Relação entre DPOC e doença cardiovascular / Relationship between COPD and Cardiovascular Disease

Este é um artigo de revisão que teve como objetivo analisar a relação entre a DPOC e a doença cardiovascular. Pacientes portadores de DPOC apresentam alta prevalência de doença cardiovascular, sendo essa a causa mais comum de morte. Ainda não está claro se essa relação ocorre devido ao aumento dos fatores de risco cardiovasculares clássicos, como a hipertensão arterial, o diabetes mellitus e a dislipidemia, ou por processos inflamatórios presentes na DPOC que estão relacionados à resposta inflamatória sistêmica. Sabe-se que DPOC per se já é considerada um fator de prognóstico independente para a doença cardiovascular.O estudo da fisiopatologia dessa relação torna-se importante para o avanço dos tratamentos

This review article aims to evaluate the relationship between COPD and cardiovascular disease.In patients with COPD, cardiovascular disease is highly prevalent and is the leading cause of death. It is unclear whether cardiovascular disease in COPD is due to an increased presence of classic cardiovascular risk factors, such as hypertension, diabetes mellitus, and dyslipidemia, or to a relationship between the inflammatory process present in COPD patients and the systemic inflammatory response. It is known that COPD itself is an independent prognostic factor for cardiovascular disease.Studies investigating the physiopathology of the relationship between COPD and cardiovascular disease could lead to advances in treatment.

Human papillomavirus infection and cervical cancer in Brazil: a retrospective study

Two hundred and thirty paraffin-embedded biopsies obtained from female cervical lesions were tested for the presence of human papillomavirus (HPV) types 6/11, 16/18 and 31/33/35 DNA using non-isotopic in situ hybridization. Specimens were classified according to the Bethesda System in low grade squamous intraepithelial lesion (LSIL), high grade SIL (HSIL) and squamous cell carcinoma (SCC). HPV prevalence ranged from 92.5 per cent in LSIL to 68.5 per cent in SCC. Benign types were prevalent in LSILs while oncogenic types infected predominantly HSILs and SCC. HPV infection showed to be age-dependent, but no significant relation to race has been detected. Patients were analyzed through a five-year period: 20.7 per cent of the lesions spontaneously regressed while 48.9 per cent persisted and 30.4 per progressed to carcinoma. Patient submitted to treatment showed a 19.4 per cent recurrence rate. High risk types were present in 78.6 per cent (CrudeOR 13.8, P=0.0003) of the progressive lesions, and in 73.7 per cent of the recurrent SILs (COR 19.3, P=0.0000001). Possible co-factors have also been evaluated: history of other sexually transmitted diseases showed to be positively related either to progression (Adjusted OR 13.0, P=0.0002) or to recurrence (AOR 17.2, P=0.0002) while oral contraceptive use and tobacco smoking were not significantly related to them (P>0.1). Association of two or more co-factors also proved to be related to both progression and recurrence, indicating that they may interact with HPV infection in order to increase the risk of developing malignant lesions.