High prevalence of Chlamydia trachomatis in pregnant women attended at Primary Health Care services in Amazon, Brazil.

Chlamydia trachomatis (CT) infection is often silent and can lead to long-term reproductive complications in women. In this study, we determined the prevalence of CT infection and possible associations between the presence of the infection and clinical-epidemiological variables in pregnant women attended at the Basic Health Units of the Coari city, Amazonas, Brazil. From July 2016 to March 2017, 164 pregnant women undergoing prenatal care were recruited. One hundred of these women were tested for CT infection using two types of samples: cervico-vaginal and urine. The diagnosis was confirmed by PCR with primers specific for the omp1 gene of CT chromosomal DNA. Of the 100 pregnant women, 18 (18%) had CT infection, 8 (8%) of which were positive in both samples, 7 (7%) only in the urine sample and 3 (3%) only in cervical-vaginal sample. There was moderate agreement (Kappa=0.55) and no statistically significant difference between sample types (p = 0.400). The mean age of infected women was 21.1 years (SD = 4.6). Of the clinical-epidemiological variables analyzed, "more than 2 partners in the last 12 months" (p = 0.022) and gynecological complaint of "pain after intercourse" (p = 0.020) were associated with CT infection. This study showed a high prevalence (18%) of CT infection among pregnant women in Coari / Amazonas. Urine sampales were as good as cervical-vaginal ones for the screening of CT infection during the prenatal period.

"Hidden" sexually transmitted infections among women in primary care health services, Amazonas, Brazil.

This study describes the prevalence of infection by Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis in a female population in Amazonas, Brazil. We collected cervical samples from 361 women examined at 10 primary care health services in the city of Coari, Amazonas, Brazil. The women were interviewed about socio-economic data, clinical history and sexual behaviour. Pelvic examinations were performed and cervical specimens were collected for detection of pathogens by PCR. The prevalence of infection was: 12.7% for Trichomonas vaginalis, 6.4% for Chlamydia trachomatis and 1.4% for Neisseria gonorrhoeae. There were no statistically significant associations between infections by any of the pathogens nor by any pathogen alone with any clinical variable, socio-demographic data or sexual behaviour. This study draws attention to the need for surveillance and possible need for screening for Chlamydia trachomatis, which often progresses asymptomatically. For the significant prevalence found, attention should also be given to asymptomatic infection by Trichomonas vaginalis, since this pathogen has recently been implicated as a risk factor for HIV infection.

High prevalence and genotypic diversity of the human papillomavirus in Amazonian women, Brazil.

The aim of this study was to determine the prevalence of human papillomavirus (HPV) in a women population living within the state of Amazonas, Brazil, and to determine the viral genotypes found. The study included 361 sexually active women over 18 years of age. We performed the Pap test and the molecular diagnosis for HPV DNA using polymerase chain reaction (PCR). The amplicons obtained were sequenced in automatic sequencer for genotyping. The presence of HPV DNA was found in 29.1% (105) of the women. Only 321 women presented satisfactory slides for cytological diagnosis, 97.9% (314) had normal cytology (negative for cancer), and 2.1% (7) had abnormal cytology (4 ASCUS, 1 LSIL, and 2 HSIL). The types more frequently found were HPV 16 (58.1%) and HPV 58 (20.0%). Additionally, we found more 13 types of HPV. Compared with previous studies in Brazil, our data confirmed a high prevalence and genotypic diversity of HPV in Brazilian women.

Detecção de Citomegalovírus Humano e Herpesvírus Simples tipo 2 em amostras cervicais / Detection of Human Cytomegalovirus and Herpes Simplex Virus type 2 in cervical sample

