Primary screening for cervical cancer through self sampling.

OBJECTIVE: To evaluate the use of community health agents (CHAs) to instruct women living in poor rural areas in obtaining self-collected cervical samples and compare the high-risk HPV (hrHPV) hybrid capture (HC) results obtained to those for gynecologist-collected samples. METHODS: After a one-day training, CHAs visited sexually active women, instructing each in the use of collection brush and the Universal Collection Medium tube. One week thereafter, a gynecologist collected cervical samples from, and performed colposcopies on, the same women. A single reference lab performed all HCs. RESULTS: 878 women (Age: 15-69 years) participated. Among self-collected samples, hrHPV prevalence was 33.9% (95% CI: 30.8%-37%), compared with 28.6% (95% CI: 27%-30%) among gynecologist-collected samples. However, 9.3% of the patients were HPV HC II-positive in the self-collected sample and HPV HC II-negative in the gynecologist-collected samples (95% CI: 7.38%-11.22%), whereas 4% tested positive in gynecologist-collected samples and negative in self-collected samples (95% CI: 2.7%-5.3%) (P<0.01; kappa=0.7). Of 9 cases of histologically-confirmed, high-grade squamous intraepithelial lesion, self-collected and provider-collected samples missed one each. CONCLUSION: Self-collected vaginal sampling could be made an additional CHA function under existing program conditions, improving access to cervical cancer screening in poor rural settings.

Function and regulation of the acid and neutral trehalases of Mucor rouxii.

Two different trehalose-hydrolysing activities, known as acid or non-regulatory trehalases, and neutral or regulatory trehalases, have been recognised in a number of fungal species. The true role of these apparently redundant hydrolases remained obscure for many years. However, recent evidence suggests that neutral trehalases would be specialised in the mobilisation of cytosolic trehalose, while acid trehalases would only hydrolyse extracellular trehalose. Results obtained with Mucor rouxii, a Zygomycete initially thought to possess only neutral trehalase activity, reinforced this hypothesis. M. rouxii grows efficiently in trehalose as the sole carbon source. Trehalose-grown or carbon-starved cells exhibit a high trehalase activity of optimum pH 4.5, bound to the external surface of the cell wall, in contrast with the neutral (pH 6.5) trehalase, which occurs in the cytosol. Other differences between the neutral and the acid trehalases are the temperature optimum (35 degrees C and 45 degrees C, respectively) and thermal stability (half-life of 2.5 min and 12 min at 45 degrees C, respectively). The neutral trehalase, but not the acid trehalase, is activated in vitro by cAMP-dependent phosphorylation, stimulated by Ca2+, and inhibited by EDTA. It shows maximal activity at germination and decreases as growth proceeds. In contrast the activity of the acid trehalase is totally repressed in glucose-grown cultures and increases upon exhaustion of the carbon source, and is strongly induced by extracellular trehalose.

Elastosis and steroid receptors in primary breast cancer.

The association between the presence of both estrogen (ER) and progesterone (PR) receptors, and the grade of elastosis was evaluated in 100 primary breast carcinomas, 37% of which were from menopausal patients. ER levels were higher in post- than in premenopausal women but only when both ER and PR were present. Progesterone receptor levels were independent of menstrual status but the lowest PR positivity in premenopausal patients was observed during the late luteal phase. The extent of elastosis of the 100 tumors was: Grade 0 (absent), 24%; Grade 1 (small or moderate), 49%, and Grade 2 (marked), 27%. The extent of elastosis was not related to the patient's menstrual status. A significant association was observed between marked elastosis and the presence or absence of both ER and PR. No relationship was observed between the ER + PR and ER-PR+ subclasses and the extent of elastosis. Our data suggest that marked elastosis results from the presence of hormone-dependent cells in human breast carcinomas.

[Hepatitis B antigens systems in schistosomiasis mansoni]. / Sistemas antigênicos da hepatite B na esquistossomose mansôncia.

The authors have studied the antigenic systems HBs and HBe and B virus hepatitis in 155 patients with mansonic schistosomiasis and have found: a) 22,5% HBsAg positivity in patients with the hepatosplenic form of the disease which was associated with histologic liver alterations and 8,7% anti-HBs positivity in patients with the hepatointestinal form of the disease which was associated with a preserved liver histology; in controls they have found 1% positivity for HBsAg. b) HBeAg and anti-HBe were of good prognostic value.