Frequência de neoplasia intraepitelial cervical e papilomavírus humano na região Sul do Brasil: um estudo retrospectivo / Frequency of cervical intraepithelial neoplasia and human papillomavirus in southern Brazil: a retrospective study

O artigo tem o objetivo de determinar a frequência de neoplasia intraepitelial cervical (NIC) e de papilomavírus humano (HPV) no Rio Grande do Sul (RS). Tratou-se de um estudo retrospectivo, em que se analisou a frequência de NIC e de HPV no RS durante o período de janeiro de 2015 a junho de 2018. Foram analisados 1.249 laudos histopatológicos de colo uterino, tendo sido possível observar na análise global que a maioria dos casos se manteve estável (183 casos), porém 107 progrediram em um nível. Dos 64 casos de NIC I em 2015, 12 apresentaram a presença de HPV; em 2016, 19 casos de NIC I, e todos com HPV; em 2017 teve uma diminuição de casos de NIC I mais HPV (12 casos). Até junho de 2018, apenas 2 casos de HPV foram registrados. Com este estudo, ficou evidente que, na população estudada, houve diminuição no número de casos de NIC (22%), o que pode estar relacionado a campanhas e incentivo aos cuidados com a saúde e prevenção.(AU)

The article aims to determine the frequency of cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) in Rio Grande do Sul (RS). This was a retrospective study, in which the frequency of CIN and HPV in RS, from January 2015 to June 2018, was analyzed. 1,249 cases of histopathological reports of the cervix were analyzed, being It is possible to observe in the global analysis that the majority of cases remained stable (183 cases), but 107 progressed at one level. Of the 64 cases of CIN I in 2015, 12 presented the presence of HPV, in 2016, 19 cases of CIN I, and all with HPV, in 2017 there was a decrease in cases of CIN I plus HPV (12 cases). As of June 2018, only 2 cases of HPV have been reported. With this study it was evident that in the studied population there was a decrease in the number of CIN cases (22%), which may be related to campaigns and incentives to health care and prevention.(AU)

Donor characteristics and hematopoietic stem cell transplantation outcome: experience of a single center in Southern Brazil

ABSTRACT Background: Hematopoietic stem cell transplantation is a curative treatment for many patients with hematological disorders. Donor-recipient genetic disparity, especially involving the human leukocyte antigen system is a critical factor for transplant outcome. Objective: To evaluate retrospectively donor characteristics and correlations with the occurrence of acute and chronic graft-versus-host disease, disease-free survival and overall survival in a Brazilian population submitted to allogeneic hematopoietic stem cell transplantation between 1994 and 2012 in a single center. Results: Three hundred and forty-seven consecutive transplantations were included. Related transplants (81.2%) were significantly more common than unrelated transplants (18.7%); donor and recipient median ages were 34 (range: 1-61) and 33 (range: 3-65) years respectively with donor HLAs being matched for 333 (95.9%) patients. Donor gender, cytomegalovirus status and ABO incompatibility did not influence the five-year overall survival. In univariate analyses, overall survival was negatively influenced by the presence of acute graft-versus-host disease (33% vs. 47%, respectively; p-value = 0.04), unrelated transplant (41.5% vs. 50.9%, respectively; p-value = 0.045) and donors aged over 40 years (41% vs. 52%, respectively; p-value = 0.03). Older donors were associated with a higher rate of acute (52% vs. 65.8%; p-value = 0.03) and chronic graft-versus-host disease (60% vs. 43%, respectively; p-value = 0.015). In multivariate analyses, acute graft-versus-host disease [relative risk (RR): 1.8; 95% confidence interval (CI): 1.1-29; p-value = 0.008] and older donors (RR: 1.6; 95% CI 1.11-2.24; p-value = 0.013) were associated with higher transplant-related mortality. Conclusions: In transplant patients, to have a donor older than 40 years of age seems to significantly increase the incidence of acute and chronic graft-versus-host disease and transplant-related mortality with no impact on disease-free survival and overall survival. In spite of the rather small cohort of patients, these findings are similar to what is described in the literature suggesting that a younger donor should be chosen whenever possible.

Células-tronco mesenquimais: caracterização, cultivo, propriedades imunológicas e aplicações clínicas / Mesenchymal stem cells: characterization, cultivation, immunological properties and clinical applications

As células-tronco mesenquimais (CTM) são consideradas células multipotentes não hematopoéticas com propriedades de autorrenovação e capacidade de diferenciação em tecidos mesenquimais e, possivelmente, em não mesenquimais. Vários estudos recentes têm reforçado o caráter multipotente destas células pela capacidade de diferenciarem-se em células derivadas da mesoderma embrionário: osteócitos, condroblastos e adipócitos. Devido ao fácil isolamento e cultivo, potencial de diferenciação e produção de fatores de crescimento e citocinas, as CTMs têm se tornado as candidatas ideais para os protocolos da medicina regenerativa. Este artigo revisa as principais características dessa célula, forma de obtenção e cultivo, propriedades imunológicas e aplicações clínicas.

Mesenchymal stem cells (MSC) are nonhematopoietic multipotent cells with selfrenewal properties and the ability to differentiate into mesenchymal tissues and possibly nonmesenchymal cells. Several lines of evidence in the past few years have confirmed the ability of these cells to differentiate into cells derived from embryonic mesoderm, such as osteocytes, adipocytes and chondroblasts. Because they are easy to isolate and culture and due to their differentiation potential and production of growth factors and cytokines, MSC have become ideal candidates for regenerative medicine protocols. This study reviews the main characteristics of MSC, how to isolate and culture them, and their immunological properties and clinical applications.

Prevalence of common α -thalassemia determinants in south Brazil: importance for the diagnosis of microcytic anemia

Alpha thalassemia has not been systematically investigated in Brazil. In this study, 493 unrelated individuals from the southernmost Brazilian state of Rio Grande do Sul were screened for deletional forms of α-thalassemia. One hundred and one individuals had microcytic anemia (MCV < 80 fL) and a normal hemoglobin pattern (Hb A2 < 3.5 percent and Hb F < 1 percent). The subjects were screened for -α3.7,-α4.2,-α20.5, -SEA and -MED deletions but only the -α3.7 allele was detected. The -α3.7 allele frequency in Brazilians of European and African ancestry was 0.02 and 0.12, respectively, whereas in individuals with microcytosis the frequency was 0.20. The prevalence of α-thalassemia was significantly higher in individuals with microcytosis than in healthy individuals (p = 0.001), regardless of their ethnic origin. There were also significant differences in the hematological parameters of individuals with -α3.7/αα, -α3.7/α3.7 and β-thalassemia trait compared to healthy subjects. These data suggest that α-thalassemia is an important cause of microcytosis and mild anemia in Brazilians.