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1.
Dis Esophagus ; 30(4): 1-9, 2017 Apr 01.
Article in English | MEDLINE | ID: mdl-28375484

ABSTRACT

Chaga's disease is an important communicable neglected disease that is gaining wider attention due to its increasing incidence worldwide. Achalasia due to chagasic megaesophagus (CM), a complication of this disease, is a known-yet, poorly understood-etiological factor for esophageal squamous cell carcinoma (ESCC) development. In this study, we aimed to perform the analysis of TP53 mutations in a series of Brazilian patients with ESCC that developed in the context CM (ESCC/CM), and to compare with the TP53 mutation profile of patients with benign CM and patients with nonchagasic ESCC. Additionally, we intended to correlate the TP53 mutation results with patient's clinical pathological features. By polymerase chain reaction (PCR) followed by direct sequencing of the hotspot regions of TP53 (exon 5 to 8), we found that TP53 mutations were present in 40.6% (13/32) of the ESCC/CM group, 45% (18/40) of the nonchagasic ESCC group, and in only 3% (1/33) of the benign CM group. Missense mutations were the most common in the three groups, yet, the type and mutated exon mutation varied significantly among the groups. Clinically, the groups exhibited distinct features, with both cancer groups (ESCC and ESCC/CM) been significantly associated higher consumption of alcohol and tobacco, older age, worse Karnofsky performance status, poor outcome than the patients with benign CM. No significant association was found between TP53 mutation profile and clinical-pathological features in any of the three groups. We describe first the time the analysis of TP53 mutations in ESCC that developed in the context of CM, and the observed high frequency of mutations, suggest that TP53 also plays an important role in the tumorigenic process of this unexplored etiological condition.


Subject(s)
Carcinoma, Squamous Cell/genetics , Chagas Disease/genetics , Esophageal Achalasia/genetics , Esophageal Neoplasms/genetics , Genes, p53 , Mutation , Adult , Aged , Brazil , Chagas Disease/complications , Esophageal Achalasia/complications , Esophageal Squamous Cell Carcinoma , Exons , Female , Genetic Association Studies , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Young Adult
2.
Ceska Gynekol ; 80(2): 140-3, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25944604

ABSTRACT

OBJECTIVE: To describe a case of prenatal diagnosis of a giant placental chorioangioma with favorable outcome. DESIGN: A case report. SETTING: Gynecology and Obstetrics Service, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil. CASE REPORT: The placental chorioangioma is the most common benign tumor, but the type giant has a small prevalence, ranging from 1:16.000 to 1:50.000 pregnancies. We reported a case of a patient aged 18, pregnant for the first time, who performed a routine obstetric ultrasound was found to have polyhydramnios associated with placental vascular lesions suggestive of chorioangioma also was defined by fetal magnetic resonance imaging and confirmed by pathological examination.


Subject(s)
Hemangioma/diagnosis , Pregnancy Complications, Neoplastic/diagnosis , Ultrasonography, Prenatal , Adolescent , Diagnosis, Differential , Female , Hemangioma/diagnostic imaging , Hemangioma/pathology , Hemangioma/surgery , Humans , Infant, Newborn , Placenta Diseases , Pregnancy , Pregnancy Complications, Neoplastic/diagnostic imaging , Pregnancy Complications, Neoplastic/pathology
3.
Eur J Gynaecol Oncol ; 35(3): 284-8, 2014.
Article in English | MEDLINE | ID: mdl-24984542

ABSTRACT

PURPOSE OF INVESTIGATION: To evaluate the distribution of GTPases RhoA, RhoB, and Cdc42 in cervical intraepithelial neoplasias (CIN) and invasive neoplasias of the uterine cervix. MATERIALS AND METHODS: samples of neoplastic lesions of the uterine cervix of 44 patients were classified in: CIN I (n = 10), CIN II (n = 10), CIN III (n = 09), and invasive carcinoma (n = 15). Antibodies anti-RhoA, anti-RhoB, and anti-Cdc42 were used and staining was classified as: negative, mild, moderate, and intense positive. RESULTS: When compared with dysplastic cells, superficial cells showed: higher expression of RhoB in CIN I (p = 0.0018), and lower expression of Cdc42 in CIN I (p = 0.0225). The authors observed higher expression of RhoA (p = 0.0002) and RhoB (p = 0.0046) in CIN dysplastic cells when compared with invasive carcinoma cells. CONCLUSIONS: GTPases Rho may be involved with the regulation of biological processes, important to the progression of cervical neoplasias. Probably, RhoA is important for maintenance of cell differentiation and RhoB protects cells from malignant cervical neoplasia.


