Tratamento de queloides e cicatrizes hipertróficas: Uma revisão descritiva / Treatment of keloids and hypertrophic scars: A descriptive review

Queloides e cicatrizes hipertróficas são lesões formadas a partir da resposta fibroproliferativa anormal ao processo de cicatrização de feridas, gerando uma proliferação excessiva do colágeno nas lesões. Geralmente, predominam em pacientes do sexo feminino e em indivíduos com tons de pele mais escuros. A abordagem terapêutica dessas cicatrizes pode ser indicada de acordo com alguns critérios, como déficit funcional, tamanho e tempo de cicatrização da ferida. Nesse sentido, o presente estudo objetivou realizar uma revisão descritiva da literatura, buscando as evidências de tratamento dos últimos cinco anos neste tema. A revisão foi realizada com base no guideline PRISMA, utilizando as bases de dados PubMed, LILACS, Cochrane Library, SCOPUS, Web of Science e Grey Literature, entre os anos de 2018 e 2022. Foram encontrados 740 artigos, dos quais 16 ensaios clínicos randomizados foram selecionados. Foi evidenciado que manejo do queloide apresenta abordagem multimodal, não havendo um padrão-ouro de tratamento, com taxa de recorrência baixa. Além disso, a terapia combinada de diferentes agentes pareceu ser superior ao uso isolado de métodos terapêuticos no tratamento dessas lesões.

Keloids and hypertrophic scars are lesions formed from the abnormal fibroproliferative response to the wound healing process, generating excessive collagen proliferation in the lesions. They generally predominate in female patients and individuals with darker skin tones. The therapeutic approach to these scars can be indicated according to criteria such as functional deficit, size, and wound healing time. In this sense, the present study aimed to conduct a descriptive review of the literature, seeking evidence of treatment over the last five years. The review was carried out based on the PRISMA guideline, using the databases PubMed, LILACS, Cochrane Library, SCOPUS, Web of Science, and Grey Literature between 2018 and 2022. Seven hundred forty articles were found, of which 16 randomized clinical trials were selected. It was demonstrated that keloid management presents a multimodal approach, with no gold standard of treatment with a low recurrence rate. Furthermore, combined therapy with different agents appeared superior to the isolated therapeutic methods in treating these injuries.

Pathogenesis of HTLV-1 infection and progression biomarkers: An overview

ABSTRACT Infection by human T-cell lymphotropic virus type 1 (HTLV-1) occurs in lymphocytes, which travel throughout the body, thus affecting several target organs and causing varied clinical outcomes, particularly in populations that are underserved and do not have access to healthcare. However, the mechanism of pathogenesis is not yet fully understood. The TAX and HTLV-1 basic leucine zipper factor (HBZ) proteins maintain viral persistence and affect pathogenesis through cell proliferation and immune and inflammatory responses that accompany each clinical manifestation. TAX expression leads to inhibition of transcription error control, OX40 overexpression, and cell proliferation in adult T-cell leukemia (ATL). OX40 levels are elevated in the central nervous system (CNS), and the expression of TAX in the CNS causes neuronal damage and loss of immune reactivity among patients with HTLV-1-associated myelopathy (HAM). HBZ reduces viral replication and suppresses the immune response. Its cell compartmentalization has been associated with the pathogenesis of HAM (cytoplasmic localization) and ATL (nuclear localization). TAX and HBZ seem to act antagonistically in immune responses, affecting the pathogenesis of HTLV-1 infection. The progression from HTLV-1 infection to disease is a consequence of HTLV-1 replication in CD4+ T and CD8+ T lymphocytes and the imbalance between proinflammatory and anti-inflammatory cytokines. The compartmentalization of HBZ suggests that this protein may be an additional tool for assessing immune and inflammatory responses, in addition to those already recognized as potential biomarkers associated with progression from infection to disease (including human leukocyte antigen (HLA), killer immunoglobulin-like receptors (KIR), interleukin (IL)-6, IL-10, IL-28, Fas, Fas ligand, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and mannose-binding lectin).

