ABSTRACT
The Zika virus (ZIKV) can be vertically transmitted, causing congenital Zika syndrome (CZS) in fetuses. ZIKV infection in early gestational trimesters increases the chances of developing CZS. This syndrome involves several pathologies with a complex diagnosis. In this work, we aim to identify biological processes and molecular pathways related to CZS and propose a series of putative protein and metabolite biomarkers for CZS prognosis in early pregnancy trimesters. We analyzed serum samples of healthy pregnant women and ZIKV-infected pregnant women bearing nonmicrocephalic and microcephalic fetuses. A total of 1090 proteins and 512 metabolites were identified by bottom-up proteomics and untargeted metabolomics, respectively. Univariate and multivariate statistical approaches were applied to find CZS differentially abundant proteins (DAP) and metabolites (DAM). Enrichment analysis (i.e., biological processes and molecular pathways) of the DAP and the DAM allowed us to identify the ECM organization and proteoglycans, amino acid metabolism, and arachidonic acid metabolism as CZS signatures. Five proteins and four metabolites were selected as CZS biomarker candidates. Serum multiomics analysis led us to propose nine putative biomarkers for CZS prognosis with high sensitivity and specificity.
Subject(s)
Pregnancy Complications, Infectious , Zika Virus Infection , Zika Virus , Pregnancy , Female , Humans , Zika Virus Infection/diagnosis , Zika Virus/genetics , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/pathology , Multiomics , BiomarkersABSTRACT
Radiation therapy for head and neck squamous cell carcinoma (HNSCC) is associated with several complications. Although photobiomodulation (PBM) has radioprotective effects in normal tissue, it could also enhance the growth of neoplastic cells. Thus, the present study aimed to investigate the cellular response of oral squamous cell carcinoma with pre-exposure to low-level phototherapy before radiotherapy. SCC9, Cal-27, A431, and HaCaT cell lines were subjected to low-level light therapy and radiotherapy. The cells were treated with a single energy density (300 J/cm2) of a light-emitting diode (660 nm) prior to ionizing radiation at different doses (0, 2, 4, and 6 Gy). After 24 h, wound scratch, proliferation, clonogenic cell survival, cell death, and reactive oxygen species (ROS) analyses were performed to evaluate cell response. The cell lines pre-exposed to PBM at the analyzed dosage were radiosensitive. The treatment significantly reduced cell proliferation and clonogenic cell survival. Migration and cell death assays also revealed positive results, with the treatment group showing lower rate of migration and higher cell death than did the control group. Moreover, PBM effectively increased the intracellular levels of ROS. PBM at 300 J/cm2 is a promising radiosensitizing modality to reduce the radiation dose and avoid the intolerable side effects of radiotherapy for HNSCC, thus increasing the probability of successful treatment. However, further studies are needed to support and confirm the results.
Subject(s)
Carcinoma, Squamous Cell , Head and Neck Neoplasms , Low-Level Light Therapy , Mouth Neoplasms , Humans , Squamous Cell Carcinoma of Head and Neck/radiotherapy , Squamous Cell Carcinoma of Head and Neck/etiology , Mouth Neoplasms/radiotherapy , Mouth Neoplasms/pathology , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/pathology , Low-Level Light Therapy/methods , Reactive Oxygen Species , Head and Neck Neoplasms/radiotherapyABSTRACT
Toxoplasmosis is the most prevalent zoonosis in the world and is associated with a large spectrum of diseases. Acute acquired toxoplasmosis (AAT) is considered a benign and self-limiting disease but severe postnatal infections have been reported, particularly in South America. Laboratory diagnosis is based on the detection of anti-Toxoplasma gondii IgM, IgG, and presence of low IgG avidity. However, these assays present limitations, and therefore, PCR has been suggested as an alternative diagnostic tool. In this study, we performed real-time and nested PCR in DNA blood samples from 59 individuals with AAT lasting less than 80 days. None of the patients had parasitic DNA detected by PCR, even in the more severe cases or when blood was collected early after disease onset. These negative results indicate that the parasitemia kinetics needs investigation to determine the best time for blood sampling, especially in immunocompetent individuals. Thus, we emphasize that a negative PCR result does not exclude recent T. gondii infection, and serological criteria are still decisive for the laboratory diagnosis of AAT.
