Human Papillomavirus Positivity at 3 Anatomical Sites Among Transgender Women in Central Brazil.

BACKGROUND: Transgender women (TGW) are susceptible to the acquisition of sexually transmitted infections (STIs), including human papillomavirus (HPV). Nonetheless, the exact data for this population are scarce. We estimated HPV positivity at the anal, genital, and oral sites among TGW and also identified the related characteristics and behaviors that could be risk factors for HPV infection in a sample of TGW in Brazil. Furthermore, we characterized the site-specific HPV genotypes among those who were positive for HPV at these 3 sites. METHODS: A cross-sectional study was conducted on TGW in Goiânia City (Central-Midwest region), Brazil, between April 2018 and August 2019. Respondent-driven sampling was applied for recruitment. Next, self-collected anal, genital, and oral samples were examined for HPV DNA using polymerase chain reaction (SPF-10 primer). Human papillomavirus genotypes were identified in 12 TGW. RESULTS: In the TGW included in the study, the anal, genital, and oral HPV positivity values were 77.2% (95% confidence interval [CI], 67.3%-84.6%), 33.5% (95% CI, 26.1%-48.9%), and 10.9% (95% CI, 5.8%-17.0%), respectively. In addition, the majority of 12 participants who tested for HPV had multiple genotypes. HPV-52 was the most prevalent genotype identified at the anal (66.6%) and genital (40.0%) sites, whereas HPV-62 and HPV-66 were the most common at the oral site (25.0%). CONCLUSIONS: A high HPV positivity was observed among TGW. Therefore, additional epidemiological studies on HPV genotypes should generate health intervention information, including the prevention, diagnosis, and treatment of sexually transmitted infections.

Circulating MicroRNAs as Specific Biomarkers in Atrial Fibrillation: A Meta-Analysis.

Atrial fibrillation (AF) is the most frequently occurring supraventricular arrhythmia. Although microRNAs (miRNAs) have been associated with AF pathogenesis, standard protocols for quantifying and selecting specific miRNAs for clinical use as biomarkers should be optimized. In this study, we evaluated the clinical application of miRNAs as biomarkers for the prognosis and diagnosis of AF. Literature searches were conducted on PubMed, Cochrane Library, and EMBASE. We included prospective or retrospective observational studies that had been published as of 14 February 2022; our main objective was to analyze the relationship between circulating miRNAs and AF. The data were extracted using the descriptors "Atrial fibrillation AND miRNA", "Atrial fibrillation AND diagnostic AND miRNA", and "Atrial fibrillation AND prognosis AND miRNA". No filters were applied for period delimitation, type of publication, or language. Studies using samples isolated from blood plasma and TaqMan and RT-qPCR for detecting and quantifying miRNAs were selected, and those that used atrial tissue samples were excluded. We identified 272 articles and excluded 102 duplicated articles. Two authors independently read the titles and abstracts of 170 out of 272 articles and selected 56 potential articles, 6 of which were selected for final review. Our analysis revealed a significant association between AF and miR-4798 [OR = 1.90 (95% CI 1.45-2.47)], AF and miRNA-133a [2.77 (2.73-2.82)], AF and miRNA-150 [3.77 (1.50-9.46); I2 = 70%], AF and miRNA-21 [2.23 (1.20-4.17); I2 = 99%], AF and hsa-miRNA4443 [2.32 (2.20-2.44)], and AF and miR-20a-5p [3.67 (1.42-9.49)]. The association between miRNAs and AF showed an OR of 2.51 [95% CI 1.99-3.16; I2 = 99%]. Our meta-analysis demonstrated that circulating miRNAs are potential biomarkers of AF, as they exhibit stable expression post-sample collection. In addition to regulating cellular processes, such as proliferation, differentiation, development, and cell death, miRNAs were found to be linked to arrhythmia development.

Bacterial vaginosis and cervical human papillomavirus infection in young and adult women: a systematic review and meta-analysis.

OBJECTIVE: To investigate the association between bacterial vaginosis and cervical human papillomavirus (HPV) infection in young and adult women. METHODS: This systematic review and meta-analysis was based on the Prisma methodological guidelines. PubMed and Web of Science were searched using the following descriptors: "bacterial vaginosis and HPV", in June 2019. Articles published from 2012 to 2019 were included. Inclusion criteria were original studies that investigated the association between bacterial vaginosis and cervical HPV infection; articles published in English, Spanish or Portuguese; studies conducted in young and adult, non-pregnant, non-HIV-infected women; studies that used the Nugent criteria for the diagnosis of bacterial vaginosis and studies in which the detection of HPV used the polymerase chain reaction technique. Assembled data, odds ratio (OR) and respective 95% confidence intervals (95%CI) were estimated for the association between bacterial vaginosis and cervical HPV infection using random-effects models. A bilateral value of p < 0.05 was considered statistically significant. RESULT: Six studies were selected for analysis and demonstrated association between bacterial vaginosis and cervical HPV infection (OR = 2.68; 95%CI: 1.64-4.40; p < 0.001). CONCLUSION: Bacterial vaginosis was considered a risk factor for cervical HPV infection, since women with bacterial vaginosis were more likely to be infected with HPV.