OBJETIVO: Testar a presença de DNA de Citomegalovírus Humano (HCMV) e Herpesvírus Simples tipo 2 (HSV-2) em amostras cervicais de mulheres atendidas em um serviço de atenção primária à saúde no município de Coari, Amazonas, Brasil. MÉTODOS: Participaram deste estudo 361 mulheres sexualmente ativas, variando entre 18 e 78 anos, atendidas em Unidades Básicas de Saúde para exame ginecológico de rotina. As amostras cervicais foram coletadas por meio de escova endocervical. A detecção dos vírus deu-se por meio de Reação em Cadeia da Polimerase (PCR) em tempo real. RESULTADOS: A média de idade das mulheres participantes foi de 36,4 anos (desvio-padrão (DP)=13,4). Foi encontrado DNA de HCMV em amostras cervicais de 30 mulheres (8,3%; IC95% 5,8 - 11,8) e de HSV-2 em 2 mulheres (0,6%; IC95% 0,1 - 2,2). Duas mulheres relataram ser portadoras do HIV, estando uma delas infectada com o HCMV. Não foram encontradas associações estatisticamente significativas entre a infecção pelos patógenos estudados e as variáveis socioeconômicas, clínicas e comportamentais. CONCLUSÕES: A prevalência de infecção pelo HCMV encontrada na amostra estudada chama a atenção para a necessidade do rastreio desse vírus na gestação e da vigilância nos pacientes imunocomprometidos. A baixa prevalência do HSV-2 deve-se provavelmente ao fato de a amostra cervical não ser adequada para este tipo de estudo por causa das características da biologia viral relacionadas à neurolatência.

PURPOSE: To detect the presence of Human Cytomegalovirus (HCMV) and Herpes Simplex Virus type 2 (HSV-2) DNA in cervical samples from women assisted in a primary health care clinic in the city of Coari, Amazonas, Brazil. METHODS: Participated in this study 361 sexually active women between 18 and 78 years. They were been assisted in a Basic Health Care Clinic for routine gynecological exam. The cervical samples were collected using endocervical brush. The viruses were detected using real-time Polymerase Chain Reaction (PCR) technique. RESULTS: Mean age was 36.4 years (standard deviation (SD)=13.4). HCMV DNA was found in cervical samples from 30 women (8.3%; IC95% 5.8 - 11.8) and HSV 2 DNA in 2 women (0.6%; IC95% 0.1 - 2.2). Two women related being HIV positive, one of them infected with HCMV. There were no statistically significant associations between infections by the pathogens studied and socioeconomic, clinical or behavioral variables. CONCLUSIONS: The prevalence of the HCMV infection found in the sample points to the need for screening of the virus during pregnancy and surveillance in immunocompromised patients. The low prevalence of HSV-2 found is probably due to the fact that cervical sampling is not appropriate for this type of study because of the characteristics of viral biology related to neurovirulence.

[Detection of Human Cytomegalovirus and Herpes Simplex Virus type 2 in cervical sample]. / Detecção de Citomegalovírus Humano e Herpesvírus Simples tipo 2 em amostras cervicais.

PURPOSE: To detect the presence of Human Cytomegalovirus (HCMV) and Herpes Simplex Virus type 2 (HSV-2) DNA in cervical samples from women assisted in a primary health care clinic in the city of Coari, Amazonas, Brazil. METHODS: Participated in this study 361 sexually active women between 18 and 78 years. They were been assisted in a Basic Health Care Clinic for routine gynecological exam. The cervical samples were collected using endocervical brush. The viruses were detected using real-time Polymerase Chain Reaction (PCR) technique. RESULTS: Mean age was 36.4 years (standard deviation (SD)=13.4). HCMV DNA was found in cervical samples from 30 women (8.3%; IC95% 5.8 - 11.8) and HSV 2 DNA in 2 women (0.6%; IC95% 0.1 - 2.2). Two women related being HIV positive, one of them infected with HCMV. There were no statistically significant associations between infections by the pathogens studied and socioeconomic, clinical or behavioral variables. CONCLUSIONS: The prevalence of the HCMV infection found in the sample points to the need for screening of the virus during pregnancy and surveillance in immunocompromised patients. The low prevalence of HSV-2 found is probably due to the fact that cervical sampling is not appropriate for this type of study because of the characteristics of viral biology related to neurovirulence.

Fibroma ossificante central: relato de caso / Central ossifyng fibroma: report of a case

O fibroma ossificante central é uma lesão rara que consiste em uma neoplasia osteogênica com tecido fibroso e calcificações similares a osso e/ou cemento. Clinicamente apresenta-se como uma tumefação, assintomática, sendo comum em pacientes jovens. N o exame imaginologico evidencia-se uma lesão bem delimitada, podendo apresentar margens escleróticas. É objetivo deste trabalho relatar o caso de um paciente do sexo masculino, 20 anos de idade, que apresentava lesão expansiva na região de primeiro molar mandibular. A imagem radiográfica revelou lesão radiolúcia com área central radiopaca e halo esclerótico, cujo exame histopatológico evidenciou uma lesão fibro-óssea benigna diagnosticada como fibroma ossificante central.

