral adjacent tissues. All metastatic samples had positive immunostaining, with strong intensity for NKX3.1 (p = 0.021; Tau = - 0.302). In the non-metastatic group, this strong protein staining was not observed in any patients. CONCLUSION: This study confirmed that NKX3.1 is highly specific for prostate tissue and indicated that NKX3.1, AKT, and TRPM8 may be candidate markers for prostate cancer prognosis.

Severe and Moderate Primary Graft Dysfunction in Adult Heart Recipients

ABSTRACT Introduction: The aims of this study were to determine the incidence of severe and moderate primary graft dysfunction (PGD) in our center, to identify, retrospectively, donors' and recipients' risk factors for PGD development, and to evaluate the impact of PGD within 30 days after heart transplantation. Methods: Donors' and recipients' medical records of 64 consecutive adult cardiac transplantations performed between January 2016 and June 2017 were reviewed. The International Society for Heart and Lung Transplantation (ISHLT) criteria were used to diagnose moderate and severe PGD. Associations of risk factors for combined moderate/severe PGD were assessed with appropriate statistical analyses. Results: Sixty-four patients underwent heart transplantation in this period. Twelve recipients (18.7%) developed severe or moderate PGD. Development of PGD was associated with previous donor cardiopulmonary resuscitation and a history of prior heart surgery in the recipient (P=0.01 and P=0.02, respectively). The 30-day in hospital mortality was similar in both PGD and non-PGD patients. Conclusion: The use of the ISHLT criteria for PGD is important to identify potential risk factor. The development of PGD did not affect short-term survival in our study. More studies should be done to better understand the pathophysiology of PGD.

THE INTESTINAL MICROBIOME IN PATIENTS UNDERGOING BARIATRIC SURGERY: A SYSTEMATIC REVIEW.

BACKGROUND: Dysbiosis of the gut microbiota is frequently found in cases of obesity and related metabolic diseases, such as type 2 diabetes mellitus. The composition of the microbiota in diabetics is similar to that of obese people, thereby causing increased energy uptake efficiency in the large intestine of obese people, maintenance of a systemic inflammatory state, and increased insulin resistance. Bariatric surgery seems to entail an improvement in gut dysbiosis, leading to an increased diversity of the gut microbiota. AIMS: This study aimed to present a literature review on obesity-associated gut dysbiosis and its status post-bariatric surgery. METHODS: A systematic review of primary studies was conducted in PubMed, SciELO, BIREME, LILACS, Embase, ScienceDirect, and Scopus databases using DeCS (Health Science Descriptors) with the terms "obesity," "intestinal dysbiosis," "bariatric surgery," and "microbiota." RESULTS: We analyzed 28 articles that had clinical studies or literature reviews as their main characteristics, of which 82% (n=23) corresponded to retrospective studies. The sample size of the studies ranged from 9 to 257 participants and/or fecal samples. The epidemiological profile showed a higher prevalence of obesity in females, ranging from 24.4 to 35.1%, with a mean age of around 25-40 years. There was a variation regarding the type of bariatric surgery, migrating between the Roux-en-Y bypass, adjustable gastric banding, and vertical gastrectomy. Of the 28 studies, 6 of them evaluated the gut microbiota of obese patients undergoing bariatric surgery and their relationship with type 2 diabetes mellitus/glucose metabolism/insulin resistance. CONCLUSIONS: The intestinal microbiota is an important influencer in the regulation of the digestive tract, and obese individuals with comorbidities (diabetes mellitus, hypercholesterolemia, and metabolic syndrome) present important alterations, with an unbalance normal state, generating dysbiosis and the proliferation of bacterial species that favor the appearance of new diseases. Patients who undergo bariatric surgery present an improvement in the intestinal microbiota imbalance as well as reversibility of their comorbidities, increasing their life expectancy.

Correlation between cow's milk protein allergy and otitis media: a systematic review / Correlação entre alergia à proteína do leite de vaca e otite média: uma revisão sistemática

Abstract Objectives To review the evidence pertaining to the association between cow's milk protein allergy and recurrent acute otitis media and otitis media with effusion. Methods The CENTRAL, Web of Science, EMBASE, MEDLINE, LILACS databases, and gray literature were searched. Results Four studies were included, identifying the prevalence rates: 0.2% of delayed speech due to chronic otitis media with effusion in 382 children with cow's milk protein allergy, 10.7% of cow's milk protein allergy in 242 children who underwent ENT procedures, 40% of cow's milk protein allergy in 25 children with recurrent otitis media with effusion and higher tendency to otitis media in children with cow's milk protein allergy of 186 children (1.5 + 0.6 vs. 0.4 + 0.1; p< 0.1). Conclusion Considering the characteristics and methodological variations of the identified studies, it is not possible to state that there is reliable evidence of an association between cow's milk protein allergy and otitis media.