Prevalence and factors associated with bacterial vaginosis in women in Brazil: a systematic review / Prevalência e fatores associados à vaginose bacteriana em mulheres no Brasil: uma revisão sistemática

Introduction: Bacterial vaginosis is characterized by the imbalance of the vaginal flora, with decrease in Lactobacillus and increase in other bacteria. Objective: To investigate the prevalence and factors associated with bacterial vaginosis. Methods: Systematic review based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, filed in the International Prospective Register of Systematic Reviews. The research was conducted in the PubMed and Scopus databases in September 2021. After reading the titles and abstracts of 84 articles and the full text of 20 articles, 10 of them were included in the review. The articles were considered eligible if they investigated the prevalence of bacterial vaginosis and used Amsel's diagnostic criteria or Gram-stained bacterioscopy in women of reproductive age without comorbidities. The studies were evaluated by two investigators to establish reliability. The risk of bias and the quality of the selected studies were evaluated using the Joanna Briggs Institute tool. Results: The mean prevalence of bacterial vaginosis in the included studies was 25.4% (95%CI 24.0­26.8). In three population-based studies, the mean prevalence was 18.1% (95%CI 16.0­20.5); and in seven clinic-based studies, it was 27.2% (95%CI 24.6­29.9). The factors associated with bacterial vaginosis were the use of sex accessories (OR 2.4; 95%CI 1.1­4.9), marital status "single" (OR 1.4; 95%CI 1.1­1.8), partner infidelity (OR 1.5; 95%CI 1.2­1.9), abnormal vaginal secretion (OR 1.5; 95%CI 1.2­2.0), and the presence of trichomoniasis (OR 4.1; 95%CI 1.5­11.5). Conclusion: The prevalence of bacterial vaginosis was high, and the associated factors are linked to sexual behavior.

Introdução: A vaginose bacteriana caracteriza-se pelo desequilíbrio da flora vaginal, com diminuição dos Lactobacillus e aumento de outras bactérias. Objetivo: Investigar a prevalência e os fatores associados à vaginose bacteriana. Métodos: Revisão sistemática baseada nas diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analyses, protocolado no International Prospective Register of Systematic Reviews. A pesquisa foi realizada nas bases de dados da PubMed e da Scopus, em setembro de 2021. Após a leitura dos títulos e dos resumos de 84 artigos e do texto completo de 20 artigos, dez foram incluídos na revisão. Os trabalhos foram considerados elegíveis quando investigaram a prevalência de vaginose bacteriana e utilizaram os critérios diagnósticos de Amsel ou a bacterioscopia corada pelo Gram em mulheres em idade reprodutiva e sem comorbidades. Os estudos foram avaliados por duas pesquisadoras para estabelecer a confiabilidade. O risco de viés e a qualidade das pesquisas selecionadas foram avaliados pela ferramenta do Joanna Briggs Institute. Resultados: A prevalência média de vaginose bacteriana nos trabalhos incluídos foi de 25,4% (intervalo de confiança ­ IC95% 24,0­26,8). Em três estudos de base populacional, a prevalência média foi de 18,1% (IC95% 16,0­20,5); e, em sete estudos de base clínica, a prevalência média foi de 27,2% (IC95% 24,6­29,9). Os fatores associados à vaginose bacteriana foram o uso de acessórios sexuais (odds ratio ­OR 2,4; IC95% 1,1­4,9), estado civil "solteira" (OR 1,4; IC95% 1,1­1,8), infidelidade do parceiro (OR 1,5; IC95% 1,2­1,9), secreção vaginal anormal (OR 1,5; IC95% 1,2­2,0) e presença de tricomoníase (OR 4,1; IC95% 1,5­11,5). Conclusão: A prevalência de vaginose bacteriana foi elevada e os fatores associados estão ligados ao comportamento sexual.

Bacterial vaginosis and trichomoniasis: prevalence, associated factors, and performance of diagnostic tests

Introduction: Bacterial vaginosis and vaginal trichomoniasis are frequent causes of health care demand. Objective: To estimate the prevalence, identify associated factors, and investigate the performance of diagnostic tests for bacterial vaginosis and trichomoniasis. Methods: Cross-sectional study with participants over 18 years old. All of them were submitted to an interview and gynecological examination with evaluation of vaginal secretion, pH verification, collection of material for Pap smear, wet mount test, Whiff test, bacterioscopy, and polymerase chain reaction for trichomoniasis detection. Logistic regression analysis was applied to identify associated factors with bacterial vaginosis. Diagnostic performance for bacterial vaginosis was evaluated following Amsel criteria, the Ison and Hay score, and the Pap smear, considering the Nugent score as the gold standard. As for trichomoniasis, diagnostic performance was evaluated through the Pap smear and the wet mount test, using the polymerase chain reaction as the gold standard. Results: The prevalence of bacterial vaginosis was 33.7%, and for trichomoniasis, 0.5%. The complaint of abnormal vaginal secretion was associated with the diagnosis of bacterial vaginosis (odds ratio 2.2). The diagnostic accuracy by Amsel criteria, the Ison and Hay score, and the Pap smear was 35.6, 97.0, and 84.2%, respectively. The sensitivity for trichomoniasis through wet mount test was 0.0%, and through the Pap smear, 100%. Conclusion: The prevalence of bacterial vaginosis was high, and trichomoniasis was low. The only associated factor with bacterial vaginosis was the report of abnormal vaginal secretion. The methods with the most accurate diagnostic performance for bacterial vaginosis were the Ison and Hay score and the Pap smear and, for trichomoniasis, the Pap smear