Análise comparativa da proliferação celular entre carcinomas de células escamosas orais HPV-positivos e HPV-negativos / Comparative analysis of the cellular proliferation between HPV-positive and HPV-negative oral squamous cell carcinomas

INTRODUÇÃO: O carcinoma de células escamosas oral (OSCC) representa a neoplasia maligna mais freqüente em boca, e, entre os agentes etiológicos implicados, o papilomavírus humano (HPV) tem sido extensivamente estudado nos últimos anos. OBJETIVO: Analisar comparativamente os índices de proliferação celular em OSCCs HPV-negativos e HPV-positivos. MATERIAL E MÉTODO: A amostra consistiu em 11 casos de OSCCs HPV-positivos (10 infectados por HPV-18 e um por HPV-16 e 18) e 13 HPV-negativos, previamente analisados quanto à presença ou ausência, bem quanto à tipagem viral por proteína C reativa (PCR) (primers GP5+/GP6+) e hibridização dot blot, respectivamente. No método imunoistoquímico utilizou-se a técnica da estreptoavidina-biotina, com anticorpo para a proteína nuclear Ki-67. RESULTADOS: O teste estatístico não-paramétrico de Mann-Whitney revelou que não houve diferença estatisticamente significativa entre os grupos HPV-positivo e HPV-negativo (p = 0,72). Discussão: Os estudos semelhantes a estes são poucos e não são concordantes em demonstrar maior atividade proliferativa tumoral nos casos HPV-positivos em relação aos HPV-negativos, seja através da análise da expressão de proteínas relacionadas ao ciclo celular, seja na análise direta da fração proliferativa tumoral. CONCLUSÃO: Não houve diferença no índice de proliferação celular entre os grupos de OSCCs HPV-positivo e HPV-negativos.

BACKGROUND: Oral Squamous Cell Carcinoma (OSCC) is the most common malignant tumor in the mouth, and the human papillomavirus (HPV) has been hardly studied as a possible etiologic agent. OBJECTIVES: The aim of this study was to compare the rates of cell proliferation in HPV-positive and HPV-negative OSCC, using the immunohistochemical antibody Ki-67. MATERIAL AND METHOD: The sample consisted of 11 cases HPV-positive OSCC (10 cases infected with HPV-18 and 1 case infected with HPV-16 and 18) and 13 cases HPV-negative OSCCs, previously analyzed regarding the presence or absence of HPV, as well as the viral type, using PCR (primers GP5+/GP6+) and dot blot hybridization, respectively. Immunohistochemical study was performed by streptoavidin-biotin technique with antibody against nuclear protein Ki-67. RESULTS: The mean of positivity index of the HPV-positive OSCC (17.7 percent) was greater than HPV-negative OSCC (14.2 percent), however the statistic analysis showed that standard deviation in both groups was very high, almost equal the mean (14 percent and 9.5 percent, respectively). The Mann-Whitney non-parametric statistic test disclosed that there wasn't a significantly statistical difference between the groups. DISCUSSION: Similar studies to these are few and they are not concordant in demonstrating a bigger tumoral proliferative activity in those cases infected by HPV in relation to those not infected, either through the analysis of the protein expression related to the cellular cycle as in the direct analysis of the tumoral proliferative fraction. CONCLUSION: There were not differences in the rates of cell proliferation between the HPV-positive and HPV-negative grups.

Papilomavírus humano e câncer oral: uma revisão dos conceitos atuais / Papilomavirus and oral cancer: review of actual concepts

Diversos fatores etiológicos estão envolvidos na etiologia do carcinoma epidermóide oral, e dentre estes, o Papilomavírus Humano (HPV) tem sido extensivamente estudado nos últimos anos. O HPV é um vírus de DNA, epiteliotrópico, cujas propriedades oncogênicas estão relacionadas a interferências nos mecanismos que controlam a proliferação celular normal. Esses mecanismos são alterados principalmente pelas proteínas E6 e E7, que interferem nas funções normais das proteínas p53 e pRb, respectivamente. Os estudos envolvendo o HPV na carcinogênese oral são controversos. Assim, a associação entre esse vírus e o câncer oral ainda não está bem definida. O objetivo desse trabalho foi realizar uma revisão literária dos aspectos atuais relacionados ao HPV no câncer oral.

