Is intrauterine exposure to acetaminophen associated with emotional and hyperactivity problems during childhood? Findings from the 2004 Pelotas birth cohort.

BACKGROUND: Longitudinal studies have consistently reported that prenatal exposure to acetaminophen can to lead to an increased risk of attention deficit-hyperactivity disorder during childhood. This study aimed to investigate the association between intrauterine exposure to acetaminophen and the presence of emotional and behavioral problems at the ages of 6 and 11 years in a low-middle income country. METHODS: We performed a prospective longitudinal population-based study using data from the 2004 Pelotas birth cohort. From the 4231 initial cohort participants, 3722 and 3566 children were assessed at 6 and 11 years of age, respectively. The outcomes were assessed using the parent version of Strengths and Difficulties Questionnaire (SDQ). The cut-off points established for the Brazilian population were used to categorize the outcomes. Crude and adjusted odds ratio were obtained through logistic regression. RESULTS: Acetaminophen was used by 27.5% (95% confidence interval [CI]: 26.1-28.9) of the mothers at least once during pregnancy. The prevalence of emotional problems at 6 and 11 years was 13.6 and 19.9%, respectively. For hyperactivity problems, prevalence was 13.9 and 16.1%, respectively. Intrauterine exposure to acetaminophen increased the odds of having emotional (odds ratio [OR] = 1.47; 95% CI: 1.07-2.02) and hyperactivity/inattention (OR = 1.42; 95% CI: 1.06-1.92) problems in 6-year-old boys. At the age of 11, a small decrease in the effect was observed for both outcomes after adjustment: OR = 1.31 (95% CI: 0.99-1.73) for emotional problems and OR = 1.25 (95% CI: 0.95-1.65) for hyperactivity/inattention in boys. No association for any phenotypes at both ages was observed for girls. CONCLUSION: The effect of intrauterine exposure to acetaminophen in emotional and hyperactivity symptoms was dependent on sex in a Brazilian cohort. While it seemed to be important for boys, mainly at 6 years of age, for girls, no association was observed.

Chlamydia trachomatis infection in young pregnant women in Southern Brazil: a cross-sectional study.

This study estimated the prevalence of Chlamydia trachomatis infection during pregnancy in a sample of women up to 29 years of age in the city of Pelotas, Rio Grande do Sul State, Brazil, and investigated socio-demographic risk factors such as maternal age, marital status, maternal schooling, and family income. C. trachomatis infection was diagnosed with PCR using BD ProbeTecTM CT/GC Amplified DNA Assay. Socio-demographic, behavioral, and reproductive data were collected using structured questionnaires. All collections were performed by previously trained medical students. The study included a stratified probabilistic sample from four maternity hospitals in the city. The sample included 562 pregnant women, and prevalence of C. trachomatis infection was 12.3% (95%CI: 9.6-15.0). No significant association was identified between C. trachomatis infection and any of the target variables, including obstetric outcomes such as history of preterm delivery. Our findings in terms of low treatment adherence, only 43% of the women and 9.7% of partners, associated with high C. trachomatis prevalence, reinforce the need to implement routine screening for C. trachomatis during prenatal care. The attempt to diagnose and treat this infection after delivery, as in this study, limits the possibility of success.

High incidence of oncogenic HPV genotypes found in women from Southern Brazil.

Oncogenic HPV genotypes are strongly associated with premalignant and malignant cervical lesion. The purpose was to determine human papillomavirus (HPV) prevalence and genotypes, and to estimate cervical cancer risk factor associations. Cervical samples were obtained from 251 women seeking gynecological care at the Pelotas School of Medicine Clinic. This is a cross-sectional study. HPV-DNA was amplified by nested-PCR using MY09/11 and GP5/6 primers, and the sequencing was used for genotyping. Sociodemographic and behavioral risk factors were obtained by closed questionnaire, and its relationship to HPV infection prevalence were analyzed. Statistical analyses were performed using SPSS 16.0 software, and differences were considered significant at p < 0.05. As results, the prevalence of HPV infection was 29.9%. The most frequent genotype was HPV-16 (41.3%), followed by HPV-18 (17.3%), and HPV-33 (9.3%). Others nine HPV genotypes were also found. On this population, prevalence of oncogenic HPV genotypes was high, but does not seem to confer relationship with the risk factors investigated. Future investigations in larger populations are necessary, for the proposition of more appropriated monitoring strategies and treatment according to the Brazilian health service reality, as well as patients.