Subject(s)
Molecular Diagnostic Techniques , Polymerase Chain Reaction , Toxoplasma/isolation & purification , Toxoplasmosis/diagnosis , Acute Disease , Adolescent , Adult , Child , DNA, Protozoan/blood , DNA, Protozoan/genetics , Female , Humans , Middle Aged , Negative Results , Toxoplasma/genetics , Toxoplasmosis/blood , Toxoplasmosis/parasitology , Young AdultABSTRACT
BACKGROUND: Prader-Willi syndrome (PWS) is a genetic disorder characterized by abnormalities in the 15q11-q13 region. Understanding the correlation between genotype and phenotype in PWS is crucial for improved genetic counseling and prognosis. In this study, we aimed to investigate the correlation between genotype and phenotype in 45 PWS patients who previously underwent methylation-sensitive high-resolution melting (MS-HRM) for diagnosis. RESULTS: We employed methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) and Sanger sequencing, along with collecting phenotypic data from the patients for comparison. Among the 45 patients, 29 (64%) exhibited a deletion of 15q11-q13, while the remaining 16 (36%) had uniparental disomy. No statistically significant differences were found in the main signs and symptoms of PWS. However, three clinical features showed significant differences between the groups. Deletion patients had a higher prevalence of myopia than those with uniparental disomy, as well as obstructive sleep apnea and an unusual skill with puzzles. CONCLUSIONS: The diagnostic tests (MS-HRM, MS-MLPA, and Sanger sequencing) yielded positive results, supporting their applicability in PWS diagnosis. The study's findings indicate a general similarity in the genotype-phenotype correlation across genetic subtypes of PWS.
Subject(s)
Genotype , Phenotype , Prader-Willi Syndrome , Humans , Prader-Willi Syndrome/genetics , Female , Male , Brazil , Child, Preschool , Child , Adolescent , Adult , Uniparental Disomy/genetics , Chromosomes, Human, Pair 15/genetics , Infant , Young AdultABSTRACT
BACKGROUND: Diagnosing imprinting defects in neonates and young children presents challenges, often necessitating molecular analysis for a conclusive diagnosis. The isolation of genetic material from oral swabs becomes crucial, especially in settings where blood sample collection is impractical or for vulnerable populations like newborns, who possess limited blood volumes and are often too fragile for invasive procedures. Oral swab samples emerge as an excellent source of DNA, effectively overcoming obstacles associated with rare diseases. METHODS: In our study, we specifically addressed the determination of the quality and quantity of DNA extracted from oral swab samples using NaCl procedures. RESULTS: We compared these results with extractions performed using a commercial kit. Subsequently, the obtained material underwent MS-HRM analysis for loci associated with imprinting diseases such as Prader-Willi and Angelman syndromes. CONCLUSIONS: Our study emphasizes the significance of oral swab samples as a reliable source for obtaining DNA for MS-HRM analysis. NaCl extraction stands out as a practical and cost-effective method for genetic studies, contributing to a molecular diagnosis that proves particularly beneficial for patients facing delays in characterization, ultimately influencing their treatment.
Subject(s)
Angelman Syndrome , DNA , Genomic Imprinting , Mouth Mucosa , Prader-Willi Syndrome , Humans , Mouth Mucosa/cytology , Mouth Mucosa/pathology , Angelman Syndrome/genetics , Angelman Syndrome/diagnosis , Prader-Willi Syndrome/genetics , Prader-Willi Syndrome/diagnosis , DNA/genetics , DNA/isolation & purification , Sodium Chloride , Infant, Newborn , Male , Imprinting DisordersABSTRACT
The aim of this study was to determine the prevalence of human papillomavirus (HPV) in a women population living within the state of Amazonas, Brazil, and to determine the viral genotypes found. The study included 361 sexually active women over 18 years of age. We performed the Pap test and the molecular diagnosis for HPV DNA using polymerase chain reaction (PCR). The amplicons obtained were sequenced in automatic sequencer for genotyping. The presence of HPV DNA was found in 29.1% (105) of the women. Only 321 women presented satisfactory slides for cytological diagnosis, 97.9% (314) had normal cytology (negative for cancer), and 2.1% (7) had abnormal cytology (4 ASCUS, 1 LSIL, and 2 HSIL). The types more frequently found were HPV 16 (58.1%) and HPV 58 (20.0%). Additionally, we found more 13 types of HPV. Compared with previous studies in Brazil, our data confirmed a high prevalence and genotypic diversity of HPV in Brazilian women.
Subject(s)
Papillomaviridae/genetics , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Adult , Brazil/epidemiology , Female , Genotype , Humans , Papillomaviridae/isolation & purification , Prevalence , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Dysplasia/virologyABSTRACT
The diagnosis of congenital toxoplasmosis presents limitations and therefore new options are necessary. The analysis of amniotic fluid by real-time PCR has already proved effective for confirmation of fetal infection. However, its performance in other biological samples is not clear yet. The aim of this study is to better understand the role of real-time PCR in the blood of the mother and newborn as well as in the amniotic fluid and placenta in the diagnosis of congenital toxoplasmosis. This is a descriptive cohort study of pregnant women with toxoplasmosis followed up in Rio de Janeiro, Brazil. Real-time PCR was performed in samples of maternal blood, amniotic fluid, placenta, and blood of newborns. In addition, histopathological examination of placentas was performed, and data collected from babies were collected. 116 pregnant women were followed up and 298 samples were analyzed. One (0.9%) pregnant woman presented positive PCR in the blood, 3 (3.5%) in the amniotic fluid, 1 (2.3%) in the placenta and no newborn had positive PCR in the blood. Histopathological study was suggestive of toxoplasmosis infection in 24 (49%) placentas. Six (5.2%) newborns were diagnosed with congenital toxoplasmosis, and only cases with positive PCR in the amniotic fluid had correlation of the PCR result with the diagnosis of congenital infection. Both maternal and blood samples of newborns and placenta did not prove to be promising in the diagnosis of congenital toxoplasmosis. Further studies are needed to evaluate the real role of molecular diagnosis in other biological materials rather than the amniotic fluid.