Some etiologic factors are related to oral squamous cell carcinoma, and, amongst these, the Human Papillomavirus (HPV) has been extensively studied in these last years. HPV is a epitheliotropic virus of DNA, and the role of HPV in carcinogenesis is supported by its capacity of interference in important mechanisms that control the cell cycle and cellular proliferation. These mechanisms are modified mainly by the proteins E6 and E7, that intervene with the normal functions of proteins p53 and pRb, respectively. The studies involving the HPV in oral carcinogenesis are controversial. Thus, the association between this virus and the oral cancer is not still very defined. The objective of this work was to carry through a literary revision of the related current aspects to the HPV in the oral cancer.

Ulceração aftosa recorrente: revisão dos conceitos atuais / Recurrent aphthous ulceration: a review of the present aspects

A ulceração aftosa recorrente (UAR) oral é uma condição caracterizada pelo desenvolvimento periódico de úlceras solitárias ou múltiplas e dolorosas na mucosa oral, de etiologia ainda não muito bem esclarecida e bastante incômoda para o paciente. Entre os fatores predisponentes propostos estão estresse, história familiar, trauma, hipersensibilidade alimentar, deficiências nutricionais, alterações hematológicas e, ainda, um possível envolvimento bacteriano. Porém, a etiologia é ainda controversa, sendo mais aceito o mecanismo imunológico, especialmente a citotoxicidade mediada por células. Como numerosos fatores têm sido propostos, torna-se difícil estabelecer um protocolo terapêutico eficaz para todos os casos. Tanto a etiologia quanto o tratamento parecem ser particulares para determinados pacientes. O entendimento dessa condição é importante para o cirurgião-dentista, pois ela dificulta a alimentação em muitos casos, interferindo na qualidade de vida dos pacientes por ela acometidos.

Recurrent aphthous ulceration (RAU) is a condition characterized by periodic development of painful, single or multiple ulcerations of the oral mucosa. The principal cause has not been discovered. The main aetiologic factors are stress, heredity, local trauma, food hypersensitivity, immunological mechanisms, alimentary deficiencies, haematological abnormalitys, and bacterial infections. Like various aetilogic factors are possible, it´s difficult to establish a efficient therapeutic protocol for all cases. It seems that the aetiology and the treatment are particular for each case. It´s important for the dentist to understand this condition, because it´s very bothering for the patient, making it difficult its feeding, influencing in its quality of life.

Expressäo imuno-histoquímica da vimentina e do HHF-35 em fibroma de células gigantes, hiperplasia fibrosa e fibroma da mucosa oral / Immunohistochemical exppression of vimentin and HHF-35 in giant cell fibroma, fibrous hyperplasia and fibroma of the oral mucosa

O fibroma de células gigantes, a hiperplasia fibrosa e o fibroma constituem algumas das mais freqüentes lesöes fibrosas orais, compartilhando características clínicas e histopatológicas. Este estudo teve o objetivo de investigar a imunorreatividade das células gigantes estreladas mono, bi ou multinucleadas, características do fibroma de células gigantes e, ocasionalmente presentes na hiperplasia fibrosa e no fibroma, a anticorpos anti-vimentina e anti-actina de músculo (HHF-35), visando detectar características fenotípicas destas células. Os resultados demonstraram que na maioria dos casos houve imunorreatividade para a vimentina, sugerindo um fenótipo fibroblástico para estas células

[Immunohistochemical expression of vimentin and HHF-35 in giant cell fibroma, fibrous hyperplasia and fibroma of the oral mucosa]. / Expressão imuno-histoquímica da vimentina e do HHF-35 em fibroma de células gigantes, hiperplasia fibrosa e fibroma da mucosa oral.

The giant cell fibroma, fibrous hyperplasia and fibroma are the most frequent fibrous oral lesions, sharing clinical and histopathological features. The purpose of this study was to investigate the immunoreactivity of the large stellate-shaped mononuclear and multinucleated cells, reported as the most characteristic histological feature of the giant cell fibroma but present occasionally in fibrous hyperplasia and fibroma, for the antibodies vimentin and HHF-35 in order to detect phenotypical characteristic of these cells. The results showed in the most of cases positive staining for vimentin, suggesting a fibroblast phenotype for these cells.