Experimental yellow fever virus infection in the squirrel monkey (Saimiri spp. ) I: gross anatomical and histopathological findings in organs at necropsy

BACKGROUND Non-human primates contribute to the spread of the yellow fever virus (YFV) and the establishment of transmission cycles in endemic areas. OBJECTIVE To describe the severe histopathological aspects of YFV infection, 10 squirrel monkeys were infected with YFV and blood, brain, liver, kidney, spleen, heart, lung, lymph node and stomach were collected at 1-7, 10, 20 and 30 days post-infection (dpi). METHODS Histopathological analysis and detection of the genome and viral antigens and neutralising antibodies were performed by RT-PCR, immunohistochemistry and neutralisation test, respectively. FINDINGS Only one animal died from the experimental infection. The genome and viral antigens were detected in all investigated organs (1-30 dpi) and the neutralising antibodies from seven to 30 dpi. The brain contained perivascular haemorrhage (6 dpi); in the liver, midzonal haemorrhage and lytic necrosis (6 dpi) were observed. The kidney had bleeding in the Bowman's capsule and tubular necrosis (6 dpi). Pyknotic lymphocytes were observed in the spleen (1-20 dpi), the lung had haemorrhage (2-6 dpi), in the endocardium it contained nuclear pyknosis and necrosis (2-3 dpi) and the stomach contained blood in the lumen (6 dpi). MAIN FINDINGS Squirrel monkeys reliably reproduced the responses observed in human cases of yellow fever and, therefore, constitute an excellent experimental model for studies on the pathophysiology of the disease.

Gênero, idade, achados endoscópicos, urease e Helicobacter pylori: ausência de correlação dentro de uma amostra de população com alta prevalência de câncer gástrico na Amazônia / Gender, age, endoscopic findings, urease and helicobacter pylori: all uncorrelated within a sample of a high gastric cancer prevalence population in amazon

ABSTRACT BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of correlation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylori infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser synergistic than is usually expected.

RESUMO CONTEXTO: É amplamente assumido que gênero, idade, gastrite e Helicobacter pylori , todos têm algum grau de correlação e, portanto, podem sinergicamente levar ao desenvolvimento de câncer gástrico. OBJETIVO: Neste estudo transversal, esperamos observar a correlação acima mencionada na análise de prontuários de 67 pacientes de ambos os sexos (sexo feminino, n=44), média de idade ± desvio padrão: 41±12 anos, todos de Belém (capital do Estado do Pará, Amazônia Brasileira), uma cidade historicamente conhecida como sendo uma das que apresenta maior prevalência de câncer gástrico no país. MÉTODOS: Todos os pacientes foram submetidos à endoscopia digestiva alta para análise histopatológica da biópsia gástrica e teste rápido da urease. Todos os diagnósticos de gastrite foram registrados considerando sua topografia, categoria e grau de atividade inflamatória, sendo associada ou não associada à infecção por H. pylori . RESULTADOS: Os resultados mostram que não foram encontradas associações estatisticamente relevantes entre as prevalências das variáveis observadas. CONCLUSÃO: Os autores levantam a hipótese de que os fatores de risco associados ao câncer gástrico podem ser menos sinérgicos do que o esperado.

Upregulation of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 in renal tissue in severe dengue in humans: Effects on endothelial activation/dysfunction

Abstract INTRODUCTION: Dengue is an important mosquito-borne disease in tropical and subtropical regions. Adhesion molecules have not been systematically characterized in the renal tissue of patients with severe dengue (SD). The objective of this study was to detect viral antigens in samples from patients that evolved with SD, correlating with the expression of ICAM-1, VCAM-1, VE-cadherin, and E-selectin to contribute to a better understanding of the pathophysiology of SD. METHODS: Kidney specimens from patients with SD were selected according to clinical and laboratorial data and submitted to histological and immunohistochemistry analysis. A semiquantitative evaluation was performed considering positive immunostaining in 20 glomeruli. RESULTS: Viral antigens were mainly detected in distal tubules. The intense immunostaining of VCAM-1 and ICAM-1 was observed. The expression of E-selectin was discrete, and VE-cadherin expression varied from mild to moderate. VCAM-1 was slightly intense in the glomerular capsule; the expression of ICAM-1 was diffuse. E-selectin was diffuse, and VE-cadherin varied from mild to moderate. The most frequent histological findings were glomerular congestion, mild glomerulitis, acute renal injury, and glomerular atrophy. CONCLUSIONS: The results appear to demonstrate an imbalance between vascular endothelial permeability regulating events in renal lesions in SD. The increase in the expression of ICAM-1 and VCAM-1 is an in-situ indicator of higher permeability with a consequent influx of cells favoring the inflammation of the endothelium. These molecules are important in the pathophysiology of the disease and provide the possibility of developing new markers for the evaluation, clinical follow-up, and therapeutic response of patients with SD.

