[Vertical transmission from abortive material and blood with emphasis on Toxoplasma gondii]. / Infecções de transmissão vertical em material abortivo e sangue com ênfase em Toxoplasmose gondii.

PURPOSE: To analyze the serological, anatomopathological and parasitological results obtained from abortive material in order to detect infections with the risk of vertical transmission, with emphasis on toxoplasmosis. METHODS: A cross-sectional cohort study was conducted in order to determine the prevalence of infectoparasitic diseases. A total of 105 women who suffered spontaneous complete or incomplete abortion participated in the study. The women were interviewed, answered a questionnaire and had their blood and abortive material collected. Immunological tests were carried out in order to detect toxoplasmosis, Chagas disease, rubeola, cytomegalovirus and syphilis, and anatomopathological analysis of the ovular remains was performed. RESULTS: 55% of the women studied were 20 to 30 years old. Most of them (68%) presented a gestational age between the 7th and 14th week. 54.3% of the women had complete or incomplete high school education. Serological analysis showed cytomegalovirus (CMV) as the most common vertically transmitted infection with 97.1% positivity, followed by rubeola with 95.2%. Toxoplasmosis showed 54.3% positivity, Chagas disease 1.9% and syphilis 0.95%. Anatomopathological analysis showed inflammation in 63.1% of the cases and absence of inflammation in 34%. The results of the serological, anatomopathological and parasitological analysis of the 105 participants showed that 57 women were T. gondii positive. However, none showed positivity in the polymerase chain reaction (PCR) or in mouse inoculation. CONCLUSIONS: The prevalence of diseases with the risk of vertical transmission is important in women with spontaneous abortion, indicating the need for more research in order to investigate the etiology of abortion.

Infeccoes de transmissao vertical em material abortivo e sangue com enfase em Toxoplasmose gondii / Vertical transmission from abortive material and blood with emphasis on Toxoplasma gondii

OBJETIVO: Analisar os resultados sorológicos, anatomopatológicos e parasitológicos de material abortivo para infecções com risco de transmissão vertical, com ênfase na toxoplasmose. MÉTODOS: Foi realizado um estudo coorte-transversal tratando da prevalência das doenças infectoparasitárias. Participaram da pesquisa 105 mulheres que sofreram aborto espontâneo completo e/ou incompleto; elas foram entrevistadas por meio de um questionário, e foram coletadas amostras de sangue e material abortivo. Foram realizados testes imunológicos para toxoplasmose, doença de Chagas, rubéola, citomegalovírus e sífilis e análise anatomopatológica nos restos ovulares. RESULTADOS: 55% das mulheres tinham entre 20 e 30 anos de idade. A maioria (68%) apresentou idade gestacional entre a 7ª e a 14ª semanas. 54,3% das mulheres tinham o ensino médio completo ou incompleto. Pela análise da sorologia, a infecção com risco de transmissão vertical mais frequente foi o citomegalovírus (CMV) com 97,1% de positividade, e em seguida a rubéola, com 95,2%. A toxoplasmose teve um percentual de 54,3%, a doença de Chagas, de 1,9% e a sífilis, de 0,95%. A análise dos laudos de biópsia demonstrou que 63,1% apresentaram inflamação e 34%, ausência de inflamação. Das análises sorológica, anatomopatológica e parasitológica das 105 mulheres, 57 foram soropositivas para T. gondii, e nenhuma teve resultado positivo para a Reação em Cadeia da Polimerase (PCR) e para inoculação em camundongos. CONCLUSÕES: A prevalência de doenças com risco de transmissão congênita nas mulheres com abortamento espontâneo é importante, sendo necessárias pesquisas visando esclarecer a etiologia do aborto. .