Subject(s)
Toxoplasma , Toxoplasmosis, Congenital , Toxoplasmosis , Pregnancy , Infant, Newborn , Female , Humans , Toxoplasmosis, Congenital/diagnosis , Real-Time Polymerase Chain Reaction , Cohort Studies , Brazil , Toxoplasmosis/diagnosis , Toxoplasma/genetics , Prenatal DiagnosisABSTRACT
The benign peripheral nerve sheath tumours are rare lesions mainly represented by schwannoma and neurofibroma. The present work evaluated the clinical and histopathological features of schwannomas and neurofibromas of the oral cavity diagnosed in a Brazilian population. Among 9.000 cases of oral lesions archived from 1970 to 2008, four schwannomas and 12 neurofibromas were identified, microscopically revised and immunohistochemically certified through a panel including monoclonal antibodies (anti-S100, vimentin, HHF-35 and desmin). From biopsy and histological sections records, clinical and histopathological data were retrieved, reviewed and statistically analysed. Predominantly, schwannomas affected non-white males (3:1), with an age and size averages of 34.7 years and 2.8 cm, respectively. Neurofibromas preferentially occurred on the gingival/alveolar ridge of white females (5:1), with 35.7-year mean age, peak of incidence between 3rd and 5th decade, and size average of 1.7 cm. (12 cases, 75%). The studied tumours exhibited more frequently as a painless, sessile and slow growth very similar to other oral lesions, but their microscopic features differed significantly. Schwannomas and neurofibromas are extremely uncommon in the oral cavity, exhibiting clinical features very similar but specific and peculiar microscopic findings that are useful in the establishment of the diagnosis, which in some particular cases must be confirmed by immunohistochemistry.
Subject(s)
Mouth Neoplasms/pathology , Neurilemmoma/pathology , Neurofibroma/pathology , Actins/analysis , Adolescent , Adult , Aged , Brazil , Child , Desmin/analysis , Female , Humans , Male , Middle Aged , S100 Proteins/analysis , Vimentin/analysis , Young AdultABSTRACT
Toxoplasmosis in pregnant women can cause significant morbidity and mortality in the fetus, which may be mitigated by early diagnosis and treatment. Social factors have also been related to the risk of developing the congenital form of toxoplasmosis, since some of these factors interfere directly in the quality of prenatal care. This study aimed to describe the clinical, laboratory, and epidemiological data of pregnant women diagnosed with toxoplasmosis and their newborns followed up at a referral hospital in Rio de Janeiro, Brazil. This was descriptive cohort study of 334 pregnant women with toxoplasmosis followed from May 2014 to December 2017. We conducted interviews to assess knowledge about the disease and its preventive measures, analyzed clinical and laboratory data during antenatal visits, and collected data from the newborns' medical charts. RESULTS: This was a predominantly low-income women cohort study, with little schooling, mainly referred from public health services late in pregnancy (178; 53.3%), in the second and third trimesters (286; 85.6%). Diagnosis of acute toxoplasmosis had not been confirmed in 171 cases (51.2%). Out of 183 (54.9%) women who had initiated treatment at the original health services, 45 (24.6%) received an incorrect prescription. Seventy-two amniocenteses were performed, with positive real-time polymerase chain reaction (qPCR) in the amniotic fluid in two cases (2.8%). Congenital toxoplasmosis at birth was identified in eight newborns (5.4%). CONCLUSION: Late referral to specialized medical services, inadequate toxoplasmosis management at the original prenatal care services, and social vulnerabilities are contributing factors to the persistent occurrence of congenital toxoplasmosis cases.
Subject(s)
Pregnancy Complications, Parasitic , Toxoplasmosis, Congenital , Toxoplasmosis , Brazil/epidemiology , Cohort Studies , Female , Hospitals , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Parasitic/diagnosis , Pregnancy Complications, Parasitic/epidemiology , Referral and Consultation , Toxoplasmosis/diagnosis , Toxoplasmosis/epidemiology , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/epidemiologyABSTRACT
Chlamydia trachomatis (CT) infection is often silent and can lead to long-term reproductive complications in women. In this study, we determined the prevalence of CT infection and possible associations between the presence of the infection and clinical-epidemiological variables in pregnant women attended at the Basic Health Units of the Coari city, Amazonas, Brazil. From July 2016 to March 2017, 164 pregnant women undergoing prenatal care were recruited. One hundred of these women were tested for CT infection using two types of samples: cervico-vaginal and urine. The diagnosis was confirmed by PCR with primers specific for the omp1 gene of CT chromosomal DNA. Of the 100 pregnant women, 18 (18%) had CT infection, 8 (8%) of which were positive in both samples, 7 (7%) only in the urine sample and 3 (3%) only in cervical-vaginal sample. There was moderate agreement (Kappa=0.55) and no statistically significant difference between sample types (p = 0.400). The mean age of infected women was 21.1 years (SD = 4.6). Of the clinical-epidemiological variables analyzed, "more than 2 partners in the last 12 months" (p = 0.022) and gynecological complaint of "pain after intercourse" (p = 0.020) were associated with CT infection. This study showed a high prevalence (18%) of CT infection among pregnant women in Coari / Amazonas. Urine sampales were as good as cervical-vaginal ones for the screening of CT infection during the prenatal period.
