High molecular prevalence of HPV and other sexually transmitted infections in a population of asymptomatic women who work or study at a Brazilian university.

Sexually transmitted infections (STIs) represent a global health problem with variable prevalence depending on the geographical region and the type of population. Human papillomavirus (HPV) encompasses widespread virus types related to cervical carcinogenesis. The present study investigated the molecular prevalence of HPV and seven other important STIs in asymptomatic women working or studying at a Brazilian university. A secondary aim was to assess cytological abnormalities associated with HPV and other STIs coinfections. We recruited 210 women from a Brazilian university. HPV was detected using a single-round polymerase chain reaction (sPCR) followed by a viral genotyping by restriction fragment length polymorphism (RFLP-PCR). The presence of seven STIs: Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV)-1 and HSV-2 was detected by multiplex PCR (M-PCR). Furthermore, cytological findings and epidemiological characteristics were evaluated.The mean age of the participants was 27.1 years old. HPV prevalence was 33.8%, and HPV16 was the most frequently detected papillomavirus genotype. Moreover, multiple HPV infections were common (42.2%). We detected at least one STI agent in 11.4% of the tested women, most frequently C. trachomatis (6.7%). Among HPV-positive women, 14.1% were coinfected with other STI agents. Cytological abnormalities were observed in 9.5% of smears, and HPV-DNA, high-risk HPV (HR-HPV), HPV16 and HPV multiple infections were associated with abnormal cytological findings. There was a high prevalence of HPV, and C. trachomatis was the most prevalent STI agent, with low rates of cytological abnormalities. These findings highlight the need of timely STI diagnosis in young asymptomatic women and of a public policy design for STI prevention.

Association between Human Papillomavirus and Non-cervical Genital Cancers in Brazil: A Systematic Review and Meta-Analysis

Background: Human papillomavirus (HPV) infection is associated with cervical cancer; however, it is controversial whether it is involved in non-cervical genital cancers. Objective: This study aimed to evaluate articles on the prevalence of HPV in penile cancer, vulvar cancer, colorectal cancer, prostate cancer and anal canal cancer in studies conducted in Brazil. Methods: The study was conducted in accordance with the Preferred Reporting of Systematic Reviews and Meta-Analysis Statement. Comprehensive searches for HPV and cancer for the years 2006 to 2016 were conducted in two databases (PubMed and Web of Knowledge) and Google Scholar system. We also tracked the references of all eligible articles to identify additional non-captured publications through online surveys. Results: Eighteen studies, with a combined sample size of 1,552 patients were analyzed. The overall prevalence of HPV was 43% (95% CI: 36­51%; p < 0.001). The pooled prevalence of HPV in penile cancer was 42% (95% CI: 32­55%; p < 0.001), in colorectal cancer it was 67% (95% CI: 64­70%; p < 0.001) and in vulvar cancer 43% (95% CI: 34­55%; p < 0.001). HPV 16 was the most prevalent in all sites evaluated, with prevalence estimated at 54% (95% CI: 44­66%; p < 0.001), followed by genotypes 33 (21%; 95% CI: 17­28; p < 0.001), 6 (15%; 95% CI: 8­26%; p < 0.001), 11 (13%; 95% CI: 5­32%; p < 0.001) and 18 (12%; 95% CI: 7­22%; p < 0.001), respectively. The pooled prevalence of single infection was 82% and infection by multiple genotypes of HPV was 22%. Conclusion: Our study demonstrated a high prevalence of HPV in non-cervical genital cancers in Brazil, with predominance of genotype 16, providing evidence for the need for preventive and control measures to avoid future harm to the population.

Human leukocyte antigen (HLA)-G and cervical cancer immunoediting: a candidate molecule for therapeutic intervention and prognostic biomarker?

While persistent infection with oncogenic types of human Papillomavirus (HPV) is required for cervical epithelial cell transformation and cervical carcinogenesis, HPV infection alone is not sufficient to induce tumorigenesis. Only a minor fraction of HPV infections produce high-grade lesions and cervical cancer, suggesting complex host-virus interactions. Based on its pronounced immunoinhibitory properties, human leukocyte antigen (HLA)-G has been proposed as a possible prognostic biomarker and therapeutic target relevant in a wide variety of cancers and viral infections, but to date remains underexplored in cervical cancer. Given the possible influence of HLA-G on the clinical course of HPV infection, cervical lesions and cancer progression, a better understanding of HLA-G involvement in cervical carcinogenesis might contribute to two aspects of fundamental importance: 1. Characterization of a novel diagnostic/prognostic biomarker to identify cervical cancer and to monitor disease stage, critical for patient screening; 2. Identification of HLA-G-driven immune mechanisms involved in lesion development and cancer progression, leading to the development of strategies for modulating HLA-G expression for treatment purposes. Thus, this systematic review explores the potential involvement of HLA-G protein expression and polymorphisms in cervical carcinogenesis.