Bacterial vaginosis, cervical Human Papillomavirus infection and cervical cytological abnormalities in adult women in Central Brazil: a cross-sectional study / Vaginose bacteriana, infecção cervical pelo Papilomavírus humano e anormalidades citológicas cervicais em mulheres adultas no Brasil Central: um estudo transversal

Bacterial vaginosis is the most common cause of vaginal discharge and occurs when there is an imbalance in the vaginal microbiota, predominantly composed of Lactobacillus spp. Human Papillomavirus is the most common sexually transmitted virus in the world. Persistent infection with high-risk Human Papillomavirus genotypes is the main cause of the development of cervical intraepithelial neoplasia and cervical cancer. Objective: To investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection and between bacterial vaginosis and cervical cytological abnormalities in adult women. Methods: Cross-sectional study carried out in a gynecology outpatient clinic of the public health network. A total of 202 women were included in the study and underwent gynecological examination with cervical specimen collection. Cervical cytopathological examinations and bacterioscopy by the Nugent method were performed to identify bacterial vaginosis, and PCR and reverse hybridization were carried out for Human Papillomavirus detection and genotyping. Bivariate analysis was performed to investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection, and between bacterial vaginosis and cervical cytological abnormalities. The odds ratio was calculated, with the respective 95% confidence intervals (95%CI) and 5% significance level (p≤0.05). Results: The prevalence of bacterial vaginosis was 33.2% (67/202), the prevalence of cervical Human Papillomavirus infection was 38.6% (78/202) and the prevalence of cervical cytological abnormalities was 6.0% (12/202). Bivariate analysis showed no significant association between bacterial vaginosis and cervical Human Papillomavirus infection (OR 0.69; 95% CI 0.37­ 1.27; p=0.23), or between bacterial vaginosis and cervical cytological abnormalities (OR 0.65; 95%CI 0.17­2.50; p=0.54). Conclusion: In this study, bacterial vaginosis did not represent a risk factor for cervical Human Papillomavirus infection or for the presence of cervical cytological abnormalities in the investigated adult women.

A vaginose bacteriana é a causa mais comum de corrimento vaginal e ocorre quando há um desequilíbrio da microbiota vaginal, composta predominantemente de Lactobacillus spp. O papilomavírus humano é o vírus sexualmente transmissível mais comum no mundo. A infecção persistente com genótipos do papilomavírus humano de alto risco é a principal causa do desenvolvimento de neoplasias intraepiteliais cervicais e câncer de colo do útero. Objetivo: Investigar a associação entre vaginose bacteriana e infecção cervical pelo papilomavírus humano e entre vaginose bacteriana e anormalidades citológicas cervicais em mulheres adultas. Métodos: Estudo de corte transversal realizado em um ambulatório de ginecologia da rede pública de saúde. O total de 202 mulheres foi incluído no estudo e submetido ao exame ginecológico com coleta de espécime cervical. Foram realizados os exames citopatológicos cervicais, a bacterioscopia pelo método de Nugent para a identificação da vaginose bacteriana e reação em cadeia da polimerase e hibridização reversa para a detecção e genotipagem do papilomavírus humano. Análise bivariada foi realizada para investigar a associação entre vaginose bacteriana e infecção cervical pelo papilomavírus humano e entre vaginose bacteriana e anormalidades citológicas cervicais. Foi calculado o odds ratio, com os respectivos intervalos de confiança de 95% (IC95%) e nível de significância de 5% (p≤0,05). Resultados: A prevalência da vaginose bacteriana foi de 33,2% (67/202), a da infecção cervical pelo papilomavírus humano foi de 38,6% (78/202) e a de anormalidades citológicas cervicais foi de 6,0% (12/202). A análise bivariada não demonstrou associação significativa entre vaginose bacteriana e infecção cervical pelo papilomavírus humano (OR 0,69; IC95% 0,37­1,27; p=0,23), nem entre vaginose bacteriana e anormalidades citológicas cervicais (OR 0,65; IC95% 0,17­2,50; p=0,54). Conclusão: Neste estudo a vaginose bacteriana não representou um fator de risco para a infecção cervical pelo papilomavírus humano e nem para presença de anormalidades citológicas cervicais nas mulheres adultas investigadas

Bacterial vaginosis and cervical human papillomavirus infection in young and adult women: a systematic review and meta-analysis