Subject(s)
Chlamydia Infections/epidemiology , Chlamydia trachomatis/genetics , Pregnancy Complications, Infectious/epidemiology , Prenatal Care/statistics & numerical data , Primary Health Care/statistics & numerical data , Adolescent , Adult , Brazil/epidemiology , Chlamydia Infections/diagnosis , Cross-Sectional Studies , Female , Humans , Mass Screening , Polymerase Chain Reaction , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Prevalence , Socioeconomic Factors , Young AdultABSTRACT
Chlamydia trachomatis infection is the most common sexually transmitted bacterial infection among women. In Brazil, there is no organized screening program for C. trachomatis, and the actual prevalence of infection is unknown. This study aimed to determine the prevalence of C. trachomatis infection in women living in riverside communities in the Amazon, using self-collection employing the Evalyn® Brush and polymerase chain reaction. A total of 299 riverine women aged 18-81 years, mean age 35.7 (±12.8) years, predominantly agricultural workers, with low schooling and living with a partner, participated in this study. The prevalence of C. trachomatis infection was found to be 3.7% (95% CI 1.8-6.5), most of them being symptomatic. The mean age of the first sexual intercourse reported by women was 15.2 (±2.3) years, and the majority reported having had none or only one partner in the last 12 months, with very low adherence to consistent condom use (15.4%). Most women (98.3%) reported having approved using the vaginal self-collecting brush, and only 4.7% reported having difficulty in handling the brush. We consider that a vaginal self-collecting device is adequate for diagnosing C. trachomatis infection in women living in remote, hard-to-reach areas.
Subject(s)
Chlamydia Infections/diagnosis , Chlamydia trachomatis/isolation & purification , Mass Screening/methods , Polymerase Chain Reaction/methods , Self Care/methods , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Brazil/epidemiology , Chlamydia Infections/epidemiology , Chlamydia trachomatis/genetics , Female , Humans , Middle Aged , Population Surveillance , Prevalence , Rural Population/statistics & numerical data , Specimen Handling , Young AdultABSTRACT
INTRODUCTION: The challenges related to the diagnosis of sexually transmitted infections present more complex factors in remote and hard-to-reach areas. The use of self-collection devices that facilitate the obtaining of a biological sample with high quality for sensitive molecular tests have been examined. This study aimed to evaluate the performance and acceptance of the Evalyn® Brush (Rovers® Medical Devices) for detection of T. vaginalis among women living in the riverside communities of Amazonas, Brazil. METHODOLOGY: The study included 300 riverside women. They received instructions for self-collection, carried out the task, and then answered a questionnaire on the use of the device. T. vaginalis was detected by Polymerase Chain Reaction, using primers TVK3/TVK7. RESULTS: The mean age of the women was 35.8 years, and most of them presented low schooling, low income, agricultural activity and lived in a marital union. All samples were positive for human genomic DNA (100%) and the prevalence of T. vaginalis infection was 5.6% (n = 17). Of the 300 women, 293 (97.7%) indicated that they liked the use of the device, 287 (95.7%) reported having had no difficulty in handling it, 265 (88.3%) did not feel any type of discomfort and 228 (76%) said they preferred the self-collection to the collection made by the professional, mainly due to privacy and comfort. CONCLUSIONS: The Evalyn® Brush proved reliable as a device for the collection of biological samples for molecular analysis and was well-accepted by women. Its use can be indicated in remote and hard to reach places.