Evidence for an epistatic effect between TP53 R72P and MDM2 T309G SNPs in HIV infection: a cross-sectional study in women from South Brazil.

OBJECTIVE: To investigate the associations of TP53 R72P and MDM2 T309G SNPs with HPV infection status, HPV oncogenic risk and HIV infection status. DESIGN: Cross-sectional study combining two groups (150 HIV-negative and 100 HIV-positive) of women. METHODS: Data was collected using a closed questionnaire. DNA was extracted from cervical samples. HPV infection status was determined by nested-PCR, and HPV oncogenic risk group by Sanger sequencing. Both SNPS were genotyped by PCR-RFLP. Crude and adjusted associations involving each exposure (R72P and T309G SNPs, as well as 13 models of epistasis) and each outcome (HPV status, HPV oncogenic risk group and HIV infection) were assessed using logistic regression. RESULTS: R72P SNP was protectively associated with HPV status (overdominant model), as well as T309G SNP with HPV oncogenic risk (strongest in the overdominant model). No epistatic model was associated with HPV status, but a dominant (R72P over T309G) protective epistatic effect was observed for HPV oncogenic risk. HIV status was strongly associated (risk factor) with different epistatic models, especially in models based on a visual inspection of the results. Moreover, HIV status was evidenced to be an effect mediator of the associations involving HPV oncogenic risk. CONCLUSIONS: We found evidence for a role of R72P and T309G SNPs in HPV status and HPV oncogenic risk (respectively), and strong associations were found for an epistatic effect in HIV status. Prospective studies in larger samples are warranted to validate our findings, which point to a novel role of these SNPs in HIV infection.

Uncommon non-oncogenic HPV genotypes, TP53 and MDM2 genes polymorphisms in HIV-infected women in Southern Brazil.

BACKGROUND: It is believed that Human Papillomavirus (HPV) and Human Immunodeficiency Virus coinfection contributes to increase the risk for cervical intraepithelial injuries. Several factors may contribute to cervical cancer (CC) development, including genetic variants such as TP53 and MDM2 gene polymorphisms. MATERIALS AND METHODS: A hundred HIV-infected women were examined for HPV detection and its genotypes, as well as the frequencies of the SNPs Arg72Pro and SNP309 and their associations with CC risk factors. Nested Polymerase Chain Reaction (nPCR) was used for HPV detection and PCR-RFLP for TP53 and MDM2 SNP309 genotyping. RESULTS: HPV DNA was detected in 68% of samples. A higher frequency of low-risk HPV genotypes (66.7%) was observed when compared to high-risk genotypes (33.3%). Nine different HPV genotypes were identified, with the highest prevalence of HPV-6, followed by HPV-16 and 31. p53 Arg72Arg and SNP309 TG genotype were the most prevalent. HPV genotyping was performed by sequencing. CONCLUSION: The data obtained suggest that HIV-infected women are more susceptible to be infected by low-risk HPV (LR-HPV) genotypes than by high-risk (HR-HPV), and Pro72Pro of TP53 gene and TG of MDM2 SNP309 genotypes apparently seem to be protective factors among HIV-infected women for HPV acquisition and HR-HPV infection, respectively, in a sample of Southern Brazilian woman. Future investigations in larger populations are necessary to better understand the potential roles of these SNPs and the behavior of non-oncogenic HPV genotypes in HIV-mediated immunosuppression cases.