ABSTRACT OBJECTIVE To investigate the association between bacterial vaginosis and cervical human papillomavirus (HPV) infection in young and adult women. METHODS This systematic review and meta-analysis was based on the Prisma methodological guidelines. PubMed and Web of Science were searched using the following descriptors: "bacterial vaginosis and HPV", in June 2019. Articles published from 2012 to 2019 were included. Inclusion criteria were original studies that investigated the association between bacterial vaginosis and cervical HPV infection; articles published in English, Spanish or Portuguese; studies conducted in young and adult, non-pregnant, non-HIV-infected women; studies that used the Nugent criteria for the diagnosis of bacterial vaginosis and studies in which the detection of HPV used the polymerase chain reaction technique. Assembled data, odds ratio (OR) and respective 95% confidence intervals (95%CI) were estimated for the association between bacterial vaginosis and cervical HPV infection using random-effects models. A bilateral value of p < 0.05 was considered statistically significant. RESULT Six studies were selected for analysis and demonstrated association between bacterial vaginosis and cervical HPV infection (OR = 2.68; 95%CI: 1.64-4.40; p < 0.001). CONCLUSION Bacterial vaginosis was considered a risk factor for cervical HPV infection, since women with bacterial vaginosis were more likely to be infected with HPV.

Expression of the cancer stem cell marker OCT4 is associated with worse prognosis and survival in cutaneous melanoma.

Cutaneous melanoma has an aggressive clinical presentation, showing rapid rate of growth and metastatic dissemination due to the permanence of cancer stem cells. The present study was to evaluate the expression of the self-renewal regulatory factor and the clinical significance of the transcription factor OCT4 in melanoma. Melanoma tissues were stained by immunohistochemistry and the correlation between the expression of this marker was determined through clinical-pathological variables and survival outcomes. Positive expression of nuclear and cytoplasmic OCT4 was observed in 49% and 41.2% of cases, respectively. The positive expression of nuclear OCT4 in melanoma was significantly associated with prognostic factors, such as Breslow depth, Clark's level, ulceration and metastasis. Survival of patients was 56% compared to positive nuclear OCT4 expression and 94.2% when compared to the low expression of the gene. Nuclear OCT4 positive genotype indicated aggressive tumor behavior with a worse clinical outcome, which indicates OCT4 as a useful biomarker in the prognosis of melanoma.

Tissue micro-RNAs associated with colorectal cancer prognosis: a systematic review.

Colorectal cancer (CRC) is a multifactorial disease commonly diagnosed worldwide, with high mortality rates. Several studies demonstrate important associations between differential expression of micro-RNAs (miRs) and the prognosis of CRC. The present study aimed to identify differentially expressed tissue miRs associated with prognostic factors in CRC patients, through a systematic review of the Literature. Using the PubMed database, Cochrane Library and Web of Science, studies published in English evaluating miRs differentially expressed in tumor tissue and significantly associated with the prognostic aspects of CRC were selected. All the included studies used RT-PCR (Taqman or SYBR Green) for miR expression analysis and the period of publication was from 2009 to 2018. A total of 115 articles accomplished the inclusion criteria and were included in the review. The studies investigated the expression of 100 different miRs associated with prognostic aspects in colorectal cancer patients. The most frequent oncogenic miRs investigated were miR-21, miR-181a, miR-182, miR-183, miR-210 and miR-224 and the hyperexpression of these miRs was associated with distant metastasis, lymph node metastasis and worse survival in patients with CRC. The most frequent tumor suppressor miRs were miR-126, miR-199b and miR-22 and the hypoexpression of these miRs was associated with distant metastasis, worse prognosis and a higher risk of disease relapse (worse disease-free survival). Specific tissue miRs are shown to be promising prognostic biomarkers in patients with CRC, given their strong association with the prognostic aspects of these tumors, however, new studies are necessary to establish the sensibility and specificity of the individual miRs in order to use them in clinical practice.

Detection of Human papillomavirus and the role of p16INK4a in colorectal carcinomas.

INTRODUCTION: Human papillomavirus (HPV) infection is associated with the development of anogenital and head and neck cancers. In recent years a potential role of HPV in colorectal cancer (CRC) has been suggested. OBJECTIVE: To investigate the presence of HPV in colorectal carcinomas and to study the role of p16INK4a as a marker of transcriptionally active HPV infection. In addition, to investigate the correlation between these findings and the CRC prognostic factors. METHODS: Case control study with 92 cases of colorectal cancers, 75 controls of normal tissue adjacent to the tumor, and 30 controls of precursor lesions, including polyps and colorectal adenomas. Paraffinized samples were used, HPV detection and genotyping were performed by PCR and reverse hybridization by using the INNO LIPA kit, with SPF10 plus primers. The expression of the p16INK4a protein was investigated using immunohistochemistry. Data analysis was performed using descriptive, univariate statistics and survival curves were calculated by using the Kaplan Meier and log-rank method. RESULTS: HPV was detected in 13% of the cases and the most prevalent genotype was HPV 16. HPV DNA was not detected in either control groups. The high expression of p16INK4a was observed in 30% of the cases, but it was not associated to the presence of HPV. The overall survival was 53.3% and was influenced by prognostic factors such as later stage, lymph node and distant metastasis. CONCLUSIONS: Based on these results, HPV is unlikely to be involved in colorectal carcinogenesis and p16INK4a expression is not a relevant marker of transcriptionally active HPV infection in CRC.

Human papillomavirus and Chlamydia trachomatis infections in adolescents and young women: Prevalence and risk factors.