Subject(s)
Specimen Handling/instrumentation , Trichomonas Vaginitis/parasitology , Adult , Aged , Brazil/epidemiology , Cross-Sectional Studies , Equipment Design , Female , Humans , Middle Aged , Prevalence , Self Care , Sexual Partners , Specimen Handling/methods , Trichomonas Vaginitis/epidemiology , Trichomonas vaginalis/genetics , Trichomonas vaginalis/isolation & purification , Young AdultABSTRACT
Coração em criss-cross (ou coração entrecruzado) foi descrito pela primeira vez em 1974. Trata-se de uma malformação cardíaca congênita, rara, ocorrendo 8 casos a cada 1.000.000 de crianças, e representando somente 0,1% das malformações congênitas. Os métodos diagnósticos de escolha são o ecocardiograma transtorácico, a ressonância magnética cardíaca (RMC), a angiotomografia (TC) e, eventualmente, o cateterismo cardíaco. Neste relato, descreve-se o caso de um recém-nascido com coração em criss-cross somado à dupla via de saída do ventrículo direito (VD), com vasos mal posicionados, além de comunicação interatrial (CIA), comunicação interventricular (CIV), displasia de valva tricúspide e veia cava superior esquerda persistente. Não se sabe a etiologia exata dessa malformação, mas parece ocorrer pela rotação dos ventrículos em seu eixo longitudinal, não acompanhada das rotações atrial e das valvas atrioventriculares (AV). Esse movimento produz uma alteração das vias de entrada dos ventrículos, determinando que o VD se posicione em plano superior e o esquerdo em plano inferior. Apesar de ainda não se saber a exata causa dessa anomalia, acredita-se que uma alteração genética possa estar levando a esses casos: a mutação do gene Cx43. O diagnóstico do caso em questão foi dado pela ecocardiografia transtorácica e da TC de aorta e artérias pulmonares, que mostraram, além do criss-cross, outras alterações, como dupla via de saída do VD, CIA e CIV amplas.(AU)
Criss-cross heart was first described in 1974. It is a rare congenital heart malformation that occurs in 8 cases per 1,000,000 children, and represents only 0.1% of congenital malformations. The diagnostic methods of choice are transthoracic echocardiography, cardiac magnetic resonance (CMR), computed tomography angiography (CT) and, sometimes, cardiac catheterization. This report describes the case of a newborn with a criss-cross heart in addition to double-outlet right ventricle (RV), with poorly positioned vessels, in addition to atrial septal defect (ASD), interventricular septal defect, tricuspid valve dysplasia and persistent left superior vena cava. The exact etiology of this malformation is not known, but it seems to occur due to rotation of the ventricles in their longitudinal axis, not accompanied by rotation of the atrial and atrioventricular (AV) valves. This movement produces abnormal ventricular inlets, determining that the RV be positioned on a superior plane and the left ventricle on an inferior plane. Although the exact cause of this anomaly is still unknown, it is believed that a genetic abnormality may be leading to these cases: mutation of the Cx43 gene. Diagnosis of the case concerned was given by transthoracic echocardiography and computed CT of the aorta and pulmonary arteries, which showed, in addition to the criss-cross heart, other abnormalities, such as double-outlet RV, large ASD and ventricular septal defect (VSD).(AU)
Subject(s)
Humans , Male , Infant, Newborn , Crisscross Heart/etiology , Crisscross Heart/diagnostic imaging , Heart Defects, Congenital/diagnosis , Heart Ventricles/abnormalities , Double Outlet Right Ventricle/diagnosis , Echocardiography/methods , Cardiac Catheterization/methods , Magnetic Resonance Spectroscopy/methods , Tomography, X-Ray Computed/methods , Persistent Left Superior Vena Cava/diagnosis , Heart Septal Defects, Atrial/diagnosisABSTRACT
ABSTRACT The diagnosis of congenital toxoplasmosis presents limitations and therefore new options are necessary. The analysis of amniotic fluid by real-time PCR has already proved effective for confirmation of fetal infection. However, its performance in other biological samples is not clear yet. The aim of this study is to better understand the role of real-time PCR in the blood of the mother and newborn as well as in the amniotic fluid and placenta in the diagnosis of congenital toxoplasmosis. This is a descriptive cohort study of pregnant women with toxoplasmosis followed up in Rio de Janeiro, Brazil. Real-time PCR was performed in samples of maternal blood, amniotic fluid, placenta, and blood of newborns. In addition, histopathological examination of placentas was performed, and data collected from babies were collected. 116 pregnant women were followed up and 298 samples were analyzed. One (0.9%) pregnant woman presented positive PCR in the blood, 3 (3.5%) in the amniotic fluid, 1 (2.3%) in the placenta and no newborn had positive PCR in the blood. Histopathological study was suggestive of toxoplasmosis infection in 24 (49%) placentas. Six (5.2%) newborns were diagnosed with congenital toxoplasmosis, and only cases with positive PCR in the amniotic fluid had correlation of the PCR result with the diagnosis of congenital infection. Both maternal and blood samples of new-borns and placenta did not prove to be promising in the diagnosis of congenital toxoplasmosis. Further studies are needed to evaluate the real role of molecular diagnosis in other biological materials rather than the amniotic fluid.