Evaluation of the efficacy of flaxseed meal and flaxseed extract in reducing menopausal symptoms.

The objective of this study was to evaluate the efficacy of flaxseed meal and flaxseed extract in reducing climacteric symptoms of menopausal women. Ninety menopausal women were randomly distributed into three study groups: group I received 1 g per day of flaxseed extract containing at least 100 mg of secoisolariciresinol diglucoside (SDG), group II received 90 g per day of flaxseed meal containing at least 270 mg of SDG, and group III received 1 g per day of collagen (placebo group). Subjects were assessed for menopausal symptoms by the Kupperman index at the beginning and at the end of the 6 months of treatment. Subjects were also assessed for endometrial thickness and vaginal cytology. The Kupperman index values at the beginning and end of the treatments were analyzed using the paired t-test. Both the flaxseed extract (P=.007) and the flaxseed meal (P=.005) were effective in reducing the menopausal symptoms when compared with the placebo control (P=.082). Alternatively, the changes in Kupperman index were also computed and submitted to analysis of variance. In this case, no significant differences were found (P=.084) although the data indicate a decreasing tendency for the Kupperman index by both the flaxseed extract and the flaxseed meal groups. Neither the flaxseed extract nor the flaxseed meal exerted clinically important estrogenic effects on the vaginal epithelium or endometrium as revealed by the absence of changes in the blood levels of follicle stimulating hormone and estradiol, as well as in the endometrial thickness, and vaginal epithelial maturation value. No serious adverse events related to the treatments were reported. Although the results of the present study do not allow an unequivocal conclusion about the action of flaxseed on the menopausal symptoms, they suggest that it could be premature to conclude that no such action exists. Clearly the matter still deserves further experimental attention.

Influência da co-agregação entre candida. albicans e lactobacillus acidophilus na capacidade de adesão destes microrganismos às células epiteliais vaginais humanas (CEVH) / Influence of the co-aggregation between candida. albicans e lactobacillus acidophilus on the adhesion capacity these microorganisms in the human ephitelial vaginal cells (HEVC)

Este trabalho teve por objetivo avaliar a influência da co-agregação in vitro entre Candida albicans e Lactobacillus acidophilus na capacidade de adesão destes microrganismos às células epiteliais vaginais humanas (CEVH). Foram utilizados um isolado vaginal de C. albicans e uma cepa ATCC de L. acidophilus. Uma suspensão de cada microrganismo isoladamente e do coagregado foram incubados com as CEVH obtidas de uma doadora saudável. Foram feitos esfregaços por cristal violeta e Papanicolaou, e o número de leveduras, lactobacilos ou coagregados aderidos às células foi contado (em 300 células superficiais-CS e 300 intermediárias- CI). A Microscopia eletrônica de varredura (MEV) foi realizada em todas as situações dos ensaios. Leveduras e lactobacilos aderiram fortemente as CEVH, tanto em CS quanto em CI. A coagregação levou a um aumento na capacidade de adesão das leveduras (p < 0,001) e diminuiu a dos lactobacilos (p < 0,001). A adesão dos microrganismos isolados ou co-agregados não apresentou diferença entre CS e CI (p > 0,05). Havendo correlação com o que acontece in vivo, probióticos à base de L. acidophillus e mesmo uma flora lactobacilar vaginal não surtiriam efeito protetor contra a adesão de C. albicans as CEVH e do possível desenvolvimento de candidíase vulvovaginal.

This work has aimed to evaluate the influence of the L. acidophilus and Candida albicans co-aggregation on the adhesion capacity this microorganisms in the human ephitelial vaginal cells (HEVC). One vaginal isolated of C. albicans and one ATCC strain of L. acidophilus was used. A suspension of the isolated and co-aggregated microorganisms was incubated with HVEC obtained from a healthy donor. After one hour, smears were made with crystal violet and Papanicolaou, and the number of yeasts adhered to HVEC was evaluated (300 superficial-SC and 300 intermediate cells-IC). Scanning electron microscopy (SEM) was made in all situations of the assays. Yeasts and lactobacilli adhered strongly to the HEVC, both SC and IC. The co-aggregation there was an increase in the adhesion capacity of the yeasts (p < 0.001) and a diminished adhesion of the lactobacilli (p < 0.001) in SC and IC. The adhesion of isolated and co-aggregated microorganisms was not significantly different between SC and IC (p > 0.05). Supposing that of these findings correlated with the conditions in vivo, the use of probiotics based on L. acidophilus or its presence in the vaginal microbiota would not protect against the adhesion of C. albicans to the HVEC and possible consequent vulvovaginal candidiasis.