BACKGROUND: The objective of this study was to estimate the prevalence of Human papillomavirus (HPV) genotypes and Chlamydia trachomatis (CT) infections among adolescents and young adult women and to identify the risk factors associated. METHODS: This study included 276 sexually active participants, classified as adolescents (15-19 years) and young adult women (20-24 years) that realized conventional cytology and were tested for 27 HPV genotypes and for CT. Bivariate and multivariate analyses were performed to evaluate the factors associated with both infections. RESULTS: The prevalence of HPV infection was 50.7% in adolescents and 43.0% in young adult women. The HPV-16 was the most prevalent (27.7%), followed by HPV-68 (6.9%), HPV-52 (6.2%), HPV-39 (4.6%), and HPV-73 (4.6%). The prevalence of CT infection was 11.5% among adolescents and 6.2% among young adult women. Cytological abnormalities were found in 14.2% among adolescents, of which 80.9% were positive for HPV and 10% of young adult women of which 84.6% were positive for HPV infection. HPV16 and HPV 68 were detected in 35.7% and 32.1% of cases with cytological abnormalities. Factors independently associated with HPV infection obtained by multivariate analysis were unmarried or divorced marital status and the presence of cytological abnormalities. The same variables were analyzed for the association with CT infection, and the association with cytological abnormalities remained significant. CONCLUSION: HPV and CT infections are very prevalent in adolescent and young adult women; these findings reinforce the need of early vaccination, prior to the onset of sexual activity, and justify implementation of molecular screening tests.

Prevalence and clinical implications of the TP53 pR337H mutation in Brazilian breast cancer patients a systematic literature review

This study assessed the prevalence and clinical implications of the TP53 p.R337H mutation in Brazilian breast cancer patients through a systematic literature review. The literature review was performed in the PubMed, Scientific Electronic Library Online (SciELO), and Medical Literature Analysis and Retrieval System Online (MEDLINE) databases from 1997 to 2018. We used the keyword "R337H" in the search since it resulted in the largest number of published articles on the subject. Initially, we found 75 articles, and, after reviewing the titles and abstracts, we selected 18 studies investigating the prevalence of the TP53 p.R337H mutation in breast cancer patients and its clinical implications. The reading of the full texts led to the inclusion of seven studies. The studies were carried out in the states of São Paulo, Rio Grande do Sul, Rio de Janeiro, and Bahia. The TP53 p.R337H mutation was detected in 87 (4.8%) of the 1.789 women with breast cancer investigated. The prevalence of the TP53 p.R337H mutation in the selected studies ranged from 0.5 to 8.6%. These findings highlight the recommendation for screening the R337H variant in breast cancer patients in Brazil and suggest the need for new research addressing the clinical and prognostic aspects of breast cancer patients with TP53 p.R337H mutation-positive.

Human Papillomavirus and Anal Cancer: Prevalence, Genotype Distribution, and Prognosis Aspects from Midwestern Region of Brazil.

BACKGROUND: Approximately 90% of all anal cancers are associated with human papillomavirus (HPV), especially high-risk genotypes such as HPVs 16 and 18. OBJECTIVE: To investigate the clinical and prognostic aspects of anal cancers associated with the presence, as well as the genotypic distribution of human papillomavirus (HPV). METHODS: A retrospective study carried out over a 10-year period, using clinical and molecular data, with PCR analysis and reverse hybridization (INNO-LIPA kit), in anal cancers. The data analysis was done using descriptive univariate statistics, and the survival curves were made using the Kaplan-Meier and log-rank methods. RESULTS: Of the 81 formalin-fixed and paraffin-embedded specimens, HPV prevalence was 69% and was significantly higher in squamous cell carcinomas (SCC) than in other anal tumors (p=0.0001). Female patients had a higher prevalence of HPV (p=0.01). Multiple infections were detected in 14.3% of cases. The most prevalent genotypes were HPVs 16, 33, and 18. The overall survival at 60 months was 44.3%, and the prognostic factors included gender (p=0.008) with greater survival for men (52.9%) in comparison to women (29.6%), histological type (p=0.01), SCC (54.4%), adenocarcinomas (37.5%), other carcinomas (14.2%), and the presence of distant metastasis (p=0.01). Survival was not influenced by the presence of HPV (p=0.54). CONCLUSIONS: The association of HPV to anal cancer was found in this study, especially in SCC. However, the presence of HPV did not influence the prognosis of patients with anal cancer.

Association between polymorphisms in the genes encoding toll-like receptors and dectin-1 and susceptibility to invasive aspergillosis: a systematic review.

Invasive aspergillosis is a common fungal infection in immunocompromised individuals. Some studies have shown that toll-like receptor and dectin-1 genetic polymorphisms may alter signaling pathways, thus increasing an individual's susceptibility to invasive aspergillosis. We investigated the pertinent literature to determine whether polymorphisms in the genes encoding toll-like receptors and dectin-1 increase the susceptibility to invasive aspergillosis. This study systematically reviewed the literature using the databases PubMed/PMC, Scopus, and Web of Science using the keywords invasive aspergillosis, polymorphism, Toll-like, and Dectin-1. From the initial search, 415 studies were found and according to our inclusion and exclusion criteria, eight studies were selected. Several studies described single-nucleotide polymorphisms (SNPs) that are associated with a greater susceptibility to invasive aspergillosis. These SNPs were found in the genes that encode toll-like receptors 1, 3, 4, and 5 and the gene that encodes dectin-1; upon activation, both cellular receptors initiate a signaling cascade that can result in the production of cytokines and chemokines. Thus, our literature review uncovered a significant association between polymorphisms in the genes that encode toll-like receptors and dectin-1 and invasive aspergillosis. More studies should be performed to better understand the relationship between toll-like receptor and dectin-1 genetic polymorphisms and invasive aspergillosis susceptibility.