ABSTRACT
OBJECTIVE: To evaluate both the performance and acceptability of a method coupling self-sampling with detection of cervical malignancy via elevated HPV 16 and 18 E6 oncoproteins (OncoE6™ Cervical Test) in remote areas in Brazil. METHODS: Women living in rural villages in proximity to Coari city, Amazonas, Brazil were invited to participate in a cervical cancer screening study. 412 subjects were enrolled; there were no refusals. In addition to E6 protein detection, DNA was extracted from the brushes and evaluated for HPV genotypes by PCR (PGMY09/11), followed by typing by the Papillocheck™ if positive. Subjects who were found to be positive for OncoE6 or HPV-DNA were referred for colposcopy. RESULTS: For 110 subjects (27%) this was the first cervical cancer exam. Overall the HPV-DNA prevalence was 19.1% (n = 79); 1.4% (n = 6) were positive by the OncoE6 Test. Fifty-six women attended the invitation for colposcopy where nine had an abnormal cervix and were subsequently biopsied. Histopathological analysis revealed 2 CIN3, 2 carcinomas and 5 CIN1. OncoE6 called two out of the three HPV 16 or 18 associated CIN3+ lesions. CONCLUSIONS: The findings suggest that self-administered sample collection in combination with OncoE6 Test is feasible in this population. This could enable expanded screening coverage while ensuring a high specificity which is imperative given the remote geographic location, since women bearing abnormal test results would necessitate travel and logistical burden to access colposcopy and treatment.
Subject(s)
DNA-Binding Proteins/analysis , Human papillomavirus 16/isolation & purification , Human papillomavirus 18/isolation & purification , Oncogene Proteins, Viral/analysis , Papillomavirus Infections/virology , Repressor Proteins/analysis , Uterine Cervical Neoplasms/virology , Adolescent , Adult , Brazil/epidemiology , Colposcopy , DNA, Viral/analysis , Early Detection of Cancer/methods , Female , Humans , Middle Aged , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Rural Population , Specimen Handling , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Vaginal Smears/methods , Young AdultABSTRACT
Objetivo: O presente estudo teve como objetivo analisar o que vem sendo publicado sobre Responsabilidade Técnica em Enfermagem. Métodos: Trata-se de uma revisão integrativa realizada nas bases de dados: Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Public Medline (PubMed), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Eletronic Library Online (Scielo), no período de janeiro a março de 2020 utilizando os descritores "Responsabilidade Técnica" e "Enfermagem" e seus correspondentes em inglês, na qual foram selecionados 11 artigos, todos em português, sem recorte temporal. Resultados: o registro da Anotação de Responsabilidade Técnica em Enfermagem, assim como em outras profissões, constitui um importante atributo para qualidade no exercício profissional, necessita ter seus conceitos e atribuições difundidos e ser mais estudada no contexto cientifico. Conclusão: para a realização desta pesquisa sobre a Responsabilidade Técnica em Enfermagem foi encontrado um número restrito de publicações, com baixos níveis de evidência científica, em sua maioria, faziam referência à responsabilidade sem vínculo ao Conselho de Enfermagem, o que demostra a necessidade da ampliação de estudos sobre o tema para que os conceitos e implicações do exercício da Responsabilidade Técnica em Enfermagem, nos serviços de saúde, sejam melhor esclarecidos. (AU)
Objective: The present study had analyze what has been published about Technical Responsibility in Nursing. Methods: This is an integrative review carried out in the databases: Periodical Portal of the Coordination for the Improvement of Higher Level Personnel (CAPES), Public Medline (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS) and Scientific Electronic Library Online (Scielo), from January to March 2020 using the descriptors "Technical Responsibility" and "Nursing" and their correspondents in English, in which 11 articles were selected, all in Portuguese, without temporal cut-off. Results: the register of the Technical Responsibility in Nursing, as well as in other professions, constitutes an important attribute for quality in the professional exercise, needs to have its concepts and attributions diffused and to be more studied in the scientific context. Conclusion: in order to carry out this research on Technical Responsibility in Nursing, a limited number of publications were found, eith low levels of scientific evidence, mostly referring to responsibility without a link to the Nursing Council, which demonstrates the need to expand studies. On the subject so that the concepts and implications of the exercise of Technocal Responsibility in Nursing in health services are better clarified. (AU)
Objetivo: El presente estudio tuvo como objetivo analizar lo publicado sobre Responsabilidad Técnica en Enfermería. Método: Se trata de una revisión integradora realizada en las bases de datos: Portal de Periódicos de la Coordinación para el Perfeccionamiento del Personal de Nivel Superior (CAPES), Public Medline (PubMed), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Scientific Electronic Library Online (Scielo), de enero a marzo de 2020 utilizando los descriptores "Technical Responsibility" y "Nursing" y sus corresponsales en inglés, en los que se seleccionaron 11 artículos, todos en portugués, sin reducción de tiempo. Resultados: el registro de la Responsabilidad Técnica en Enfermería, así como en otras profesiones, constituye un atributo importante para la calidad en la práctica profesional, necesita que sus conceptos y atribuciones sean difundidos y profundizados em el contexto científico. Conclusión: para realizar esta investigación sobre Responsabilidad Técnica em Enfermería se encontró um número limitado de publicaciones, com bajos niveles de evidencia científica, mayoritariamente referidas a responsabilidade sin vinculación al Consejo de Enfermería, lo que demuestra la necesidad de ampliar los estúdios sobre el tema para que se aclaren mejor los conceptos e implicaciones del ejercicio de la Responsabilidad Técnica em Enfermería em los servicios de salud. (AU)