PURPOSE: To analyze the serological, anatomopathological and parasitological results obtained from abortive material in order to detect infections with the risk of vertical transmission, with emphasis on toxoplasmosis. METHODS: A cross-sectional cohort study was conducted in order to determine the prevalence of infectoparasitic diseases. A total of 105 women who suffered spontaneous complete or incomplete abortion participated in the study. The women were interviewed, answered a questionnaire and had their blood and abortive material collected. Immunological tests were carried out in order to detect toxoplasmosis, Chagas disease, rubeola, cytomegalovirus and syphilis, and anatomopathological analysis of the ovular remains was performed. RESULTS: 55% of the women studied were 20 to 30 years old. Most of them (68%) presented a gestational age between the 7th and 14th week. 54.3% of the women had complete or incomplete high school education. Serological analysis showed cytomegalovirus (CMV) as the most common vertically transmitted infection with 97.1% positivity, followed by rubeola with 95.2%. Toxoplasmosis showed 54.3% positivity, Chagas disease 1.9% and syphilis 0.95%. Anatomopathological analysis showed inflammation in 63.1% of the cases and absence of inflammation in 34%. The results of the serological, anatomopathological and parasitological analysis of the 105 participants showed that 57 women were T. gondii positive. However, none showed positivity in the polymerase chain reaction (PCR) or in mouse inoculation. CONCLUSIONS: The prevalence of diseases with the risk of vertical transmission is important in women with spontaneous abortion, indicating the need for more research in order to investigate the etiology of abortion. .

Human papillomavirus types 16 and 18 and the prognosis of patients with stage I cervical cancer.

OBJECTIVE: This study sought to evaluate the prevalence of human papillomavirus (HPV) types 16 and 18 in women with clinical stage IB cervical cancer treated by radical hysterectomy with pelvic lymphadenectomy as well as to establish a correlation between HPV type and cancer prognosis. METHODS: A single-center cohort study was conducted with 86 patients who had undergone radical hysterectomy for stage I cervical cancer. Prognostic factors and the presence of HPV 16 and 18 were analyzed using a polymerase chain reaction assay. A univariate analysis using Kaplan-Meier curves was conducted to estimate survival. RESULTS: The prevalence of HPV 16 in the study group was 65.3%, and the prevalence of HPV 18 was 33.3%. The prevalence of infection with both viruses was 26.9%. Overall survival at 5 years was 91% among women with HPV 18 and 96% among those without this virus type (p=0.133). Among the women with HPV 16, the overall survival was 94%, whereas this rate was 96% among those without this virus type (p=0.663). Disease-free survival was unaffected by the presence of HPV type 16 or 18. CONCLUSION: In the present study, despite the high prevalence of HPV types 16 and 18, the presence of these virus types did not affect the prognosis of patients with stage I cervical cancer who underwent radical hysterectomy.

Human papillomavirus types 16 and 18 and the prognosis of patients with stage I cervical cancer

OBJECTIVE: This study sought to evaluate the prevalence of human papillomavirus (HPV) types 16 and 18 in women with clinical stage IB cervical cancer treated by radical hysterectomy with pelvic lymphadenectomy as well as to establish a correlation between HPV type and cancer prognosis. METHODS: A single-center cohort study was conducted with 86 patients who had undergone radical hysterectomy for stage I cervical cancer. Prognostic factors and the presence of HPV 16 and 18 were analyzed using a polymerase chain reaction assay. A univariate analysis using Kaplan-Meier curves was conducted to estimate survival. RESULTS: The prevalence of HPV 16 in the study group was 65.3%, and the prevalence of HPV 18 was 33.3%. The prevalence of infection with both viruses was 26.9%. Overall survival at 5 years was 91% among women with HPV 18 and 96% among those without this virus type (p = 0.133). Among the women with HPV 16, the overall survival was 94%, whereas this rate was 96% among those without this virus type (p = 0.663). Disease-free survival was unaffected by the presence of HPV type 16 or 18. CONCLUSION: In the present study, despite the high prevalence of HPV types 16 and 18, the presence of these virus types did not affect the prognosis of patients with stage I cervical cancer who underwent radical hysterectomy. .

Cervical cancer mortality trends in Brazil: 1980-2009.