Effects of depomedroxyprogesterone acetate on the development and maintenance of Candida albicans in the vagina of oophorectomized Wistar rats (Rattus norvegicus) / Efeitos do acetato de depomedroxyprogesterone sobre o desenvolvimento e manutenção de Candida albicans na vagina de ooforectomizado ratos Wistar ( Rattus norvegicus )

The objective of this study was to determine the effect of medroxyprogesterone acetate (DMPA) on the development and maintenance of Candida albicans in the vagina of oophorectomized Wistar rats. The animals were divided into negative control groups (NCG), which received injections of sterile saline; positive control groups (PCG), which were given injections of estradiol valerate; and progesterone groups (PG), which were given injections of Depo-Provera®. After one week of hormonal induction, vaginal infection by C. albicans was induced in all the groups and detected by vaginal yeast culture and Papanicolaou smear. In addition, scanning and transmission electron microscopy images were obtained to confirm the vaginal infection by yeast in PG. A difference in progesterone levels in PG was observed between the basal level and after hormonal induction (P<0.0001). In this group, 100 percent of the rats acquired vaginal infection in the first week, but did not maintain it until the third week. The pharmaceutical brand of DMPA was effective for inducing the metestrus or diestrus phase of the estrous cycle in rats, similar to the use of pure progesterone. In contrast to estrogen treatment, progesterone alone could not support an experimental vaginal infection by C. albicans for any significant period of time.

O objetivo do presente estudo foi determinar os efeitos do acetato de depomedroxyprogesterona (ADMP) no desenvolvimento e manutenção de Candida albicans na vagina de ratas Wistar ooferectomizadas. Os animais foram divididos em grupos controle negativos (GCN), que receberam injeções de salina estéril; grupos controle positivos (GCP), que receberam injeções de valerato de estradiol; e grupos progesterona (GP), nos quais foram feitas injeções de Depo-Provera®. Após uma semana da aplicação hormonal, foi induzida a infecção vaginal por C. albicans em todos os grupos, detectada por cultura para leveduras vaginais e esfregaço de Papanicolaou. Foram feitas ainda imagens por microscopia eletrônica de varredura e transmissão para confirmar a infecção pela levedura no GP. Foram observados diferentes níveis de progesterona em GP, entre os valores basais e após a indução hormonal (P<0,0001). Neste grupo, 100,0 por cento das ratas contraíram a infecção vaginal na primeira semana, mas não a mantiveram até a terceira semana. A forma farmacêutica de ADMP foi efetiva em induzir as fases de metaestro e diestro do ciclo estral das ratas, da mesma forma que usando progesterona pura. Em contraste com o que ocorre no tratamento com estrógeno, a progesterona não pôde manter a infecção vaginal experimental por C. albicans por um período significativo de tempo.

Avaliação da influência do uso de métodos contraceptivos sobre os resultados dos esfregaços de Papanicolaou / Evaluation of the influence of contraceptive methods on the results of Papanicolaou smears

Foi avaliada a influência do uso de métodos contraceptivos como dispositivo intrauterino (DIU), contraceptivos hormonais (CPH) e preservativo (PRESER), nos resultados dos esfregaços de Papanicolaou (Pap), por meio de análise retrospectiva de seus laudos e das informações sobre métodos contraceptivos de 2251 mulheres, distribuídas em: DIU (n=80), CPH (n=172), PRESER (n=40) e não usuárias (n=1959). As não usuárias apresentaram mais resultados normais e as com DIU mais alterações benignas. Os três grupos de usuárias, principalmente DIU, manifestaram mais metaplasia escamosa do que as não usuárias. Não houve aumento de ASCUS/LIS ou câncer nas usuárias de métodos contraceptivos. Predominaram as infecções candidíase e vaginose bacteriana e em DIU houve mais vaginose. Actinomyces sp. ocorreu apenas em DIU e Trichomonas vaginalis apenas em não usuárias. Assim, é importante a realização de Pap nas usuárias de DIU e CPH para acompanhar as alterações benignas, pois as mesmas podem predispor e/ou facilitar infecções, incluindo por HPV.

This study aimed to evaluate the influence of the use of contraceptive methods, such as the intrauterine device (IDU), the hormonal contraceptive (HCP) and the preservative (PRESER), on the results of Papanicolaou smears (Pap). A retrospective analysis was conducted based on Papanicolau results and on information from 2251 women's contraceptive methods, distributed in: IDU (n=80), HCP (n=172), PRESER (n=40) and non-users (n=1959). Non-users presented more normal results; and IDU users presented benign alterations. Among the three groups, the IDU users manifested more squaly squamous metaplasia than the non-users. There was no notice of ASCUS/SIL or cancer in the users of contraceptive methods. The infections with candidiasis and bacterial vaginosis prevailed. Particularly in IDU users, there was more vaginosis. Actinomyces sp. was only noticed in IDU users, and Trichomonas vaginalis in non-users. Thus, submitting to Pap examination is mainly important for the users of IDU and HCP due to the benign alterations, because these can be predisposed to and/or facilitate infections, including HPV.

