RESUMO
The prevalence of human papillomavirus (HPV) genotypes in relation to age was investigated by the polymerase chain reaction (PCR) method in cytologically normal smears from 4 different groups of women. Group A consisted of young women from a district population, aged 15-34 years, using oral contraceptives and visiting general practitioners for a check-up (n = 156); group B were asymptomatic women, aged 35-55, in a district population participating in a triennial screening program for cervical cancer (n = 1555); group C and D consisted of women, seen at the gynecological outpatient department for a wide spectrum of gynecological complaints or for control of their hormonal contraception, aged 15-34 years (n = 2320), and aged 35-55 years (n = 1826) respectively. An HPV (all types) prevalence of 14.1%, 4.1%, 13.9% and 6.6% and an HPV 16/18 prevalence of 3.8%, 0.9%, 3.3% and 1.5% were found in groups A, B, C and D respectively. Statistically significant differences (p value < 0.001) in HPV prevalence were found between women aged 15-34 years and women aged 35-55 years in the district population and in the hospital population. No statistically significant differences in HPV 16/18 were observed after age-matching between women in corresponding age-classes of both populations. In a 5-year interval analysis a strong age-dependent relationship was demonstrated, with a maximum between 20 and 24 years. After the age of 35 a constant level of 1-2% HPV 16/18 was observed. These results indicate that genital HPV infections are age-dependent and suggest that HPV infections at young age can be transient. The implications of these findings in the context of cervical cancer screening are discussed.
Assuntos
Envelhecimento/fisiologia , Colo do Útero/microbiologia , Papillomaviridae/genética , Reação em Cadeia da Polimerase , Infecções Tumorais por Vírus/epidemiologia , Doenças do Colo do Útero/epidemiologia , Doenças do Colo do Útero/microbiologia , Esfregaço Vaginal , Adolescente , Adulto , Fatores Etários , Medicina de Família e Comunidade , Feminino , Genótipo , Hospitais Gerais , Humanos , Pessoa de Meia-Idade , Prevalência , População Suburbana , Infecções Tumorais por Vírus/microbiologia , População UrbanaRESUMO
A 31-year-old woman is reported with in the genital region multiple squamous carcinomas of the skin (buttock), vulva, vagina, anus and cervix uteri. All these carcinomas were HPV 16 positive as tested by DNA in situ hybridization. The existence of areas with normal epithelium between all tumor localisations and the absence of distant metastases indicate multicentric development of these multiple carcinomas. The presence of HPV 16 DNA in all carcinoma cells, as detected by DNA in situ hybridisation, argues for an etiological role of HPV 16 in the development of these multiple tumors.
Assuntos
Neoplasias do Ânus/genética , Carcinoma de Células Escamosas/genética , Neoplasias Cutâneas/genética , Infecções Tumorais por Vírus/complicações , Neoplasias do Colo do Útero/genética , Neoplasias Vaginais/genética , Neoplasias Vulvares/genética , Adulto , Neoplasias do Ânus/etiologia , Neoplasias do Ânus/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Hibridização In Situ , Papillomaviridae , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologia , Neoplasias do Colo do Útero/etiologia , Neoplasias Vaginais/etiologia , Neoplasias Vulvares/etiologiaRESUMO
Tick borne relapsing fever is an endemic disease in Sengerema district, Mwanza region, Tanzania, East Africa. Five cases of neonatal relapsing fever occurring in this endemic area are described. Two neonates showed signs of septicaemia, clumping of spirochetes (Borrelia index is uncountable) in the thick blood smear and they died the day of admission. Two neonates showed severe spirochetaemia (Borrelia index: 3). The neonate treated with low dose penicillin died, the other neonate, treated with erythromycin, survived. One neonate had only a mild spirochetaemia (Borrelia index is 0.5) and responded well to penicillin treatment. Jaundice was seen in four of the five cases, three of them died. Only twenty cases of neonatal relapsing fever were previously reported. Findings are discussed in comparison with those of former reports on relapsing fever in the literature. Based on the fact that in a relatively short time (1 year), 5 cases of neonatal relapsing fever were diagnosed in an endemic area in East Africa, we conclude that neonatal relapsing fever is probably underdiagnosed.