Chlamydia trachomatis infection in young pregnant women in Southern Brazil: a cross-sectional study / Infecção por Chlamydia trachomatis em gestantes jovens no Sul do Brasil: um estudo transversal / Infección por Chlamydia trachomatis en gestantes jóvenes en el sur de Brasil: un estudio transversal

Abstract: This study estimated the prevalence of Chlamydia trachomatis infection during pregnancy in a sample of women up to 29 years of age in the city of Pelotas, Rio Grande do Sul State, Brazil, and investigated socio-demographic risk factors such as maternal age, marital status, maternal schooling, and family income. C. trachomatis infection was diagnosed with PCR using BD ProbeTecTM CT/GC Amplified DNA Assay. Socio-demographic, behavioral, and reproductive data were collected using structured questionnaires. All collections were performed by previously trained medical students. The study included a stratified probabilistic sample from four maternity hospitals in the city. The sample included 562 pregnant women, and prevalence of C. trachomatis infection was 12.3% (95%CI: 9.6-15.0). No significant association was identified between C. trachomatis infection and any of the target variables, including obstetric outcomes such as history of preterm delivery. Our findings in terms of low treatment adherence, only 43% of the women and 9.7% of partners, associated with high C. trachomatis prevalence, reinforce the need to implement routine screening for C. trachomatis during prenatal care. The attempt to diagnose and treat this infection after delivery, as in this study, limits the possibility of success.

Resumo: Este estudo estimou a prevalência de Chlamydia trachomatis durante a gestação entre mulheres de até 29 anos e investigou fatores de risco sociodemográficos, como idade materna, estado civil, escolaridade materna e renda familiar, para a infecção na cidade de Pelotas, Rio Grande do Sul, Brasil. Infecção por C. trachomatis foi diagnosticada por PCR utilizando BD ProbeTecTM CT/GC Amplified DNA Assay system. Dados sociodemográficos, comportamentais e reprodutivos foram coletados através de questionários estruturados. Todas as coletas foram realizadas por estudantes de medicina treinados. Amostra probabilística estratificada de quatro maternidades da cidade foi estudada. A amostra constou de 562 gestantes e a prevalência de infecção por C. trachomatis foi de 12,3% (IC95%: 9,6-15,0). Não foi identificada associação significativa entre infecção por C. trachomatis e as variáveis investigadas, incluindo desfechos obstétricos como parto pretermo. Nossos achados de baixa adesão ao tratamento, de apenas 43% entre as mulheres e de 9,7% entre os parceiros, associados a alta prevalência, reforçam a necessidade de implementar rastreamento de rotina para C. trachomatis durante a assistência pré-natal. A tentativa de diagnosticar e tratar esta infecção depois do parto, como feito neste estudo, limita a possibilidade de sucesso.

Resumen: Este estudio estimó la prevalencia de Chlamydia trachomatis durante la gestación, entre mujeres de hasta 29 años, e investigó factores de riesgo sociodemográficos como: edad materna, estado civil, escolaridad materna y renta familiar, para esta infección en la ciudad de Pelotas, Rio Grande do Sul, Brasil. La infección por C. trachomatis fue diagnosticada mediante PCR, utilizando BD ProbeTecTM CT/GC Amplified DNA Assay system. Los datos sociodemográficos, comportamentales y reproductivos se recogieron a través de cuestionarios estructurados. Todas las recogidas de datos se realizaron por parte de estudiantes de medicina entrenados. Se estudió la muestra probabilística estratificada de cuatro maternidades de la ciudad. La muestra constó de 562 gestantes y la prevalencia de infección por C. trachomatis fue de un 12,3% (IC95%: 9,6-15,0). No se identificó una asociación significativa entre infección por C. trachomatis y las variables investigadas, incluyendo desenlaces obstétricos como el parto pretérmino. Nuestros hallazgos de baja adhesión al tratamiento, solamente un 43% entre las mujeres y un 9,7% entre los compañeros, asociados a la alta prevalencia, refuerzan la necesidad de implementar una exploración de rutina para C. trachomatis durante la asistencia prenatal. La tentativa de diagnosticar y tratar esta infección después del parto, como se realizó en este estudio, limita la posibilidad de éxito.