First isolation of West Nile virus in Brazil

BACKGROUND Serological evidence of West Nile virus (WNV) infection has been reported in different regions of Brazil from equine and human hosts but the virus had never been isolated in the country. OBJECTIVES We sought to identify the viral etiology of equine encephalitis in Espírito Santo state. METHODS We performed viral culture in C6/36 cells, molecular detection of WNV genome, histopathology and immunohistochemistry from horse cerebral tissue. We also carried out sequencing, phylogenetic analysis and molecular clock. FINDINGS Histopathologic analysis from horse cerebral tissue showed injury related to encephalitis and WNV infection was confirmed by immunohistochemistry. The virus was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) from brain tissue and subsequently isolated in C6/36 cells. WNV full-length genome was sequenced showing the isolated strain belongs to lineage 1a. The molecular clock indicated that Brazilian WNV strain share the same common ancestor that were circulating in US during 2002-2005. MAIN CONCLUSIONS Here we report the first isolation of WNV in Brazil from a horse with neurologic disease, which was clustered into lineage 1a with others US WNV strains isolated in beginning of 2000's decade.

Tissue immunostaining for factor XIIIa in dermal dendrocytes of pityriasis alba skin lesions

BACKGROUND: Pityriasis alba affects 1% of the world population and about 9.9% of the children in Brazil. However, its etiology remains uncertain. OBJECTIVE: The objective of the present study was to evaluate the immunoexpression of factor XIIIa in dermal dendrocytes of skin lesions of pityriasis alba. METHOD: Twenty patients with pityriasis alba and 20 patients with atopic dermatitis underwent biopsy. The dermal dendrocytes marked by factor XIIIa were counted by means of immunohistochemical analysis. RESULTS: The mean amount of dermal dendrocytes found in the patients with pityriasis alba was 2, whereas in the patients with atopic dermatitis it was 4, with a statistically significant difference between them. A cutoff point of 3 cells/square inch was established to differentiate pityriasis alba from atopic dermatitis, with 80% sensibility and 90% specificity. CONCLUSION: We believe that pityriasis alba and atopic dermatitis should be considered different clinical forms within the spectrum of atopic disease, in which sun radiation plays an important role by modulating the progression of the disease. .

Autoanticorpos contra antígenos celulares e sua correlação com o genótipo viral em pacientes com infecção pelo vírus da hepatite C (HCV) / Autoantibodies against cellular antigens and its relationship to virus genotype in hepatitis C virus (HCV) infected subjects

Objetivo: estabelecer relação entre a presença de fator anti-núcleo em células HEp-2 (FAN HEp-2) e o genótipo viral empacientes portadores de infecção pelo vírus da hepatite C (HCV). Método: estudo transversal analítico de prontuários de51 pacientes, com anti-HCV positivos, atendidos no Núcleo de Medicina Tropical/Universidade Federal do Pará e grupocontrole constituído de doadores de sangue. Foi realizada sorologia para anti-HCV, Reação de Polimerase em Cadeiaem Tempo Real RPCTR, genotipagem e dosagens bioquímicas e pesquisa de FAN HEp-2. Os dados foram submetidos atestes estatísticos com auxílio do Programa BioEstat 5.0, sendo aceito como significante o valor de p < 0,05. Resultados:dos 51 pacientes portadores de HCV, 28.9% (13) apresentaram FAN positivo, 88.2.% (45) com genótipo tipo 1 e 11,8%(6) com genótipo tipo 3. Os pacientes que se apresentaram com anticorpos detectáveis não apresentaram níveis deAST, ALT, AST/ALT, ?-GT e fosfatase alcalina, significativamente, diferente daqueles com auto-anticorpos negativos.Conclusão: o estudo demonstra que os auto-anticorpos presentes na amostra possuem padrão citoplasmático e estãorelacionados ao genótipo tipo1