Resumo Objetivo Revisar as evidências sobre a correlação entre alergia à proteína do leite de vaca e otite média aguda recorrente e otite média com efusão. Métodos As buscas foram feitas nas bases de dados Central, Web of Science, Embase, Medline, Lilacs e na literatura cinzenta. Resultados Quatro estudos foram incluídos, identificaram‐se as prevalências: 0,2% de fala atrasada devido a otite média com efusão crônica entre 382 crianças com alergia à proteína do leite de vaca, 10,7% de alergia à proteína do leite de vaca entre 242 crianças submetidas a procedimentos otorrinolaringológicos, 40% de alergia à proteína do leite de vaca entre 25 crianças com otite média com efusão recorrente e maior tendência à otite média em alérgicos à proteína do leite de vaca entre 186 crianças (1,5 + 0,6vs.0,4 + 0,1; p < 0,1). Conclusão Se considerarmos as características e variações metodológicas dos estudos identificados, não é possível afirmar a existência de evidência confiável sobre a correlação entre alergia à proteína do leite de vaca e otite média.

Beliefs Toward Cure of Homosexuality Scale: evidence for factor structure / Escala de Crenças sobre a Cura da Homossexualidade: evidências para a estrutura fatorial / Escala de Creencias sobre la Cura de la Homosexualidad: prueba de la estructura factorial

This study aimed to confirm the multifactorial structure of the Beliefs Toward Cure of Homosexuality Scale (BTCHS) - (ECCH in Portuguese) and to verify evidence of its validity based on external variables. To this end, two studies were carried out. In Study 1, there were 214 university students, with an average age of 24 years (SD = 9.15). These students answered the HCBS and demographic questions. The results indicated a satisfactory fit for multifactorial modeling. Study 2, in turn, presented 430 university students with an average age of 23 years (SD = 7.90). In addition to the HCBS, the participants responded to the measures of sexual prejudice (MSP) and attitudes towards gays and lesbians (ATGL) questionnaires. Performing correlation analyses between the variables, we found significant correlations between the HCBS and the MSP and ATGL. In conclusion, the HCBS presented an adequate data-model fit for its multifactorial structure and evidence for its validity based on external variables. (AU)

Este estudo objetivou confirmar a estrutura multifatorial da Escala de Crenças sobre a Cura da Homossexuliade (ECCH) e verificar evidências de validade baseada em variáveis externas. Para tal, foram realizados dois estudos. No Estudo 1 contou-se com 214 estudantes universtários, com uma média de idade de 24 anos (DP = 9,15). Estes responderam a ECCH e a perguntas demográficas. Os resultados indicaram um ajuste satisfatório do modelo multifatorial. O Estudo 2, por sua vez, contou com a participação de 430 estudantes universitários com uma média de idade de 23 anos (DP = 7,90). Além da ECCH, esses participantes responderam as medidas de preconceito sexual (EMPS) e atitudes frente a gays e lésbicas (EMAFGL). Mediante a realização de análises de correlação entre as variáveis foi possível constatar correlações significativas da ECCH com as dimensões da EMPS e EMAFGL. Conclui-se, que a ECCH apresenta bons indicadores de ajuste do modelo multifatorial e evidências de validade baseada em variáveis externas. (AU)

Este estudio objetivó confirmar la estructura multifactor de la Escala de Creencias sobre la Cura de la Homosexualidad (ECCH) y verificar evidencias de validez basadas en variables externas. Para ello, fueron realizados dos estudios. En el estudio 1 participaron 214 estudiantes universitarios, con una edad media de 24 años (DS = 9,15). Estos respondieron la ECCH y a las preguntas demográficas. Los resultados indicaron un ajuste satisfactorio del modelo multifactorial. El estudio 2, por su parte, contó con la participación de 430 estudiantes universitarios con una edad media de 23 años (DS = 7,90). Además de la ECCH, los participantes contestaron las medidas de prejuicio sexual (EMPS) y actitudes frente a gays y lesbianas (ATGL). Mediante la realización de análisis de correlación entre las variables fue posible constatar correlaciones significativas de la ECCH con las dimensiones de la EMPS y ATGL. Se concluye, que la ECCH presenta buenos índices de ajuste del modelo multifactorial y evidencias de validez basadas en variables externas. (AU)