[Human papillomavirus: prevalence and genotypes found among HIV-positive and negative women at a reference center in the far south of Brazil]. / Papilomavírus humano: prevalência e genótipos encontrados em mulheres HIV positivas e negativas, em um centro de referência no extremo Sul do Brasil.

INTRODUCTION: The aim of this study was detect the presence of human papillomavirus and investigate the prevalence and distribution of the HPV-6, 11, 16 and 18 genotypes among HIV-1 positive and negative women. METHODS: Samples of cervical smears from 98 women were analyzed using the nested polymerase chain reaction for the presence of HPV and using the type-specific technique for genotype detection. Genotypes were confirmed by means of restriction fragment analysis. The chi-square and Fisher tests were performed for the statistical analysis. RESULTS: HPV-DNA was observed in 66.3% of the samples analyzed: 76.4% in the HIV-positive group and 60% in the HIV-negative group (p = 0.1). Higher prevalence of viral infection due to oncogenic genotypes was observed in the HIV-positive group (65.2%) than in the HIV-negative group (28.6%), (p = 0.006), and HPV-16 was the most frequent in the two groups, followed by HPV-18. CONCLUSIONS: It is suggested that HIV-positive women present a higher likelihood of infection by oncogenic HPV genotypes, and the importance of a screening and differential diagnosis program for this group is highlighted.

High incidence of oncogenic HPV genotypes found in women from Southern Brazil

Oncogenic HPV genotypes are strongly associated with premalignant and malignant cervical lesion. The purpose was to determine human papillomavirus (HPV) prevalence and genotypes, and to estimate cervical cancer risk factor associations. Cervical samples were obtained from 251 women seeking gynecological care at the Pelotas School of Medicine Clinic. This is a cross-sectional study. HPV-DNA was amplified by nested-PCR using MY09/11 and GP5/6 primers, and the sequencing was used for genotyping. Sociodemographic and behavioral risk factors were obtained by closed questionnaire, and its relationship to HPV infection prevalence were analyzed. Statistical analyses were performed using SPSS 16.0 software, and differences were considered significant at p < 0.05. As results, the prevalence of HPV infection was 29.9%. The most frequent genotype was HPV-16 (41.3%), followed by HPV-18 (17.3%), and HPV-33 (9.3%). Others nine HPV genotypes were also found. On this population, prevalence of oncogenic HPV genotypes was high, but does not seem to confer relationship with the risk factors investigated. Future investigations in larger populations are necessary, for the proposition of more appropriated monitoring strategies and treatment according to the Brazilian health service reality, as well as patients.

Uncommon non-oncogenic HPV genotypes, TP53 and MDM2 genes polymorphisms in HIV-infected women in Southern Brazil

Background: It is believed that Human Papillomavirus (HPV) and Human Immunodeficiency Virus coinfection contributes to increase the risk for cervical intraepithelial injuries. Several factors may contribute to cervical cancer (CC) development, including genetic variants such as TP53 and MDM2 gene polymorphisms. Materials and methods: A hundred HIV-infected women were examined for HPV detection and its genotypes, as well as the frequencies of the SNPs Arg72Pro and SNP309 and their associations with CC risk factors. Nested Polymerase Chain Reaction (nPCR) was used for HPV detection and PCR-RFLP for TP53 and MDM2 SNP309 genotyping. Results: HPV DNA was detected in 68% of samples. A higher frequency of low-risk HPV genotypes (66.7%) was observed when compared to high-risk genotypes (33.3%). Nine different HPV genotypes were identified, with the highest prevalence of HPV-6, followed by HPV-16 and 31. p53 Arg72Arg and SNP309 TG genotype were the most prevalent. HPV genotyping was performed by sequencing. Conclusion: The data obtained suggest that HIV-infected women are more susceptible to be infected by low-risk HPV (LR-HPV) genotypes than by high-risk (HR-HPV), and Pro72Pro of TP53 gene and TG of MDM2 SNP309 genotypes apparently seem to be protective factors among HIV-infected women for HPV acquisition and HR-HPV infection, respectively, in a sample of Southern Brazilian woman. Future investigations in larger populations are necessary to better understand the potential roles of these SNPs and the behavior of non-oncogenic HPV genotypes in HIV-mediated immunosuppression cases. .