Objective: This paper aims to establish a relationship between anti-nuclear fator (HEp-2) and virus genotypes in HepatitisC virus infected sunjects. Methods: This is a single-center, transversal analytical study that enrolled 51 out-patients atthe Núcleo de Medicina Tropical (Tropical Medicine Center) of the Universidade Federal do Para (Federal Universityof Para) in Brazil, compared to a control group of blood donors. HCV serology, real-time polymerase chain reaction,genotyping, biochemistry and anti-nuclear fator (HEp-2) analysis were carried out for each patient. Statiscal analysiswere made in Bioestat 5.0 software, considering ? ? 0,05 and power of 80%. Results: Out of 51 HCV subjects, 28.9%(13) also had anti-nuclear factor (HEp-2), 88.2.% (45) HCV type 1 and 11,8% (6) HCV type 3. There was no significantdifference in aspartate transaminase (AST), alanine transaminase (ALT), AST/ALT ratio, gamma glutamyl transpeptidase(GGT) e alcaline phosphatase (ALP) serum levels between patients presenting with anti-nuclear factor (HEp-2) and theones without it. Conclusion: Autoantibodies present in this sample showed a cytoplasmic pattern and were related toHCV type 1.

Differences in virulence markers between Helicobacter pylori strains from the Brazilian Amazon region

Introduction This study compares virulence markers of Helicobacter pylori isolated from patients in 2 cities in the Brazilian Amazon. Methods The study analyzed 168 patients with chronic gastritis from Belém and 151 from Bragança, State of Pará, Brazil. Levels of bacterial DNA associated with cagA and vacA alleles were checked by PCR, and hematoxylin-eosin staining was used for histologic diagnosis. Results In Bragança 87% of patients were genotype s1m1 cagA-positive (s1m1 cagA+), compared with 76% in Belém. In samples from patients in both cities, there was an association between s1m1 cagA+ strains and gastric mucosal damage. Conclusions Both cities have a high frequency of s1m1 cagA+ strains of H. pylori. .

Preditores de mortalidade na cirurgia de revascularizção do miocárdio / Mortality predictors in coronary artery bypass grafting surgery

Fundamentos: A alta morbidade pós-operatória e os elevados índices de mortalidade dos pacientes submetidos à revascularização cirúrgica (RM) na fase aguda do infarto do miocárdio podem induzir o adiamento do procedimento. Objetivos: Identificar variáveis relacionadas à mortalidade, bem como os fatores de risco para o óbito de pacientes submetidos à cirurgia de revascularização do miocárdio. Métodos: A pesquisa foi realizada no período de setembro 2011 a maio 2012, no Hospital de Clínicas Gaspar Vianna, Belém, PA, Brasil. Foram utilizados prontuários de 240 pacientes, tendo sido aproveitados 223 (17 excluídos), referentes a pacientes internados no período de janeiro 2008 até dezembro 2011. Inicialmente foi calculada a frequência dos óbitos e, em seguida, a frequência das variáveis pré, intra e pós-operatórias e respectivos intervalos de confiança para caracterizar a população de estudo. Resultados: Dos 223 pacientes, 12 (5,4 %) foram a óbito. A variável no período pré-operatório mais significativa para o estudo foi a idade. No período intraoperatório, são os procedimentos cirúrgicos de urgência/emergência e, no pós-operatório, a transfusão sanguínea.Conclusão: No pós-operatório, as complicações cardiovasculares e as transfusões são fatores de risco, e a UTI se tornou um fator de proteção contra o óbito.