Assuntos
Febre Recorrente/epidemiologia , Antibacterianos/uso terapêutico , Feminino , Humanos , Recém-Nascido , Masculino , Prognóstico , Febre Recorrente/diagnóstico , Febre Recorrente/tratamento farmacológico , Índice de Gravidade de Doença , Taxa de Sobrevida , Tanzânia/epidemiologiaRESUMO
Clinical findings on 25 patients with a high spirochaetemia are presented. The diagnosis was established by demonstration of Borrelia spirochaetes in the thick blood smear and a Borrelia-index was estimated to calculate the density of the spirochaetemia. Causes of death were septicaemia (3x), severe spirochaetemia in a neonate (1x), and successive relapses in complicated cases without adequate treatment (2x). The results show a positive correlation between the degree of spirochaetemia and severity of complications and the Borrelia-index shows to have a prognostic value.
Assuntos
Febre Recorrente/mortalidade , Adolescente , Adulto , Causas de Morte , Criança , Pré-Escolar , Feminino , Hospitais de Distrito , Humanos , Lactente , Recém-Nascido , Masculino , Valor Preditivo dos Testes , Prognóstico , Recidiva , Febre Recorrente/sangue , Febre Recorrente/parasitologia , Índice de Gravidade de Doença , Tanzânia/epidemiologiaRESUMO
FNA biopsies were performed on 24 patients with bone lesions. Cytology diagnosed ten of the cases as classic Burkitt's lymphomas. The cytodiagnoses in the remaining 14 cases were primary bone tumors (5 cases), bone cysts (2 cases), inflammatory lesions (4 cases) and inadequate material (3 cases). Smears of the Burkitt's lymphomas of the jaw contained starry sky macrophages and neoplastic lymphoid cells with deep basophilic cytoplasms and fine vacuolizations. Taking into consideration the load of Burkitt's lymphoma cases in Africa, FNA cytology appears to be a very simple method for getting a quick tissue diagnosis (results were available within 24 hours). For doctors working in tropical hospitals with limited facilities, FNA cytopathology is very useful for distinguishing between tumors and inflammations and for differentiating between benign and malignant tumors.
Assuntos
Doenças Ósseas/diagnóstico , Neoplasias Ósseas/diagnóstico , Adolescente , Adulto , Idoso , Biópsia por Agulha , Doenças Ósseas/patologia , Neoplasias Ósseas/patologia , Linfoma de Burkitt/diagnóstico , Linfoma de Burkitt/patologia , Criança , Pré-Escolar , Feminino , Humanos , Neoplasias Maxilomandibulares/diagnóstico , Neoplasias Maxilomandibulares/patologia , Masculino , Pessoa de Meia-Idade , TanzâniaRESUMO
The diagnosis of tick-borne relapsing fever was established in 27 pregnant patients by demonstration of Borrelia spirochaetes in a thick blood smear and the borrelia index was estimated to calculate the density of the spirochaetaemia. Clinical findings are described and compared with those reported from Rwanda. The results suggest that the density of the spirochaetaemia and the gestational age are the main high-risk factors.
Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Febre Recorrente/epidemiologia , Adolescente , Adulto , Fatores Etários , Feminino , Idade Gestacional , Humanos , Paridade , Gravidez , Estudos Prospectivos , Fatores de RiscoRESUMO
A fatal Jarisch-Herxheimer reaction developed after treatment with high doses of penicillin in a case of lobar pneumonia caused by Borrelia duttoni. Penicillin given on the first day and tetracycline on subsequent days to avoid severe Jarisch-Herxheimer reactions, has the disadvantage of a longer period of spirochetemia and hypotension as compared with tetracycline on the first day. Treatment may have contributed to the death of this patient.