Subject(s)
Technical Responsibility , Organization and Administration , Nursing , EthicsABSTRACT
ABSTRACT Toxoplasmosis in pregnant women can cause significant morbidity and mortality in the fetus, which may be mitigated by early diagnosis and treatment. Social factors have also been related to the risk of developing the congenital form of toxoplasmosis, since some of these factors interfere directly in the quality of prenatal care. This study aimed to describe the clinical, laboratory, and epidemiological data of pregnant women diagnosed with toxoplasmosis and their newborns followed up at a referral hospital in Rio de Janeiro, Brazil. This was descriptive cohort study of 334 pregnant women with toxoplasmosis followed from May 2014 to December 2017. We conducted interviews to assess knowledge about the disease and its preventive measures, analyzed clinical and laboratory data during antenatal visits, and collected data from the newborns' medical charts. Results: This was a predominantly low-income women cohort study, with little schooling, mainly referred from public health services late in pregnancy (178; 53.3%), in the second and third trimesters (286; 85.6%). Diagnosis of acute toxoplasmosis had not been confirmed in 171 cases (51.2%). Out of 183 (54.9%) women who had initiated treatment at the original health services, 45 (24.6%) received an incorrect prescription. Seventy-two amniocenteses were performed, with positive real-time polymerase chain reaction (qPCR) in the amniotic fluid in two cases (2.8%). Congenital toxoplasmosis at birth was identified in eight newborns (5.4%). Conclusion: Late referral to specialized medical services, inadequate toxoplasmosis management at the original prenatal care services, and social vulnerabilities are contributing factors to the persistent occurrence of congenital toxoplasmosis cases.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Toxoplasmosis , Toxoplasmosis, Congenital , Pregnancy Complications, Parasitic , Referral and Consultation , Brazil/epidemiology , Toxoplasmosis/diagnosis , Toxoplasmosis/epidemiology , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/epidemiology , Cohort Studies , Pregnancy Complications, Parasitic/diagnosis , Pregnancy Complications, Parasitic/epidemiology , HospitalsABSTRACT
This study describes the prevalence of infection by Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis in a female population in Amazonas, Brazil. We collected cervical samples from 361 women examined at 10 primary care health services in the city of Coari, Amazonas, Brazil. The women were interviewed about socio-economic data, clinical history and sexual behaviour. Pelvic examinations were performed and cervical specimens were collected for detection of pathogens by PCR. The prevalence of infection was: 12.7% for Trichomonas vaginalis, 6.4% for Chlamydia trachomatis and 1.4% for Neisseria gonorrhoeae. There were no statistically significant associations between infections by any of the pathogens nor by any pathogen alone with any clinical variable, socio-demographic data or sexual behaviour. This study draws attention to the need for surveillance and possible need for screening for Chlamydia trachomatis, which often progresses asymptomatically. For the significant prevalence found, attention should also be given to asymptomatic infection by Trichomonas vaginalis, since this pathogen has recently been implicated as a risk factor for HIV infection.
Subject(s)
Chlamydia Infections/epidemiology , Chlamydia trachomatis/isolation & purification , Gonorrhea/epidemiology , Neisseria gonorrhoeae/isolation & purification , Trichomonas Vaginitis/epidemiology , Trichomonas vaginalis/isolation & purification , Adult , Brazil/epidemiology , Chlamydia Infections/diagnosis , Chlamydia trachomatis/genetics , Female , Gonorrhea/diagnosis , Gonorrhea/microbiology , Humans , Neisseria gonorrhoeae/genetics , Polymerase Chain Reaction , Prevalence , Primary Health Care , Risk Factors , Sexual Behavior , Sexually Transmitted Diseases/parasitology , Trichomonas Vaginitis/parasitology , Trichomonas vaginalis/genetics , Young AdultABSTRACT
OBJETIVO: Verificar a efetividade da higiene bucal como forma de redução da microbiota patogênica causadora da pneumonia associada à ventilação mecânica (PAVM) em pacientes internados na Unidade de Terapia Intensiva (UTI) cardíaca. MÉTODO: Comparação da microbiota oral obtida através do exame de swab, antes e após a realização da higiene oral com clorexidina a 0,12%. Cada paciente foi avaliado (exame de swab) em dois períodos: em até 24 horas a partir da sua chegada na UTI e após 48 horas ou após 72 horas. Se houve alta após 48 horas da admissão, o exame foi realizado 48 horas depois; se houve alta após 72 horas da admissão, o exame foi realizado 72 horas depois. Além disso, foi verificada a presença de saburra lingual através de exame visual. A amostra foi coletada em 16 pacientes, de ambos os sexos, com média de idade de 61,8 anos. RESULTADOS: A saburra lingual foi considerada espessa em 68,75% dos pacientes, o que caracterizava uma higienização deficiente. Após as sessões de higiene oral, 81,25% dos indivíduos apresentaram redução da quantidade de cocos e bacilos Gram negativos, os quais representam a potencial flora patogênica bucal. Quando a segunda avaliação da microbiota oral foi realizada após 72 horas, 100% dos indivíduos apresentaram alteração positiva (redução da quantidade de cocos e bacilos Gram negativos); já quando a microbiota foi reavaliada após 48 horas, 75% dos participantes apresentaram alteração positiva em relação à patogenicidade das bactérias. CONCLUSÃO: É possível reduzir a microbiota patogênica potencialmente causadora de PAVM através da higiene oral, no presente trabalho realizada com a associação de métodos químico e mecânico. (AU)