Comparison between two methods for molecular characterization of human papillomavirus

A sensitive method of detection for Human Papillomavirus (HPV) is important to facilitate the early treatment of cervical cancer precursors.Objective: to analyze the spectrum of HPV infection and compare the sensibility of DNA HPV detection using polymerase chain reaction (PCR) and nestedPCR (nPCR) methods in a group of 251 women of Pelotas-RS. Methods: genomic DNA was extracted from the collected samples and was submitted toPCR methods with the primers MY09/11 and nPCR with the pair of primers MY09/MY11 and GP5+/6+. The results were applied to the softwares Epi-Info v.3.5.1* and STATA v.11 * for analyzes. Results: the prevalence of HPV infection was 6.8% with the use of primers MY09/11. When associated withprimers GP5/6, this result increased to 29.9% (p < 0.001). Conclusion: the increase founded in HPV DNA detection from 6.8 to 29.9% suggests that thetechnique of nPCR MY09/11 followed by GP5/6 is the most sensitive method to detect HPV DNA from cervical specimens.

Papilomavírus humano: prevalência e genótipos encontrados em mulheres HIV positivas e negativas, em um centro de referência no extremo Sul do Brasil / Human papillomavirus: prevalence and genotypes found among HIV-positive and negative women at a reference center in the far south of Brazil

INTRODUÇÃO: O objetivo deste estudo foi detectar a presença do papilomavírus humano e verificar a prevalência e distribuição dos genótipos HPV-6, -11, -16 e -18 em mulheres HIV-1 positivas e negativas. MÉTODOS: Analisou-se amostras de secreção cervical de 98 mulheres por reação em cadeia da polimerase nested para presença do HPV e tipo-específica para detecção dos genótipos, sendo estes confirmados por análise dos fragmentos de restrição. Realizou-se os testes do qui-quadrado e Fisher para a análise estatística. RESULTADOS: O DNA-HPV foi observado em 66,3 por cento das amostras analisadas, 76,4 por cento no grupo HIV positivo e 60 por cento no grupo HIV negativo (p=0,1). Uma prevalência maior de infecção viral por genótipos oncogênicos foi observada no grupo de pacientes HIV positivo (65,2 por cento) quando comparado ao grupo HIV negativo (28,6 por cento), (p=0,006), sendo HPV-16 foi o mais frequente nos dois grupos, seguido pelo HPV-18. CONCLUSÕES: Sugere-se que mulheres HIV positivas apresentam maior probabilidade de se infectar por genótipos oncogênicos de HPV, ressaltando a importância de um programa de rastreamento e diagnóstico diferenciado para este grupo.

INTRODUCTION: The aim of this study was detect the presence of human papillomavirus and investigate the prevalence and distribution of the HPV-6, 11, 16 and 18 genotypes among HIV-1 positive and negative women. METHODS: Samples of cervical smears from 98 women were analyzed using the nested polymerase chain reaction for the presence of HPV and using the type-specific technique for genotype detection. Genotypes were confirmed by means of restriction fragment analysis. The chi-square and Fisher tests were performed for the statistical analysis. RESULTS: HPV-DNA was observed in 66.3 percent of the samples analyzed: 76.4 percent in the HIV-positive group and 60 percent in the HIV-negative group (p = 0.1). Higher prevalence of viral infection due to oncogenic genotypes was observed in the HIV-positive group (65.2 percent) than in the HIV-negative group (28.6 percent), (p = 0.006), and HPV-16 was the most frequent in the two groups, followed by HPV-18. CONCLUSIONS: It is suggested that HIV-positive women present a higher likelihood of infection by oncogenic HPV genotypes, and the importance of a screening and differential diagnosis program for this group is highlighted.