Evidence of Association between MTRR and TNF-α Gene Polymorphisms and Oral Health-Related Quality of Life in Children with Anterior Open Bite.

Genetic polymorphisms could explain the inter-individual differences in the oral health-related quality of life (OHRQoL) of children with anterior open bite (AOB). OBJECTIVE: To assess the impact of AOB on OHRQoL in children and to evaluate whether MTR (rs1805087), MTRR (rs1801394), TGFß1 (rs1800469) and TNF-α (rs1799964, rs1799724 and rs1800629) genes are potential biomarkers for OHRQoL in children with AOB. STUDY DESIGN: A cross-sectional study was performed with 173 children aged between 2-6 years. The Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS) was applied. Genetic polymorphisms were analyzed using real-time PCR. Mann-Whitney U-test and Chi-square were used. RESULTS: The overall mean ECOHIS scores were 5.49 (SD= 5.72) and 3.45 (SD = 4.49) (p < 0.01) in the AOB and control groups, respectively. Children with the CC genotype of TNF-α (rs1799724) had a significantly higher psychological QoL level. The MTRR AA genotype group showed a lower QoL level in the child subscale (p = 0.006), function (p = 0.017), and psychological (p = 0.006) domains. There was no significant difference between OHRQoL and the genetic polymorphisms in MTR and TGFß1. CONCLUSIONS: Genetic polymorphisms in TNF-α and MTRR are associated with the impact on the OHRQoL in children with AOB.

Polymorphisms of IL-10 gene in patients infected with HCV under antiviral treatment in southern Brazil.

Interleukin-10 (IL-10) is a cytokine that plays an important role in the regulation of the immune system. Gene polymorphisms of IL-10 have been associated with the different expression levels of this cytokine. In hepatitis C virus infection, IL-10 appears to interfere with the progression of disease, viral persistence and the response to therapy. This study investigated genetic variability in the IL-10 gene promoter between patients infected with hepatitis C virus (HCV) and healthy individuals, associating the frequency of polymorphisms with different aspects of viral infection. This is a case-control study with 260 patients who were infected with HCV and 260 healthy individuals. Genotyping of the polymorphisms was performed using the technique of amplification refractory mutation system PCR (ARMS-PCR) for regions of the IL-10 gene promoter (-1082 G/A, -819 C/T, -592 C/A). The frequencies of alleles and genotypes related to polymorphisms in the IL-10 gene promoter showed a higher frequency of the G allele and genotype GG in the -1082 region between the infected group and the control group (p=0.005 and p=0.001, respectively), whereas the AA genotype was significantly more frequent in the control group. The frequencies of the haplotypes GTA and GCC were higher in the group of infected individuals, whereas the haplotype ATA was more frequent in the healthy group (p<0.006). It was also observed that the genotypes GG and AG in the region -1082 were significantly more frequent among patients infected with HCV who were in advanced stages of fibrosis and cirrhosis (p=0.042). No association was observed between polymorphisms of IL-10 and sustained virologic response (SVR).

Detection of hepatitis C virus in patients with terminal renal disease undergoing dialysis in southern Brazil: prevalence, risk factors, genotypes, and viral load dynamics in hemodialysis patients.

UNLABELLED: Hepatitis C (HCV) is a serious public health issue, and it is estimated that 3% of the world's population is infected. Patients in hemodialysis units have an increased risk for contracting HCV, and high prevalence rates have been found in hemodialysis units around the world. This study is aimed at determining the prevalence of HCV in patients with terminal chronic renal disease (tCRD) who have been submitted to hemodialysis and peritoneal dialysis in southern Brazil to characterize the most prevalent genotypes, the viral load, and possible risk factors and to assess the validity between the ELISA and RT-PCR detection methods. Of 320 patients from three dialysis units, 318 participated in this study. According to the medical records, 55 patients were reactive to HCV, as determined via ELISA. All 318 samples were submitted to RT-PCR and genotyped using an Abbott Realtime m2000 system. Data obtained through a questionnaire and chemical variables were associated with the HCV. RESULTS: The prevalence of HCV was 18.24% (58), and the concordance between the HCV serology and the RT-PCR was 94%. Three patients were diagnosed to be negative for HCV using the ELISA assay but positive when using RT-PCR. Genotype 1 was the most prevalent (46.7%) genotype, within which subtype 1a was the most frequent (74.1%). One of the risk factors associated with HCV infection was the length of time that the patient had been undergoing hemodialysis treatments (p < 0.001). Additionally, the viral load was found to vary when tested before and after hemodialysis (p < 0.001). CONCLUSION: The prevalence of HCV in dialysis units continues to remain high, indicating nosocomial contamination. RT-PCR detected the presence of the hepatitis C virus in patients with a non-reactive serology, which highlights the importance of performing molecular tests on dialysis patients. The variation in the viral load in patients submitted to hemodialysis indicates a possible destruction or gripping of viral particles to the dialyzer membrane.