The objective was to describe time trends in cervical cancer mortality rates in Brazil as a whole and in the country's major geographic regions and States from 1980 to 2009. This was an ecological time series study using data recorded in the Mortality Information System (SIM) and census data collected by the Brazilian Institute of Geography and Statistics (IBGE). Analysis of mortality trends was performed using Poisson regression. Cervical cancer mortality rates in Brazil tended to stabilize. In the geographic regions, a downward trend was observed in the South (-4.1%), Southeast (-3.3%), and Central-West (-1%) and an upward trend in the Northeast (3.5%) and North (2.7%). The largest decreases were observed in the States of São Paulo (-5.1%), Rio Grande do Sul, Espírito Santo, and Paraná (-4.0%). The largest increases in mortality trends occurred in Paraíba (12.4%), Maranhão (9.8%), and Tocantins (8.9%). Cervical cancer mortality rates stabilized in the country as a whole, but there was a downward trend in three geographic regions and 10 States, while two geographic regions and another 10 States showed increasing rates.

Cervical cancer mortality trends in Brazil: 1980-2009 / Tendência da mortalidade por câncer do colo do útero no Brasil: 1980 a 2009 / Tendencia de la mortalidad por cáncer del cuello de útero en Brasil: 1980 a 2009

The objective was to describe time trends in cervical cancer mortality rates in Brazil as a whole and in the country's major geographic regions and States from 1980 to 2009. This was an ecological time series study using data recorded in the Mortality Information System (SIM) and census data collected by the Brazilian Institute of Geography and Statistics (IBGE). Analysis of mortality trends was performed using Poisson regression. Cervical cancer mortality rates in Brazil tended to stabilize. In the geographic regions, a downward trend was observed in the South (-4.1%), Southeast (-3.3%), and Central-West (-1%) and an upward trend in the Northeast (3.5%) and North (2.7%). The largest decreases were observed in the States of São Paulo (­5.1%), Rio Grande do Sul, Espírito Santo, and Paraná (-4.0%). The largest increases in mortality trends occurred in Paraíba (12.4%), Maranhão (9.8%), and Tocantins (8.9%). Cervical cancer mortality rates stabilized in the country as a whole, but there was a downward trend in three geographic regions and 10 States, while two geographic regions and another 10 States showed increasing rates.

O objetivo deste estudo foi fornecer um quadro quanto à tendência da mortalidade por câncer do colo de útero no Brasil, em suas regiões e estados, entre 1980 e 2009. Estudo ecológico de série temporal, com uso de informações sobre óbitos (Sistema de Informações sobre Mortalidade - SIM) e base demográfica (Instituto Brasileiro de Geografia e Estatística - IBGE). Foram realizadas análises das tendências da mortalidade por meio da regressão de Poisson. Houve estabilização nas taxas de mortalidade no Brasil. Nas regiões, houve queda no Sul (-4,1%), Sudeste (-3,3%) e Centro-Oeste (-1%); aumento no Nordeste (3,5%) e Norte (2,7%). As maiores reduções foram observadas em São Paulo (-5,1%), Rio Grande do Sul, Espírito Santo e Paraná (-4,0%). Os maiores aumentos foram observados na Paraíba (12,4%), Maranhão (9,8%) e Tocantins (8,9%). No Brasil, houve estabilização na mortalidade por câncer do colo do útero. No entanto, houve redução em 3 regiões e em 10 estados, enquanto, em 2 regiões e em outros 10 estados, a mortalidade segue aumentando. Uma das razões para essa disparidade pode ser o menor acesso ao tratamento para as pacientes de áreas menos desenvolvidas.

El objetivo fue analizar la mortalidad por cáncer de cuello de útero en Brasil, en sus macrorregiones y estados en el período de 1980 a 2009. Se trata de un estudio ecológico de serie temporal, con uso de información sobre óbitos del Sistema de Información sobre Mortalidad (SIM), y base demográfica del Instituto Brasileño de Geografía y Estadística (IBGE). Se realizaron análisis de las tendencias de la mortalidad, mediante la regresión de Poisson. En Brasil se observó la estabilización en las tasas de mortalidad. En las macrorregiones, hubo caída en el Sur (-4,1%), Sudeste (-3,3%) y Centro-Oeste (-1%); aumento en el Nordeste (3,5%) y Norte (2,7%). En los estados, las principales caídas fueron observadas en São Paulo (-5,1%), Rio Grande do Sul, Espírito Santo y Paraná (-4%). Los mayores aumentos se observaron en Paraíba (12,4%), Maranhão (9,8%) y Tocantins (8,9%). Conclusión: Brasil presenta estabilización en las tasas de mortalidad. No obstante, hubo una reducción en 3 macrorregiones y en 10 estados, mientras que en 2 macrorregiones y en 10 estados la mortalidad sigue aumentando. Una de las razones para esa disparidad puede ser el menor acceso al tratamiento para las pacientes de áreas menos desarrolladas.