Background: High postoperative morbidity and mortality rates among patients undergoing coronary artery bypass surgery (CABG) during the acute phase of myocardial infarction may lead to the post ponement of these procedures.Objectives: To identify variables linked to o mortality and risk factors related to death among patients undergoing coronary artery bypass grafting surgery.Methods: The survey was conducted from September 2011 to May 2012 at the Hospital de Clinicas Gaspar Vianna in Belém, Pará State, Brazil, using the medical records of 240 patients (223 assessed and 17 excluded) admitted from January 2008 through December 2011. Initially, the death frequency was caculated, followed by the pre-, intra- and post-operative variable frequencies and their respective confidence intervals, in order to characterize the study population. Results: Among all 223 patients, 12 (5,4%) died, with age being the most significant varible in the pre-operative period. During the intra-operative stage, this was urgente or emergency surgical procedures, followed by post-operative blood transfusions. Conclusion: During the post-operative stage, cardiovascular complications and transfusions are risk factors, with the ICU constituting a protection fator against death.

Immunohistochemistry of the uterine cervix of rats bearing the Walker 256 tumor treated with copaiba balsam

PURPOSE: To investigate the immunohistochemistry of the uterine cervix of 20 Wistar rats (Rattus norvegicus) bearing the Walker 256 tumor, treated with copaiba oil (Copaifera officinalis). METHODS: The animals were grouped into four subgroups, with five rats each: the GCT and GCopT received distilled water and topically copaiba, respectively, while the GCG and GCopG received distilled water and copaiba by gavage, respectively. The substances were administered for nine days. On the 12th day, after euthanasia, the tumor pieces were sent to the identification of T CD4+, T CD8+ and Natural Killer cells. RESULTS: It was found that the pattern of expression for specific markers of phenotypes of cells involved in tumor immune response was similar in all groups, regardless the administration way of copaiba oil (topical or gavage). CONCLUSION: Copaiba balsam, administered either topically or by gavage, did not alter the pattern of tumor immune response in rats bearing Walker 256 Tumor.

Clinical, epidemiological and mycological report on 65 patients from the Eastern Amazon region with chromoblastomycosis / Relato clínico, epidemiológico e micológico de 65 pacientes com cromoblastomicose procedentes da Amazônia oriental

BACKGROUND: Chromoblastomycosis is a chronic fungal infection caused by fungi from the Dematiaceae family. According to several studies, Fonsecaea pedrosoi is the most common of these fungi. The infection is more common in tropical countries, with the Brazilian state of Pará having one of the largest infected populations worldwide. The disease is difficult to treat and recurrences are common. OBJECTIVES: To describe the epidemiological and mycological aspects of cases of chromoblastomycosis and its clinical forms in the state of Pará, Brazil. METHODS: Mycological exams (direct mycological examinations, culture and microculture) were performed and a clinical/epidemiological evaluation was made of 65 patients receiving care at the Dermatology Department of the Federal University of Pará between 2000 and 2007. The clinical classification proposed by Carrión in 1950 was used in this study. RESULTS: The majority of the patients were male (93.8%), agricultural workers (89.2%) of 45 to 55 years of age, and the majority of lesions (55.4%) were of the verrucous type, located principally on the lower limbs (81.5%). In the majority of the cases investigated (61.5%), the infection had been present for a long time, with a mean duration of 11 years. Direct mycological examination was performed in 86.2% of the patients (n=56). Of these, 96.4% (n=54) tested positive. Culture and microculture were performed in vitro in 47 cases of those that tested positive at direct microscopy, results showing Fonsecaea pedrosoi to be the only agent present in this sample. CONCLUSION: This study highlighted the extent to which chromoblastomycosis still affects the quality of life of the local population, principally individuals working in agriculture. This is a chronic disease for which there is no effective treatment. The importance of continuing to investigate this disease should be emphasized, as further studies may lead to new clinical or epidemiological findings.