OBJECTIVE: To verify the effectiveness of oral hygiene as a means of reducing the pathogenic microbiota that causes ventilator-associated pneumonia (VAP) in patients admitted to a cardiac Intensive Care Unit (ICU). METHODS: Comparison between oral microbiota obtained by swab, before and after oral hygiene with 0.12% chlorhexidine. Each patient was assessed (swab test) at two time points: within 24 hours after ICU admission and after 48 hours or 72 hours. If hospital discharge occurred more than 48 hours after admission, the test was conducted 48 hours later if discharge occurred more than 72 hours after admission, the test was conducted 72 hours later. In addition, the presence of tongue plaque was determined by visual examination. The sample was collected from 16 patients of both sexes, with a mean age of 61.8 years. RESULTS: Tongue plaque was considered thick in 68.75% of patients, characterizing poor hygiene. After the oral hygiene sessions, 81.25% of subjects presented with a reduction in the number of Gram-negative cocci and bacilli, which represent the potential pathogenic oral flora. When the second evaluation of the oral microbiota was performed after 72 hours, 100% of subjects presented with positive change (reduction in the amount of Gram-negative cocci and bacilli), whereas when the microbiota was revaluated after 48 hours, 75% of the subjects presented with positive change in terms of bacterial pathogenicity. CONCLUSION: It is possible to reduce the pathogenic microbiota with the potential to cause VAP by means of oral hygiene, carried out in this study with a combination of chemical and mechanical methods. (AU)
Subject(s)
Humans , Oral Hygiene , Inpatients , Intensive Care UnitsABSTRACT
RESUMO: A chegada de uma criança com Síndrome de Down (SD) requer uma readaptação familiar, demandando esforços em relação aos cuidados diários ou às rotinas terapêuticas e escolares. Os objetivos deste estudo foram compreender quais são os principais focos de estresse parental em cuidadores de crianças com SD e identificar quem são os cuidadores principais dessas crianças. Trata-se de uma revisão de literatura de abordagem qualitativa, que utilizou como referencial teórico pesquisas empíricas publicadas a partir de 2010, encontradas nos portais Google Acadêmico, Scielo e Psicologia.PT, e nos periódicos: Interação em Psicologia, CEPE UEG e Ata CIAIQ 2016. Inicialmente, foram identificadas 23 pesquisas, utilizando-se os descritores Síndrome de Down, estresse e cuidadores. Após filtragem, cinco passaram para revisão final. O resultado evidencia que o estresse parental está relacionado a três fatores - à deficiência, ao desenvolvimento da criança e ao papel do cuidador. Os principais focos de estresse foram o impacto do diagnóstico; medo da discriminação e preconceito; falta de autonomia da criança; sobrecarga emocional do cuidador; preocupação com a sexualidade; baixa escolaridade paterna; mães que não podem trabalhar; e crianças mais velhas. As mães apresentaram os níveis mais elevados de estresse. A divisão familiar equilibrada em relação aos cuidados com a criança com SD, além de um acompanhamento psicológico familiar, são alternativas para reduzir os níveis de estresse e garantir saúde física e mental aos cuidadores. Conclui-se que os focos de estresse parental são diversos e causam abalo emocional, dificuldades de aceitação e adaptação familiar.
ABSTRACT: The arrival of a child with Down Syndrome (DS) requires a family readaptation, demanding efforts in relation to daily care or therapeutic and school routines. The aims of this study were to understand what the main sources of parental stress in caregivers of children with DS are and identify who the main caregivers of these children are. This is a literature review of a qualitative approach that used a theoretical framework of empirical researches published as of 2010, found in the Google Scholar, Scielo and Psychology.PT portals, and in the journals: Interação em Psicologia, CEPE UEG e Ata CIAIQ 2016. Initially, 23 researches were identified, through the use of the descriptors Down syndrome, stress and caregivers. After filtering, five works were selected for a final review. The result shows that parental stress is related to three factors - disability, development of the child and the role of the caregiver. The main stress outbreaks were the impact of the following diagnosis; fear of discrimination and prejudice; lack of autonomy of the child; emotional overload of the caregiver; concern about sexuality; low paternal schooling; mothers who cannot work; and older children. Mothers had the highest levels of stress. A balanced family division in relation to childcare with DS, as well as family psychological counseling, are alternatives to reducing stress levels and guarantee physical and mental health to caregivers. It is concluded that parental stress outbreaks are diverse and cause emotional distress, difficulties of acceptance and family adaptation.