Metilação aberrante de DNA, câncer cervical e HPV / Aberrant DNA methylation, cervical cancer and HPV

O diagnóstico laboratorial de metilação de DNA pode ser uma ferramenta fundamental para auxiliar no rastreio do câncer cervical. Os genes de metilação contribuem para o prognóstico de tumores do câncer cervical. O objetivo deste estudo foi identificar a frequência dos genes metilados mais frequentes no câncer cervical e a correlação da hipermetilação com a infecção por papilomavírus humano (HPV). Realizou-se uma revisão bibliográfica de publicações entre 2002 a 2012, utilizando-se a base de dados da PubMed. Os artigos selecionados revelaram que os genes metilados mais frequentes no câncer cervical são: CDH1, DAPK, RARβ, HIC1, DKK3, SFRP2, SOX17, WIF1, MGMT, hTERT e RASSF1A. Não houve correlação estatística significativa entre a positividade do HPV e a hipermetilação. Esses dados sugerem que os genes metilados mais frequentes no câncer cervical podem influenciar no início da progressão da doença. Acredita-se que o conhecimento sobre metilação de DNA no câncer cervical possa ser útil para prever as neoplasias do colo do útero, evitar a progressão da doença e servir como alvos de tratamento.

Laboratory diagnosis of DNA methylation may be a fundamental tool to help cervical cancer screening. Methylated genes contribute to the prognosis of cervical tumors. The objective of this study was to identify the frequency of the methylated genes most commonly found in cervical cancer and the correlation between hypermethylation and human papillomavirus (HPV) infection. A literature review was conducted of papers published between 2002 and 2012 using the PubMed database. The selected papers showed that the most common methylated genes in cervical cancer are: CDH1, DAPK, RARβ, HIC1, DKK3, SFRP2, SOX17, WIF1, MGMT, hTERT and RASSF1A. No statistically significant correlation was found between HPV positivity and hypermethylation. These data suggest that the methylated genes most commonly found in cervical cancer may exert an effect on the onset of disease. It is believed that the knowledge about DNA methylation in cervical cancer may be useful for predicting uterine neoplasias, avoid disease progression and may reveal possible targets for treatment.

Perfil sorológico de camundongos cronicamente infectados com a cepa cistogênica ME-49 de Toxoplasma gondii antes e após terapêutica específica / Serological profile of chronically infected mice with the cystogenic ME-49 strain of Toxoplasma gondii before and after specific treatment

Neste trabalho, foi avaliado o perfil sorológico experimental, após terapêutica específica, em camundongos, BALB/c infectados com cepa cistogênica ME-49. Foram inoculados, individual e intraperitonealmente, 45 animais com dez cistos da cepa ME-49. Os camundongos foram divididos em três grupos de 15 animais e um grupo controle com cinco animais não infectados e não tratados, todos acompanhados ao mesmo tempo, diariamente, durante 20 dias. Após este período, foram subdivididos em dois grups - A e B - e submetidos a esquemas terapêuticos específicos: grupo A - pirimetamina e ácido folínico; grupo B - pirimetamina, ácido folínico e sulfadiazina por dez dias consecutivos. A partir do quinto dia de tratamento, um camundongo de cada grupo foi anestesiado para a coleta de sangue por punção cardíaca, fazendo-se a análise do soro pela técnica de imunofluorescência indireta. Os animais tratados apresentaram diminuição significativa nos títulos de anticorpos (IgG) em relação ao grupo de infectados e não tratados. Entre as amostras analisadas com diferentes esquemas terapêuticos não houve diferença significativa. Isso mostra que o tratamento precoce da toxoplasmose reduz rapidamente os níveis de IgG, sugerindo uma possível cura desta parasitose.