FUNDAMENTOS: A cromoblastomicose é uma infecção fúngica crônica, causada por fungos da família Dematiaceae, sendo Fonsecaea pedrosoi a mais comum, segundo vários estudos. É mais frequente em países tropicais e o estado do Pará possui grande casuística mundial. A doença é de difícil tratamento e apresenta recorrência frequente. OBJETIVOS: Descrever os aspectos epidemiológicos, micológicos e formas clínicas dos casos de cromoblastomicose procedentes do estado do Pará - Brasil. MÉTODOS: Foram realizados exames micológicos (direto, cultura e microcultivo) e observação clinicoepidemiológica em 65 pacientes do Serviço de Dermatologia da Universidade Federal do Pará, atendidos no período de 2000 a 2007. Empregou-se a classificação clínica proposta por Carrión em 1950. RESULTADOS: Os pacientes eram, em sua maioria, homens (93,8%), lavradores (89,2%), faixa etária entre 45-55 anos, com predominância de lesões verruciformes (55,4%), localizadas principalmente nos membros inferiores (81,5%). A maioria dos casos pesquisados (61,5%) apresentou um longo tempo de doença, com uma média de 11 anos. O exame micológico direto foi realizado em 86,2% (n=56) dos pacientes; destes, 96,4% (n=54) apresentaram resultado positivo. Foram realizados cultura e microcultivo in vitro de 47 pacientes com exame micológico positivo e os resultados mostraram o Fonsecaea pedrosoi como único agente etiológico identificado nesta amostra. CONCLUSÃO: Este estudo mostrou o quanto a cromoblastomicose ainda compromete a qualidade de vida da população local, principalmente a de indivíduos que trabalham em lavouras, cursando com evolução crônica e sem tratamento eficaz. Observa-se a importância de dar continuidade a este estudo, o que poderá proporcionar novas contribuições clínicas ou epidemiológicas.

Persistence of experimental Rocio virus infection in the golden hamster (Mesocricetus auratus)

Rocio virus (ROCV) is an encephalitic flavivirus endemic to Brazil. Experimental flavivirus infections have previously demonstrated a persistent infection and, in this study, we investigated the persistence of ROCV infection in golden hamsters (Mesocricetus auratus). The hamsters were infected intraperitoneally with 9.8 LD50/0.02 mL of ROCV and later anaesthetised and sacrificed at various time points over a 120-day period to collect of blood, urine and organ samples. The viral titres were quantified by real-time-polymerase chain reaction (qRT-PCR). The specimens were used to infect Vero cells and ROCV antigens in the cells were detected by immunefluorescence assay. The levels of antibodies were determined by the haemagglutination inhibition technique. A histopathological examination was performed on the tissues by staining with haematoxylin-eosin and detecting viral antigens by immunohistochemistry (IHC). ROCV induced a strong immune response and was pathogenic in hamsters through neuroinvasion. ROCV was recovered from Vero cells exposed to samples from the viscera, brain, blood, serum and urine and was detected by qRT-PCR in the brain, liver and blood for three months after infection. ROCV induced histopathological changes and the expression of viral antigens, which were detected by IHC in the liver, kidney, lung and brain up to four months after infection. These findings show that ROCV is pathogenic to golden hamsters and has the capacity to cause persistent infection in animals after intraperitoneal infection.

Prevalência de infecção genital pelo HPV em populações urbana e rural da Amazônia Oriental Brasileira / Prevalence of genital HPV infection in urban and rural women in the Eastern Brazilian Amazon

Foram investigados a prevalência e os fatores associados à infecção genital pelo HPV em mulheres de população urbana e rural de duas regiões da Amazônia Oriental brasileira. Foi um estudo transversal com 444 mulheres submetidas ao rastreamento para câncer cervical, sendo 233 urbanas e 211 rurais, de janeiro de 2008 a março de 2010. Coletaram-se amostras da cérvice uterina para a pesquisa de DNA do HPV pela PCR. Todas responderam a um formulário epidemiológico. Análise bivariada e por regressão logística foram empregadas na investigação dos fatores associados ao HPV. A prevalência geral de HPV foi de 14,6 por cento. Entre as populações, não houve diferença significativa, 15 por cento urbana e 14,2 por cento rural. O único fator de risco explorado no estudo significativamente associado ao HPV foi a situação conjugal de mulheres residentes na zona rural na faixa de 13 a 25 anos, com maior prevalência de infecção entre solteiras, separadas ou viúvas. Conclui-se que, apesar das prevalências entre as populações serem semelhantes, as estratégias preventivas a serem aplicadas seriam específicas para cada população.