Subject(s)
Uterine Cervical Dysplasia/pathology , Uterine Cervical Neoplasms/pathology , rhoA GTP-Binding Protein/physiology , rhoB GTP-Binding Protein/physiology , Adult , Female , Humans , Immunohistochemistry , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Uterine Cervical Neoplasms/enzymology , cdc42 GTP-Binding Protein/analysis , rhoA GTP-Binding Protein/analysis , rhoB GTP-Binding Protein/analysis , Uterine Cervical Dysplasia/enzymology
4.
Clin Exp Obstet Gynecol ; 40(1): 40-4, 2013.
Article in English | MEDLINE | ID: mdl-23724504

ABSTRACT

OBJECTIVE: This study investigated the association between gynecological neoplasms, endometriosis, and adenomyosis in women who underwent surgical treatment for gynecological cancer and uterine leiomyoma during reproductive years or after menopause. MATERIALS AND METHODS: Information was collected from patient records from the Hospital's database from 1985 to 2007. The study included 502 women, of which 375 were premenopausal and 132 were postmenopausal. RESULTS: A significant association was observed between the occurrence of adenomyosis in cancer in women with four or more pregnancies, and in women aged over 40 years (p < 0.0001). The frequency of adenomyosis was significantly higher than the frequency of endometriosis for cancer in two sites (p = 0.0419) or for leiomyomas (p < 0.0001). CONCLUSION: Therefore adenomyosis is more frequently found than endometriosis in women with leiomyomas or cancer in two sites in premenopausal women, and clinicians need to be aware of patients with adenomyosis and the risk of cancer.


Subject(s)
Adenomyosis/epidemiology , Endometriosis/epidemiology , Leiomyoma/epidemiology , Uterine Neoplasms/epidemiology , Adolescent , Adult , Aged , Brazil/epidemiology , Comorbidity , Female , Humans , Middle Aged , Postmenopause , Premenopause , Retrospective Studies , Young Adult
6.
Eur J Gynaecol Oncol ; 33(3): 245-8, 2012.
Article in English | MEDLINE | ID: mdl-22873090

ABSTRACT

PURPOSE OF INVESTIGATION: The objective was to demonstrate the frequency of invasive cervical cancer or recurrent CIN in patients treated by a previous diagnosis of CIN 1-3. METHODS: We analyzed 1,397 records colpocytologic and medical records. Recurrence of CIN or invasive neoplasia of the cervix after treatment of CIN was assessed. The chi-square test was used for statistical analysis (significance level set at less than 0.05). RESULTS: We obtained 696 CIN 1, 244 CIN 2, 451 CIN 3, and six squamous carcinoma. Regarding patients who relapsed, there were 6/690 (0.9%) patients had an initial diagnosis of CIN 1, 8/236 (3.4%) CIN 2 and 21/430 (4.9%) CIN 3 (p < 0.0001). Comparing the frequency of relapse among each group, we found: CIN 1 vs CIN 2: p = 0.0073; CIN 1 vs CIN 3: p < 0.0001; CIN 2 vs CIN 3: p = 0.38. CONCLUSION: Although the number of relapses when comparing CIN 2 and CIN 3 were not significant, the data suggest that CIN 2 has lower recurrence rates, so these patients require more conservative treatment if a desire of future pregnancy is expressed.


Subject(s)
Neoplasm Recurrence, Local , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/surgery , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/surgery , Adult , Aged , Chi-Square Distribution , Female , Humans , Middle Aged , Neoplasm Grading , Retrospective Studies , Time Factors , Young Adult
7.
Eur J Gynaecol Oncol ; 32(3): 297-302, 2011.
Article in English | MEDLINE | ID: mdl-21797121

ABSTRACT

INTRODUCTION: Conservative treatment with intralesional interferon (IFN) is a therapeutic option for cervical intraepithelial neoplasia (CIN) patients of childbearing age. MATERIALS AND METHODS: The study group was made up of patients diagnosed with a high-grade lesion and treated with intralesional human recombinant IFNalpha-2b. Vaginal secretion was collected during IFNalpha-2b treatment for analysis of cytokines and viral load. RESULTS: The initial histology diagnostic was 62.5% (n = 5) with CIN 2 and 37.5% (n = 3) with CIN 3. In terms of clinical evaluation and anatomopathology, 6.5% (n = 5) had a good clinical response, while 37.5% (n = 3) had therapeutic failure. All the patients with therapeutic failure were smokers. Interleukin 6 and tumor necrosis factor-alpha concentrations were raised at the sixth application for the patient group who failed to respond to therapy compared to the responsive group (p = 0.0357). Patients with a good response exhibited a reduction in human papillomavirus viral load (p = 0.03). CONCLUSIONS: Patients that had a good response had lower concentrations of inflammatory cytokines than did non-responders.