In-Hospital Outcomes of Right Minithoracotomy vs. Periareolar Access for Minimally Invasive Video-Assisted Mitral Valve Repair

Abstract Introduction: In minimally invasive mitral valve repair, right minithoracotomy is the most widely performed method, providing a good view of the mitral valve. But regarding other techniques and although it offers limited visualization, the periareolar access is a less traumatic alternative. This study's purpose is to compare in-hospital outcomes in patients who underwent video-assisted minimally invasive mitral valve repair via right minithoracotomy and periareolar access. Methods: This is a retrospective observational study including 37 patients (> 18 years old), without previous right thoracic surgery, who underwent their primary mitral valve repair, with indication for minimally invasive video-assisted approach (via right minithoracotomy or periareolar access), between January 2018 and August 2019. Patients' medical records were consulted to collect demographics data, operative details, and in-hospital outcomes. Results: Twenty-one patients underwent right minithoracotomy, and 16 were operated via periareolar access. The mean patients' age was 62±12 years in the right minithoracotomy group and 61±9 years in the periareolar access group (P=0.2). There are no significant differences in incision length, cardiopulmonary bypass time, aortic cross-clamping time, hematocrit, amount of chest tube drainage, and intensive care unit and in-hospital length of stay. Time to extubation presented significant differences between the right minithoracotomy and the periareolar access group (4.85 hours vs. 5.62 hours, respectively) (P=0.04). Conclusion: In this study, we found similar results in the two applied surgical techniques, except for the time to extubation.

In-Hospital Outcomes of Right Minithoracotomy vs. Periareolar Access for Minimally Invasive Video-Assisted Mitral Valve Repair.

INTRODUCTION: In minimally invasive mitral valve repair, right minithoracotomy is the most widely performed method, providing a good view of the mitral valve. But regarding other techniques and although it offers limited visualization, the periareolar access is a less traumatic alternative. This study's purpose is to compare in-hospital outcomes in patients who underwent video-assisted minimally invasive mitral valve repair via right minithoracotomy and periareolar access. METHODS: This is a retrospective observational study including 37 patients (> 18 years old), without previous right thoracic surgery, who underwent their primary mitral valve repair, with indication for minimally invasive video-assisted approach (via right minithoracotomy or periareolar access), between January 2018 and August 2019. Patients' medical records were consulted to collect demographics data, operative details, and in-hospital outcomes. RESULTS: Twenty-one patients underwent right minithoracotomy, and 16 were operated via periareolar access. The mean patients' age was 62±12 years in the right minithoracotomy group and 61±9 years in the periareolar access group (P=0.2). There are no significant differences in incision length, cardiopulmonary bypass time, aortic cross-clamping time, hematocrit, amount of chest tube drainage, and intensive care unit and in-hospital length of stay. Time to extubation presented significant differences between the right minithoracotomy and the periareolar access group (4.85 hours vs. 5.62 hours, respectively) (P=0.04). CONCLUSION: In this study, we found similar results in the two applied surgical techniques, except for the time to extubation.

CXCL12/CXCR4 axis gene variants contribute to an increased vulnerability to HPV infection and cervical oncogenesis.

PURPOSE: Every year, more than half a million women are diagnosed with cervical cancer (CC). Individual factors may contribute to the cervical cancer development, such as immunogenetic variation. CXCL12/CXCR4 axis is involved in tumor progression and aggressiveness. In the present study, we aimed to investigate a possible association between two single-nucleotide variants (CXCL12 rs1801157 and CXCR4 rs2228014) with HPV infection and cervical cancer development. METHODS: PCR technique was used to test HPV positivity in 424 women, in which the allelic frequency of CXCL12 rs1801157 and CXCR4 rs2228014 was also assessed by PCR-restriction fragment length polymorphism. RESULTS: CXCL12 rs1801157 was associated with HPV infection in the allelic distribution as well in the codominant, dominant and recessive genetic models; as well with squamous intraepithelial lesions (SIL) and CC in the codominant and dominant models. CXCR4 rs2228014 was associated to HPV infection in the codominant model and allelic distribution; as well with SIL/CC in the codominant, dominant and allelic models. Independent associations were found for CXCL12 AA genotype and HPV infection, SIL and CC development, as well as, CXCR4 allele T and HPV infection and CC. The variants interaction analysis demonstrated that the presence of both polymorphisms increases the susceptibility of HPV infection in 10.1 times, SIL (2 times) and CC development in 4.2 times. CONCLUSIONS: This is the first study demonstrating that the interaction of CXCL12 and CXCR4 variants contributes to the increased susceptibility of HPV infection, squamous intraepithelial lesions and cervical cancer development.