Association between polymorphisms in the genes encoding toll-like receptors and dectin-1 and susceptibility to invasive aspergillosis: a systematic review

Abstract Invasive aspergillosis is a common fungal infection in immunocompromised individuals. Some studies have shown that toll-like receptor and dectin-1 genetic polymorphisms may alter signaling pathways, thus increasing an individual's susceptibility to invasive aspergillosis. We investigated the pertinent literature to determine whether polymorphisms in the genes encoding toll-like receptors and dectin-1 increase the susceptibility to invasive aspergillosis. This study systematically reviewed the literature using the databases PubMed/PMC, Scopus, and Web of Science using the keywords invasive aspergillosis, polymorphism, Toll-like, and Dectin-1. From the initial search, 415 studies were found and according to our inclusion and exclusion criteria, eight studies were selected. Several studies described single-nucleotide polymorphisms (SNPs) that are associated with a greater susceptibility to invasive aspergillosis. These SNPs were found in the genes that encode toll-like receptors 1, 3, 4, and 5 and the gene that encodes dectin-1; upon activation, both cellular receptors initiate a signaling cascade that can result in the production of cytokines and chemokines. Thus, our literature review uncovered a significant association between polymorphisms in the genes that encode toll-like receptors and dectin-1 and invasive aspergillosis. More studies should be performed to better understand the relationship between toll-like receptor and dectin-1 genetic polymorphisms and invasive aspergillosis susceptibility.

Prognostic impact of micro-rna expression in breast cancer: systematic review / Impacto prognóstico da expressão de micrornas no câncer de mama: revisão sistemática

Breast cancer is an important health problem worldwide and the identification of new prognostic markers is important in establishing the best treatment for each patient. MicroRNAs (miRNAs) are non-coding RNAs that regulate gene expression and that can be useful biomarkers for prognosis in breast cancer. The objective of this systematic review was to investigate tumor miRNA expression potentially associated with the prognostic factors of breast carcinomas. The search was done in the PubMed database; 1457 articles were initially found and 20 studies were included in the review. MiRNA-21 and miRNA-200b were the most commonly investigated in breast cancer prognosis. Lymph node metastasis was associated with the hyperexpression of miRNA-211, miRNA-301a and miRNA-370 and also associated with the hypoexpression of miRNA-124, miRNA-127, miRNA-129-5p, miRNA199-5p, miRNA-206, miRNA-218 and miRNA-339-5p. Distant metastasis was associated with miRNA-204 hypoexpression. Tumor size was associated with hyperexpression of miRNA-21 and miRNA-301a and also to the hypoexpression of miRNA-29b and miRNA129-5p. Lower survival rates were associated with the hyperexpression of miRNA-21, miRNA-301a and microRNA-711, and hypoexpression of miRNA-15a, miRNA-29b, miRNA-124, miRNA-129-5p, miRNA 199b -5p, miRNA-200b, miRNA-204, miRNA-206 and miRNA-218. On the other hand, higher survival rates were associated with the hyperexpression of miRNA-339-5p and miRNA-127 and also to the hypoexpression of miRNA-210. The results of this review emphasize the need to validate these findings in additional studies

O câncer de mama é um importante problema de saúde em todo o mundo e a identificação de novos marcadores prognósticos é necessária para estabelecer o melhor tratamento para cada paciente. MicroRNAs (miRNAs) são RNAs não codificadores reguladores da expressão gênica que têm sido evidenciados como biomarcadores úteis no prognóstico do câncer de mama. O objetivo desta revisão sistemática foi verificar o papel da expressão de miRNAs tumorais associados aos fatores prognósticos dos carcinomas de mama. A busca de estudos foi feita no banco de dados PubMed; 1.457 artigos foram inicialmente encontrados e 20 estudos foram incluídos na revisão. MiRNA-21 e miRNA-200b foram os mais comumente investigados em relação aoprognóstico do câncer de mama. A presença de metástase linfonodal foi significativamente associada à hiperexpressão de miRNA-211, miRNA-301a e miRNA-370 e também associada à hipoexpressão de miRNA-124, miRNA-127, miRNA-129-5p, miRNA199-5p, miRNA-206, miRNA-218 e miRNA- 339-5p. Metástase a distância foi associada à hipoexpressão de miRNA-204. O tamanho do tumor foi associado à hiperexpressão de miRNA-21 e miRNA-301a e também à hipoexpressão de miRNA-29b e miRNA129-5p. Em relação à sobrevida global, menores taxas de sobrevida foram associadas à hiperexpressão de miRNA-21, miRNA-301a e microRNA-711 e à hipoexpressão de miRNA- 15a, miRNA-29b, miRNA-124, miRNA-129-5p, miRNA 199b-5p, miRNA-200b, miRNA-204, miRNA-206 e miRNA-218. Por outro lado, maiores taxas de sobrevida foram associadas à hiperexpressão de miRNA-339-5p e miRNA-127 e também à hipoexpressão de miRNA-210. Os resultados desta revisão enfatizam a necessidade de validar esses achados em estudos adicionais

Human papillomavirus (HPV) genotype distribution in penile carcinoma: Association with clinic pathological factors.