Subject(s)
Antineoplastic Agents/therapeutic use , Interferon-alpha/therapeutic use , Uterine Cervical Dysplasia/drug therapy , Uterine Cervical Neoplasms/drug therapy , Vagina/metabolism , Adult , Cytokines/metabolism , DNA, Viral/analysis , Female , Flow Cytometry , Humans , Interferon alpha-2 , Interferon-alpha/administration & dosage , Middle Aged , Papillomaviridae/genetics , Prospective Studies , Recombinant Proteins , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Vagina/pathology , Vagina/virology , Vaginal Smears , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/virology
8.
Eur J Gynaecol Oncol ; 31(5): 522-9, 2010.
Article in English | MEDLINE | ID: mdl-21061793

ABSTRACT

Conservative treatment with interferons (IFNs) has the advantage of preserving reproductive capacity in patients with grade 2 or 3 cervical intraepithelial neoplasia (CIN). The objective of this work was to study patients with high-grade CIN treated with intralesional IFN alpha-2b and to analyze the expression of Th1, Th2 and Th3 cytokines in cervical stroma. We observed that patients with a satisfactory response (60%) to treatment with IFN alpha-2b expressed more Th1 (IFN-gamma TNF-alpha, IL-2) cytokines, with a significant reduction in the viral load of high-risk human papillomavirus (p = 0.0313). All patients with therapeutic failure were smokers and had higher expression of cytokines Th2 (IL-4) or Th3 (TGF-beta2 and TGF-beta3).


Subject(s)
Antiviral Agents/administration & dosage , Cytokines/metabolism , Interferon-alpha/administration & dosage , Uterine Cervical Dysplasia/drug therapy , Uterine Cervical Dysplasia/metabolism , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/metabolism , Adolescent , Adult , Female , Humans , Injections, Intralesional , Interferon alpha-2 , Middle Aged , Neoplasm Staging , Prospective Studies , Recombinant Proteins , Treatment Failure , Uterine Cervical Neoplasms/pathology , Young Adult , Uterine Cervical Dysplasia/pathology
9.
Arch Gynecol Obstet ; 278(6): 525-30, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18343936

ABSTRACT

OBJECTIVE: Data from the literature demonstrate that the local and systemic immune responses seem to play an important role in the progression of cervical intraepithelial neoplasia (CIN). Our aim was to investigate whether recurrences among CIN III patients might be related to the presence of local lymphocytes, macrophage and enzyme iNOS. METHODS: We analyzed 35 patients with CIN III who underwent conization and followed up for a minimum of 4 years. Using immunohistochemistry, the presence of T lymphocytes (CD3, CD8 and CD45RO), B lymphocytes (CD20), macrophages (CD68) and the expression of the enzyme iNOS were investigated. The quantity of marked cells is graded as: 0, absence of cells; 1, rare cells; 2, moderate number of cells; 3, many cells. For statistical purposes, we took the scores 0 and 1 to indicate weak marking and the scores 2 and 3 to indicate strong marking. RESULTS: We found strong positive expression of CD3-positive T lymphocytes among CIN III patients with recurrence following conization (100 vs. 50% without recurrence, p=0.02). We did not find any statistical differences in the expression of CD20, CD68, CD45RO, CD8 or iNOS. CONCLUSIONS: It is concluded that strong positive findings of CD3 T lymphocytes were related to recurrence following conization due to CIN III.


Subject(s)
CD3 Complex/immunology , Neoplasm Recurrence, Local/immunology , T-Lymphocytes/immunology , Uterine Cervical Dysplasia/immunology , Uterine Cervical Neoplasms/immunology , Adult , B-Lymphocytes/enzymology , B-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/enzymology , CD8-Positive T-Lymphocytes/immunology , Female , Follow-Up Studies , Humans , Immunohistochemistry , Macrophages/enzymology , Macrophages/immunology , Middle Aged , Neoplasm Recurrence, Local/pathology , Nitric Oxide Synthase Type II/biosynthesis , T-Lymphocytes/enzymology , Uterine Cervical Neoplasms/enzymology , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/surgery , Young Adult , Uterine Cervical Dysplasia/enzymology , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/surgery
10.
Eur J Gynaecol Oncol ; 28(3): 236-8, 2007.
Article in English | MEDLINE | ID: mdl-17624097