This study investigated the prevalence and risk factors for genital infection with HPV in women from rural and urban areas in two different regions of the Eastern Brazilian Amazon. A cross-sectional survey was performed in Pap screening programs, with a total sample of 444 women (233 urban and 211 rural). Uterine cervical swabs were collected for the detection of HPV DNA with the established PCR assay using MY09-MY11. All volunteers answered an epidemiological questionnaire. Bivariate and multivariate logistic regression analyses were performed to identify risk factors associated with HPV infection. Overall prevalence of HPV infection was 14.6 percent (15 percent in urban women and 14.2 percent in rural). The only factor associated with HPV was marital status in the 13-25-year-old rural population, with higher HPV prevalence among single and divorced women and widows. The findings indicate the need for risk factor control strategies targeted specifically to women in rural and urban areas.

Deteccção do DNA de Mycobacterium leprae em secreção nasal / Detección del ADN de Mycobacterium leprae en secreción nasal / Detection of Mycobacterium leprae DNA in nasal swab

Estudos têm demonstrado alta sensibilidade da técnica da reação em cadeia de polimerase (PCR) na identificação do DNA do Mycobacterium leprae. Este estudo objetivou avaliar a sensibilidade da PCR na detecção do DNA do M. leprae em "swab" nasal de pacientes hansenianos e comparar os resultados com a baciloscopia e formas multibacilares (MBs) e paucibacilares (PBs). Foram coletadas amostras de secreção nasal de 24 pacientes hansenianos, conservadas em solução de lise um e dois. Os resultados da PCR foram altamente significativos (p<0.0000) e revelaram maior sensibilidade do que a baciloscopia, nas diversas formas clínicas. Contudo, são necessários ainda outros estudos, testando novos marcadores e conservantes, com o intuito de elevar a sensibilidade dessa técnica, em amostras de secreção nasal.

Studies have demonstrated high sensibility of the polimerase chain reaction (PCR) technique in the identification of the Mycobacterium leprae DNA . This study aimed to evalue the PCR sensibility at the detection of the M. leprae DNA in nasal swab of leprosy patients and to compare the results with the bacilloscopy and multibacillary (MBs) and paucibacilares (PBs) forms. Nasal secretion samples of 24 leprosy patients were collected, and were preserved in one and two lise's solution. The PCR results were highly significant (p <0.0000) and they revealed grater sensibility than bacilloscopy, in several clinical forms. Nevertheless, still different studies are necessary, testing new markers and preservatives, with the purpose of lifting up the sensibility of this technique, in nasal secretion samples.

Los estudios han demostrado una alta sensibilidad de la técnica de Reacción en Cadena de la Polimerasa (PCR) para identificar el ADN de Mycobacterium leprae. El objetivo del estudio fue evaluar la sensibilidad de la PCR en la detección de ADN de M. leprae en hisopo nasal de los pacientes hansenianos y comparar los resultados con la baciloscopía y las formas multibacilares (MBs) y paucibacilares (PBS). Se obtuvieron muestras de secreción nasal de 24 pacientes hansenianos, conservados en solución de lisis uno y dos. Los resultados de la PCR fueron muy significativas (p <0.0000) y mostró una mayor sensibilidad que la baciloscopía, en diferentes formas clínicas. Sin embargo, otros estudios son aún necesarios, el ensayo de nuevos marcadores y conservantes con el fin de aumentar la sensibilidad de esta técnica, en muestras de secreción nasal.