BACKGROUND: Penile carcinoma (PC) is a rare, highly mutilating disease, common in developing countries. The evolution of penile cancer includes at least two independent carcinogenic pathways, related or unrelated to HPV infection. OBJECTIVES: To estimate the prevalence, identify HPV genotypes, and correlate with clinicopathological data on penile cancer. METHODS: A retrospective cohort study involving 183 patients with PC undergoing treatment in a referral hospital in Goiânia, Goiás, in Midwestern Brazil, from 2003 to 2015. Samples containing paraffin embedded tumor fragments were subjected to detection and genotyping by INNO-LiPA HPV. The clinicopathological variables were subjected to analysis with respect to HPV positivity and used prevalence ratio (PR), adjusted prevalence ratio (PRa) and 95% confidence interval (CI) as statistical measures. RESULTS: The prevalence of HPV DNA in PC was 30.6% (95% CI: 24.4 to 37.6), high-risk HPV 24.9% (95% CI: 18.9 to 31.3), and 62.5% were HPV 16. There was a statistical association between the endpoints HPV infection and HPV high risk, and the variable tumor grade II-III (p = 0.025) (p = 0.040), respectively. There was no statistical difference in disease specific survival at 10 years between the HPV positive and negative patients (p = 0.143), and high and low risk HPV (p = 0.325). CONCLUSIONS: The prevalence of HPV infection was 30.6%, and 80.3% of the genotypes were identified as preventable by anti-HPV quadrivalent or nonavalent vaccine. HPV infections and high-risk HPV were not associated with penile carcinoma prognosis in this study.

Coralsnake Venomics: Analyses of Venom Gland Transcriptomes and Proteomes of Six Brazilian Taxa.

Venom gland transcriptomes and proteomes of six Micrurus taxa (M. corallinus, M. lemniscatus carvalhoi, M. lemniscatus lemniscatus, M. paraensis, M. spixii spixii, and M. surinamensis) were investigated, providing the most comprehensive, quantitative data on Micrurus venom composition to date, and more than tripling the number of Micrurus venom protein sequences previously available. The six venomes differ dramatically. All are dominated by 2-6 toxin classes that account for 91-99% of the toxin transcripts. The M. s. spixii venome is compositionally the simplest. In it, three-finger toxins (3FTxs) and phospholipases A2 (PLA2s) comprise >99% of the toxin transcripts, which include only four additional toxin families at levels ≥0.1%. Micrurus l. lemniscatus venom is the most complex, with at least 17 toxin families. However, in each venome, multiple structural subclasses of 3FTXs and PLA2s are present. These almost certainly differ in pharmacology as well. All venoms also contain phospholipase B and vascular endothelial growth factors. Minor components (0.1-2.0%) are found in all venoms except that of M. s. spixii. Other toxin families are present in all six venoms at trace levels (<0.005%). Minor and trace venom components differ in each venom. Numerous novel toxin chemistries include 3FTxs with previously unknown 8- and 10-cysteine arrangements, resulting in new 3D structures and target specificities. 9-cysteine toxins raise the possibility of covalent, homodimeric 3FTxs or heterodimeric toxins with unknown pharmacologies. Probable muscarinic sequences may be reptile-specific homologs that promote hypotension via vascular mAChRs. The first complete sequences are presented for 3FTxs putatively responsible for liberating glutamate from rat brain synaptosomes. Micrurus C-type lectin-like proteins may have 6-9 cysteine residues and may be monomers, or homo- or heterodimers of unknown pharmacology. Novel KSPIs, 3× longer than any seen previously, appear to have arisen in three species by gene duplication and fusion. Four species have transcripts homologous to the nociceptive toxin, (MitTx) α-subunit, but all six species had homologs to the ß-subunit. The first non-neurotoxic, non-catalytic elapid phospholipase A2s are reported. All are probably myonecrotic. Phylogenetic analysis indicates that the six taxa diverged 15-35 million years ago and that they split from their last common ancestor with Old World elapines nearly 55 million years ago. Given their early diversification, many cryptic micrurine taxa are anticipated.

