RESUMO
Esophageal cancer is a prevalent cancer worldwide. Some studies have reported the possible etiology of human papillomavirus (HPV) in benign and malignant papillomas of the esophagus but the conclusions are controversial. In the present study, we investigated an esophageal papilloma from a 30-year-old male patient presenting aphasia. HPV DNA was detected by generic PCR using MY09/11 primers, and restriction fragment length polymorphism revealed the presence of HPV54, usually associated with benign genital lesions. Hypermethylation of the pINK4A gene was also investigated due to its relation to malignant transformation, but no modification was detected in the host gene. Except for an incipient reflux, no risk factors such as cigarette smoking, alcohol abuse or an infected sexual partner were recorded. Since esophageal lesions may have a malignant potential, HPV detection and typing are useful tools for patient follow-up.
Assuntos
Adulto , Humanos , Masculino , Metilação de DNA/genética , DNA Viral/genética , Neoplasias Esofágicas/virologia , Papiloma/virologia , Papillomaviridae/genética , Infecções por Papillomavirus/virologia , Neoplasias Esofágicas/diagnóstico , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Papiloma/diagnóstico , Infecções por Papillomavirus/diagnósticoRESUMO
Aborda à luz do debate atual sobre o poder local, o processo de descentralizaçäo dos serviços de saúde no Brasil. Trata essa questäo central tendo por eixo a implementaçäo da Lei do SUS em geral, e no particular as questöes de financiamento e de desenvolvimento de recursos humanos. Conclui, apresentando alternativas no sentido de levar a uma maior autonomia local