Evidence of association between hepatitis C virus genotype 2b and nosocomial transmissions in hemodialysis centers from southern Brazil.

BACKGROUND: Hepatitis C virus infection is a serious public health problem. Hemodialysis is considered one of the main risk factors of HCV infection, due to several invasive medical procedures and potential nosocomial transmission that patients with chronic renal failure (CRF) are continuously submitted. The aims of this study were to determine the prevalence of HCV and its genotypes in patients with CRF in hemodialysis units in southern Brazil. METHODS: Demographic data and risk factors for HCV transmission were collected and analyzed. These data were obtained from patients undergoing hemodialysis treatment from January 2009 to August 2010, on two dialysis units of Rio Grande, southern Brazil. Genotyping was carried out by sequencing analysis of HCV NS5b, core-E1 junction and 5'UTR genomic regions. RESULTS: One hundred fifty-nine patients under regular hemodialysis treatment were studied. HCV prevalence was 23.3%. HCV-infected patients had been on dialysis treatment for 91.9 months, a more prolonged period compared to HCV-negative patients (p = 0.001). While HCV genotypes 1b and 3a were identified as the most frequent strains, a surprisingly high proportion of genotype 2b was observed among patients in one of the dialysis centers compared to the general HCV-infected population of the same area. Hemodialysis treatment exposure time and healthcare working were associated with HCV infection. CONCLUSIONS: Besides the efforts to minimize nosocomial transmission of HCV, some events of transmission are still evidenced in dialysis units.

Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern Brazil: high rate of intraepithelial cervical lesions.

Human immunodeficiency virus type 1 (HIV-positive) pregnant women require specific prophylactic and therapeutic approaches. The efficacy of established approaches is further challenged by co-infection with other sexually transmitted diseases (STDs). The objective of this study was to determine the prevalence of co-infections in pregnant women infected with different HIV-1 subtypes and to relate these findings, together with additional demographic and clinical parameters, to maternal and infant outcomes. Blood samples from pregnant women were collected and tested for syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV). Human papillomavirus (HPV) diagnosis was evaluated by the presence of alterations in the cervical epithelium detected through a cytopathological exam. Medical charts provided patient data for the mothers and children. Statistical analyses were conducted with STATA 9.0. We found a prevalence of 10.8% for HCV, 2.3% for chronic HBV, 3.1% for syphilis and 40.8% for HPV. Of those co-infected with HPV, 52.9% presented high-grade intraepithelial lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1' and 5' and Capurro scores were similar between co-infected and non-co-infected women. The presence of other STDs did not impact maternal and concept outcomes. More than half of the patients presenting cervical cytology abnormalities suggestive of HPV had high-grade squamous intraepithelial lesions or cervical cancer, evidencing an alarming rate of these lesions.

[Prevalence of Chlamydia trachomatis and risk factors associated with infection detected in endocervical sample]. / Prevalência de Chlamydia trachomatis e fatores de risco associados à infecção detectada em amostra endocervical.

PURPOSE: It was to determine the prevalence of Chlamydia trachomatis and the risk factors associated with infection in endocervical specimens from women seen in outpatient Obstetrics and Gynecology. METHODS: Samples of endocervical secretion of 200 women treated at the University Hospital of the Federal University of Rio Grande were analyzed for the presence of C. trachomatis by polymerase chain reaction (PCR) using primers that amplify CT05/CT06 281 base pairs of the main outer membrane protein of C. trachomatis. All participants completed a pre-coded and self-report questionnaire. Data were analyzed with the SPSS 17.0 software; for multivariate analysis it was used Poisson regression. RESULTS: Of the 200 women who were included in the study, the prevalence of infection with C. trachomatis was 11% (22 patients) and these 55 (27.5%) were positive for HPV. Risk factors associated with infection by C. trachomatis were: 8 years or less of schooling (p<0.001), family income below the poverty level (p=0.005), first intercourse at age 15 or less (p=0.04) and being a carrier of the virus HIV (p<0.001). After multivariate analysis, only the variables of schooling or less than eight years (PR 6.0; 95%CI 1.26 - 29.0; p=0.02) and presence of HIV (RP 14.1; 95%CI 3.4 - 57.5; p<0.001) remained statistically significant. CONCLUSIONS: The prevalence of C. trachomatis in endocervical specimens by PCR was 11%. The factors associated with a higher infection by C. trachomatis were lower education and being HIV positive.