Padrão de metástase no câncer de mama triplo negativo / Metastatic pattern of triple negative breast cancer

Introdução: Os carcinomas de mama triplo negativos (TN) são neoplasias malignas clinicamente heterogêneas que não apresentam receptores para estrógeno, progesterona e superexpressão do HER2 (ERBB2 ou NEU). Os TN estão entre os subtipos mais agressivos e mortais de câncer de mama. Objetivo: O presente estudo objetivou elucidar o comportamento metastático dos carcinomas de mama TN e correlacioná-los a idade, histologia, grau de diferenciação, tamanho do tumor, entre outras variáveis clínico-patológicas. Métodos: Foram selecionados 140 prontuários de pacientes com câncer de mama no Hospital Araújo Jorge em Goiânia (GO) durante o período de 1998 a 2010, dos quais 75 casos (53,6%) possuíam diagnóstico de câncer de mama TN. Resultados: As variáveis que apresentaram significância foram o tamanho do tumor (p=0,0497) e o número de linfonodos acometidos (p=0,002). Durante os cinco anos de observação, a doença metastática ocorreu em pouco mais da metade de todas as pacientes (52,0%). Os locais mais comuns de recorrência foram pulmão, osso e cérebro. Conclusão: Os resultados indicam que as pacientes com carcinomas mamários TN apresentam um perfil tumoral mais agressivo, necessitando de maior vigilância nos anos iniciais do seguimento.

Introduction: Triple negative breast cancers (TNBC) are clinically heterogeneous malignancies that do not present receptors of the estrogen, progesterone and HER2 (ERBB2 or NEU). TNBC are among the most aggressive and deadly breast cancer subtypes. Objective: The present study aimed to elucidate the metastatic pattern of TNBC and attempt to correlate it to age, histology, tumor grade, tumor size, and other clinicopathological variables. Methods: 140 clinical files of patients with breast cancer in Araújo Jorge Hospital in Goiânia (GO), during the period 1998-2010, were selected; among these, 75 cases (53.6%) with TNBC diagnosis were found. Results: The significant variables were tumor size (p=0.0497) and number of metastatic lymph nodes (p=0.002). During the period of five years of observation, metastatic disease occurred in over half of all patients (52.0%). The most common sites of recurrence were lung, bone, and brain. Conclusion: Our finds concluded that patients with TNBC feature a more aggressive type of tumor, requiring increased vigilance in the early years of follow-up

Human papillomavirus in oral cavity and oropharynx carcinomas in the central region of Brazil / Papilomavírus humano (HPV) em carcinomas de cavidade oral e orofaringe na região central do Brasil

Abstract Introduction Molecular studies about carcinomas of the oral cavity and oropharynx demonstrate the presence of human papilomavirus genome in these tumors, reinforcing the participation of human papilomavirus in oral carcinogenesis. Objectives This study aimed to determine the prevalence of human papilomavirus and genotype distribution of HPV16 and HPV18 in oral cavity and oropharynx carcinomas, as well as their association with clinical characteristics of the tumors. Methods This is a retrospective study, with clinical data collected from 82 patients. Human papilomavirus detection was conducted on specimens of oral cavity and oropharynx carcinomas included in paraffin blocks. Patients were assisted in a cancer reference center, in the central region of Brazil, between 2005 and 2007. Polymerase chain reaction was used for the detection and genotyping of human papilomavirus. Results Among the patients evaluated, 78% were male. The average age of the group was about 58 years. Risk factors, such as smoking (78%) and alcohol consumption (70.8%) were recorded for the group. HPV DNA was detected in 21 cases (25.6%; 95% confidence interval 16.9–36.6) of which 33.3% were HPV16 and 14.3% were HPV18. The presence of lymph node metastases and registered deaths were less frequent in human papilomavirus positive tumors, suggesting a better prognosis for these cases; however, the differences between the groups were not statistically significant. Conclusion The results obtained in the present study, with respect to the presence of the high-risk HPV16 and HPV18 genotypes, highlight the importance of human papilomavirus vaccination in the control of oral cavity and oropharynx carcinomas.

Resumo Introdução Estudos moleculares sobre carcinomas da cavidade oral e orofaringe demonstram a presença do genoma do papilomavírus humano (HPV) nesses tumores, o que enfatiza a participação do HPV na carcinogênese oral. Objetivos Determinar a prevalência de HPV e a distribuição genotípica de HPV16 e HPV18 nos carcinomas de cavidade oral e orofaringe, bem como sua associação com as características clínicas dos tumores. Método Estudo retrospectivo, com dados clínicos coletados de 82 pacientes. A detecção de HPV foi feita em amostras de carcinomas de cavidade oral e orofaringe incluídos em blocos de parafina. Os pacientes foram atendidos em um centro de referência para tratamento do câncer, na região central do Brasil, entre 2005 e 2007. Foi usada a reação em cadeia de polimerase (PCR) para a detecção e genotipagem do HPV. Resultados Entre os pacientes avaliados, 78% eram homens. A média de idade do grupo era de 58 anos. Fatores de risco como o tabagismo (78%) e consumo de álcool (70,8%) foram registrados para o grupo. HPV DNA foi detectado em 21 casos (25,6%; IC de 95%, 16,9-36,6), dos quais 33,3% eram HPV16 e 14,3% eram HPV18. A presença de metástases em linfonodos e os óbitos registrados foram menos frequentes em tumores positivos para HPV, o que sugere melhor prognóstico para esses casos; contudo, as diferenças entre os grupos não foram estatisticamente significantes. Conclusão Os resultados obtidos no presente estudo, com respeito à presença de genótipos de alto risco de HPV16 e HPV18, destacam a importância da vacinação para HPV no controle dos carcinomas de cavidade oral e orofaringe.