Nitrito urinário e infecção do trato urinário por cocos gram-positivos / Urinary nitrite and urinary-tract infection by gram-positive cocci

INTRODUÇÃO: A infecção do trato urinário (ITU) é uma das mais comuns na clínica médica. Os testes que utilizam tiras reagentes detectam significativamente mais infecções por bactérias gram-negativas do que por espécies gram-positivas, uma vez que o teste de nitrito não revela a presença de patógenos gram-positivos em muitos casos. OBJETIVOS: Explorar a microbiologia e a freqüência de infecção urinária por cocos em adultos sintomáticos, relacionando-as com o resultado de nitrito urinário, para traçar o perfil epidemiológico desses pacientes. MATERIAL E MÉTODO: Um estudo retrospectivo foi conduzido na Secretaria de Saúde do município de Maringá-PR, no período de abril de 2004 a março de 2005. RESULTADOS: Amostras de urina de 3.426 pacientes foram coletadas e analisadas. Um total de 448 (13,1 por cento) amostras foi positivo para cultura. Em 388 (86,6 por cento) casos houve crescimento de bacilos gram-negativos (BGN) e em 60 (13,4 por cento) casos, cocos gram-positivos (CGP). A análise estatística de co-morbidades revelou diferença significativa na proporção de pacientes com hipertensão (31,3 por cento com nitrito positivo versus 4,5 por cento com nitrito negativo, p < 0,05). Os pacientes com resultado de nitrito positivo relataram febre em proporção maior que os com nitrito negativo (75 por cento versus 43,2 por cento, respectivamente; p < 0,05). Staphylococcus aureus redutores de nitrato mostraram maior resistência à ciprofloxacina (66,7 por cento) quando em comparação com os isolados não-redutores (100 por cento sensíveis). CONCLUSÕES: Este estudo preliminar mostrou que a avaliação de sinais clínicos e sintomas, juntamente com o resultado de nitrito urinário na tira reagente, poderia auxiliar o médico na tomada de decisões importantes.

BACKGROUND: Urinary tract infection (UTI) is among the most common infections in medical center. Urinalysis tests detect significantly more gram-negative infections than those due to gram-positive bacteria because the urinary nitrite test does not detect the presence of gram-positive pathogens in many cases. OBJECTIVES: Explore the microbiology and frequency of UTI by coccus in symptomatic adult patients, comparing them with urinary nitrite results, in order to delineate the epidemiological profile of these patients. MATERIAL AND METHOD: Retrospective analysis was conducted from April 2004 through March 2005 at Health Center, Maringa, Brazil. RESULTS: Urine specimens from 3,426 patients were collected and examined. A total of 448 (13.1 percent) samples had positive culture results. There were 388 (86.6 percent) strains of gram-negative rods and 60 (13.4 percent) of gram-positive cocci. A statistical analysis of patients' comorbidities revealed a significant difference in the proportion of patients with hypertension (31.3 percent with positive nitrite vs. 4.5 percent with negative nitrite, p < 0.05). The proportion of patients with positive nitrite who had fever was larger than patients with negative nitrite (75 percent vs. 43.2 percent respectively, p < 0.05). Nitrate-reducing Staphylococcus aureus showed high level resistance to ciprofloxacin (66.7 percent) in comparison with nitrite-negative isolates (100 percent sensitive). CONCLUSIONS: This preliminary study had shown that evaluation of clinical signs and symptoms, together with urinary nitrite result, could help physician to take important decisions.

Decolorization of synthetic dyes by solid state cultures of Lentinula (Lentinus) edodes producing manganese peroxidase as the main ligninolytic enzyme.

The ability of the white-rot fungus Lentinula (Lentinus) edodes to decolorize several synthetic dyes was investigated using solid state cultures with corn cob as substrate. Cultures, containing amido black, congo red, trypan blue, methyl green, remazol brilliant blue R, methyl violet, ethyl violet and Poly R478 at 200 ppm, were completely decolorized after 18 days of incubation. Partial decolorization was observed in the cultures containing 200 ppm of brilliant cresyl blue and methylene blue. High manganese peroxidase activity (2600 U/g substrate), but very low lignin peroxidase (<10 U/g substrate) and laccase (<16 U/g substrate) activities were detected in the cultures. In vitro, the dye decolorization was markedly decreased by the absence of manganic ions and H2O2. These data suggest that manganese peroxidase appear to be the main responsible for the capability of L. edodes to decolorize synthetic dyes.