[High prevalence of users who did not return to the Testing and Counseling Center (TCC) for knowing their serological status: Rio Grande, RS, Brazil]. / Alta prevalência de usuários que não retornam ao Centro de Testagem e Aconselhamento (CTA) para o conhecimento do seu status sorológico: Rio Grande, RS, Brasil.

The Testing and Counseling Centers are important sources of epidemiological information. This study describes a research conducted with the users of the Testing and Counseling Center of Rio Grande-RS submitted to anti-HIV test during the period 2001-2004. Demographic and behavioral factors of individuals attended in the service were analyzed using the database SISCTA-2002/RG. HIV-1 seropositivity between 2001 and 2004 was of 1,1%; 2,4%; 2,3% and 1,7%, respectively. In 2003 and 2004, 37,7% and 36% of the HIV-1 positive patients did not return to the Testing and Counseling Center for getting the result of their serological anti-HIV or confirmatory tests. These results seem to reflect some tendencies of the HIV epidemic in Rio Grande and in Brazil. It is important to emphasize the high percentage of HIV-1 positive patients who do not return for getting the result of their test. In terms of public health this risk behavior may jeopardize the efforts for controlling the epidemic.

Prevalência de Chlamydia trachomatis e fatores de risco associados à infecção detectada em amostra endocervical / Prevalence of Chlamydia trachomatis and risk factors associated with infection detected in endocervical sample

OBJETIVO: Foi avaliar a prevalência de Chlamydia trachomatis e os fatores de risco associados à infecção em amostras endocervicais de mulheres atendidas em ambulatório de Ginecologia e Obstetrícia. MÉTODOS: Amostras de secreção endocervical de 200 mulheres atendidas em Hospital Universitário foram avaliadas para diagnosticar C. trachomatis com uso da reação em cadeia da polimerase (PCR) utilizando primers CT05/CT06 que amplificam 281 pares de bases da principal proteína de membrana externa de C. trachomatis. Todas as participantes responderam a um questionário pré-codificado e autoaplicável. Os dados foram analisados no programa do software SPSS 17.0; para a análise multivariada foi utilizada a regressão de Poisson. RESULTADOS: Das 200 mulheres que foram incluídas no estudo, a prevalência de infecção por C. trachomatis foi de 11% (22 pacientes) e destas 55 (27,5%) foram positivas para o HPV. Os fatores de risco associados à infecção por C. trachomatis foram: ter 8 anos ou menos de escolaridade (p<0,001), renda familiar de até 1 salário mínimo (p=0,005), primeira relação sexual com 15 anos ou menos (p=0,04) e ser portadora do vírus HIV (p<0,001). Após a análise multivariada, apenas as variáveis escolaridade igual ou inferior a oito anos (RP 6,0; IC95% 1,26 - 29,0; p=0,02) e presença do HIV (RP 14,1; IC95% 3,4 - 57,5; p<0,001) permaneceram significantes. CONCLUSÕES: A prevalência de C. trachomatis em amostras endocervicais pelo método de PCR foi de 11%. Os fatores associados à maior infecção por C. trachomatis foram menor escolaridade e ser portar o vírus HIV.

PURPOSE: It was to determine the prevalence of Chlamydia trachomatis and the risk factors associated with infection in endocervical specimens from women seen in outpatient Obstetrics and Gynecology. METHODS: Samples of endocervical secretion of 200 women treated at the University Hospital of the Federal University of Rio Grande were analyzed for the presence of C. trachomatis by polymerase chain reaction (PCR) using primers that amplify CT05/CT06 281 base pairs of the main outer membrane protein of C. trachomatis. All participants completed a pre-coded and self-report questionnaire. Data were analyzed with the SPSS 17.0 software; for multivariate analysis it was used Poisson regression. RESULTS: Of the 200 women who were included in the study, the prevalence of infection with C. trachomatis was 11% (22 patients) and these 55 (27.5%) were positive for HPV. Risk factors associated with infection by C. trachomatis were: 8 years or less of schooling (p<0.001), family income below the poverty level (p=0.005), first intercourse at age 15 or less (p=0.04) and being a carrier of the virus HIV (p<0.001). After multivariate analysis, only the variables of schooling or less than eight years (PR 6.0; 95%CI 1.26 - 29.0; p=0.02) and presence of HIV (RP 14.1; 95%CI 3.4 - 57.5; p<0.001) remained statistically significant. CONCLUSIONS: The prevalence of C. trachomatis in endocervical specimens by PCR was 11%. The factors associated with a higher infection by C. trachomatis were lower education and being HIV positive.

Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern Brazil: high rate of intraepithelial cervical lesions

Human immunodeficiency virus type 1 (HIV-positive) pregnant women require specific prophylactic and therapeutic approaches. The efficacy of established approaches is further challenged by co-infection with other sexually transmitted diseases (STDs). The objective of this study was to determine the prevalence of co-infections in pregnant women infected with different HIV-1 subtypes and to relate these findings, together with additional demographic and clinical parameters, to maternal and infant outcomes. Blood samples from pregnant women were collected and tested for syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV). Human papillomavirus (HPV) diagnosis was evaluated by the presence of alterations in the cervical epithelium detected through a cytopathological exam. Medical charts provided patient data for the mothers and children. Statistical analyses were conducted with STATA 9.0. We found a prevalence of 10.8 percent for HCV, 2.3 percent for chronic HBV, 3.1 percent for syphilis and 40.8 percent for HPV. Of those co-infected with HPV, 52.9 percent presented high-grade intraepithelial lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1' and 5' and Capurro scores were similar between co-infected and non-co-infected women. The presence of other STDs did not impact maternal and concept outcomes. More than half of the patients presenting cervical cytology abnormalities suggestive of HPV had high-grade squamous intraepithelial lesions or cervical cancer, evidencing an alarming rate of these lesions.

Alta prevalência de usuários que não retornam ao Centro de Testagem e Aconselhamento (CTA) para o conhecimento do seu status sorológico: Rio Grande, RS, Brasil / High prevalence of users who did not return to the Testing and Counseling Center (TCC) for knowing their serological status: Rio Grande, RS, Brazil

Os Centros de Testagem e Aconselhamento (CTA) constituem importantes fontes de informações epidemiológicas, que quando bem gerenciadas e atualizadas, permitem o conhecimento e a análise das características da população atendida por esses serviços. Esse estudo descreve o perfil dos usuários do CTA de Rio Grande (RS) que foram submetidos à sorologia anti-HIV entre os anos de 2001 e 2004. Variáveis demográficas relativas ao comportamento e práticas das pessoas que procuraram o serviço foram analisadas, mediante consulta ao banco de dados SISCTA-2002/RG. A soropositividade para HIV-1 foi de 1,1 por cento; 2,4 por cento; 2,3 por cento e 1,7 por cento de 2001 a 2004, respectivamente. Nos anos de 2003 e 2004, 37,7 por cento e 36 por cento, respectivamente, dos pacientes HIV-1+ não retornaram ao CTA para conhecimento dos exames anti-HIV ou confirmatório. Os resultados analisados parecem refletir algumas tendências da epidemia em Rio Grande e no país. É importante ressaltar a alta porcentagem de pacientes HIV-1 positivos que não procuram o resultado do seu teste. Em termos de saúde pública essa situação pode colocar em risco os esforços para o controle da epidemia.

The Testing and Counseling Centers are important sources of epidemiological information. This study describes a research conducted with the users of the Testing and Counseling Center of Rio Grande-RS submitted to anti-HIV test during the period 2001-2004. Demographic and behavioral factors of individuals attended in the service were analyzed using the database SISCTA-2002/RG. HIV-1 seropositivity between 2001 and 2004 was of 1,1 percent; 2,4 percent; 2,3 percent and 1,7 percent, respectively. In 2003 and 2004, 37,7 percent and 36 percent of the HIV-1 positive patients did not return to the Testing and Counseling Center for getting the result of their serological anti-HIV or confirmatory tests. These results seem to reflect some tendencies of the HIV epidemic in Rio Grande and in Brazil. It is important to emphasize the high percentage of HIV-1 positive patients who do not return for getting the result of their test. In terms of public health this risk behavior may jeopardize the efforts for controlling the epidemic.