Lacaziose (doença de Jorge Lobo): revisão e atualização / Lacaziosis (Jorge Lobo’s disease): review and update

Lacaziose ou doença de Jorge Lobo é micose crônica, granulomatosa, causada por implantação traumática do fungo Lacazia loboi - patógeno não cultivável até o presente - nos tecidos cutâneo e subcutâneo, manifestando-se clinicamente por lesões nodulares queloidianas predominantes, envolvendo sobretudo pavilhões auriculares, face, membros superiores e inferiores, e não comprometendo as mucosas. A maioria dos casos humanos está registrada em países da América do Sul. Entretanto, a enfermidade apresenta aspectos epidemiológicos destacados, como o aparecimento em tribo Caiabi, no Brasil Central e em mamíferos não humanos, golfinhos de duas espécies (Tursiops truncatus e Sotalia guianensis) capturados na costa da Flórida (EUA), na foz do rio Suriname, na costa de Santa Catarina (Brasil), no golfo de Gasconha (baía de Biscaia-Europa), com manifestações cutâneas e achados histopatológicos muito similares às encontradas no homem. O artigo objetiva abordar características do fungo e sua taxonomia, e aspectos históricos, ecoepidemiológicos, clínicos, imuno-histoquímicos, histopatológicos, ultra-estruturais e terapêuticos.

Lacaziosis, also known as Jorge Lobo’s disease, lobomycosis and keloidal blastomycosis, is a chronic cutaneous and subcutaneous fungal granulomatous disease, caused by Lacazia loboi - an uncultivated fungal pathogen - characterized by the development of nodular keloidal lesions, particularly on the pinnae, face, upper and lower limbs, and with no involvement of mucous membranes. Most cases in humans were reported in South America, including the Caiabi Indians, in Central Brazil. The disease was described in non-human mammals, such as two species of dolphins (Tursiops truncatus and Sotalia guianensis) inhabiting the coasts of Florida (USA), South America (Suriname River estuary, Santa Catarina-Brazil coast) and Gulf of Gascony (Biscaya Bay, in Europe). The histopathological findings in dolphins were very similar to those observed in humans. The aspects related to the history, etiology, epidemiology and ecology, clinical manifestations, differential diagnosis, immunohistochemistry, pathology, ultrastructural, laboratory diagnosis and therapy of lacaziosis, are presented.

Arboviroses da Amazônia: estudo do mecanismo de morte celular e da resposta fenotípica do hospedeiro na febre amarela / Arboviruses of the Amazonia: study of the cell death mechanism of cell death and the fenotipic host response in the yellow fever[

Os eventos histológicos no fígado foram quantificados, usando técnica de imunomarcação para avaliar 53 amostras hepáticas provenientes de viscerotomia de pacientes vitimados por febre amarela silvestre. A análise quantitativa dos eventos demonstrou amplo predomínio do componente apoptótico sobre a necrose. O infiltrado inflamatório é desproporcional em intensidade à morte dos hepatócitos. Houve predomínio de linfócitos TCD4+, ocorrendo em menor proporção linfócitos TCD8+, linfócitos B, células NK e apresentadoras de antígenos (S100). A expressão citocínica foi de perfil Th1, com expressão de TNF-a, IFN-g e acompanhada de intensa imunomarcação para TGF-b. Frente aos achados acreditamos que a predileção pela localização médio zonal das lesões do fígado poderia decorrer de fenômenos de hipóxia por hipofluxo secundária à vasculopatia sistêmica e associada ao efeito citopático viral.In this work, the histological events in the liver were quantified, using a immunomarking technique to evaluate 53 hepatic samples from the viscerotomy of patients with the sylvatic form of yellow fever. Quantitative analysis of the events demonstrated an ample prevalence of an apoptotic component in the necrosis. The intensity of the inflammatory infiltration is disproportionate to the death of the hepatocytes. There is a prevalence of TCD4+ lymphocytes, with a smaller proportion of TCD8+ lymphocytes, B lymphocytes, NK cells and antigen-presenting cells (S100). The cytokine expression presented a profile of Th1, with expression of TNF-a, IFN-g and accompanied by intense immunomarking by TGF-b. Faced with these findings, we consider that the predilection for the midzonal location of the lesions in the liver could arise from the phenomena of hypoxia secondary to systemic vasculopathy associated to the viral cytopathic effect...