ABSTRACT

Granulosa cell tumors account for approximately 1-2% of all ovarian tumors. There are two types: adult granulosa cell tumor and juvenile granulosa cell tumor. Juvenile granulosa cell tumors constitute 5% of this histological subtype, and the prognosis is good because the majority present as Stage I tumors. The treatment can consist of conservative surgery. Androgen production is rare and produces virilization in women. These tumors are usually solid or predominantly solid. We describe the case of a 13-year-old girl with androgenic manifestations and increased abdominal size. Her plasma testosterone level was elevated. A left adnexal cyst (14.4 x 9.1 x 9.7 cm) was revealed at pelvic ultrasonography. The patient underwent an exploratory laparotomy, revealing a left ovarian cystic tumor. Diagnosis was juvenile granulosa cell tumor.


Subject(s)
Granulosa Cell Tumor/pathology , Granulosa Cell Tumor/surgery , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , 17-alpha-Hydroxyprogesterone/blood , Adolescent , Female , Granulosa Cell Tumor/blood , Humans , Ovarian Neoplasms/blood , Testosterone/blood
11.
Parasitology ; 134(Pt 6): 789-96, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17288632

ABSTRACT

The mechanisms involved in the pathogenesis of chagasic megacolon are not completely characterized. Although autoimmunity may play a role in the pathogenesis of Chagas' disease, recent studies suggest a positive association of tissue parasitism, inflammation, and severity of lesions. The aim of this study was to evaluate the role of inflammatory cells and the occurrence of fibrosis in the colon of chagasic patients with and without megacolon. Samples from 26 patients were randomly selected and paraffin-embedded tissue blocks were sectioned and evaluated by histology and immunohistochemistry to analyse the occurrence and relation among eosinophils, mast cells, macrophages and fibrosis. Section analyses showed that the presence of eosinophils and mast cells in the analysed inflammatory cells has a direct correlation with fibrosis density in the chagasic megacolon. These data suggest that the megacolon's pathogenesis is based on a continuous process of cell damage. Our data propose that eosinophils, mast cells and macrophages may have a direct connection with the occurrence of fibrosis in the colon of chagasic patients. We believe that potential therapeutic agents against these cells could avoid the fibrosis process and contribute to prevent the development of chagasic megacolon.


Subject(s)
Chagas Disease/complications , Chagas Disease/pathology , Eosinophils/pathology , Macrophages/pathology , Mast Cells/pathology , Megacolon/etiology , Megacolon/pathology , Aged , Animals , Cell Count , Fibrosis , Humans , Middle Aged
12.
Clin Exp Obstet Gynecol ; 34(4): 219-22, 2007.
Article in English | MEDLINE | ID: mdl-18225682

ABSTRACT

BACKGROUND: Although the cytological finding of atypical squamous cells of undetermined significance (ASCUS) occurs in around 5% of women undergoing cytological screening, the clinical evolution is unknown. The objective of this study was to evaluate women with a diagnosis of ASCUS and compare the histological findings and clinical evolution over six and 12 months. METHODS: 1244 patients with ASCUS (two diagnostic cytologists) were evaluated in this study with Pap Smears and colposcopy (biopsy if necessary) at the first visit, and thereafter at second and third visits (6 and 12 months after the first visit). Comparisons were made between cytological findings and histological diagnoses at every visit during the study and during evolution. RESULTS: At the first visit, 60.3% of the biopsied patients presented histological findings of CIN I, 17.46% CIN II/III and 6.3% invasive neoplasia. At the second visit, 48.3% of the biopsied patients presented CIN I, 24.1% CIN II/III and none invasive neoplasia. At the third visit, 68.9% of the biopsied patients presented CIN I, 13.8% CIN II/III and none invasive carcinoma. If we consider all visits, a total of 213 colposcopy-guided biopsies were performed, representing 17.1% of all the patients included. Of these, 164 (13.2%) presented a histological diagnosis of cervical intraepithelial neoplasia (CIN) and eight (0.6%) presented with invasive carcinoma. CONCLUSION: We conclude that CIN or invasive lesions frequently occur in women with a diagnosis of ASCUS. Immediate review of the thin sections, new cytological tests or colposcopy and rigorous follow-up should be considered when making a diagnosis of ASCUS.


Subject(s)
Epithelial Cells/pathology , Papanicolaou Test , Uterine Cervical Dysplasia/pathology , Uterine Cervical Neoplasms/pathology , Vaginal Smears , Adult , Disease Progression , Female , Follow-Up Studies , Humans , Middle Aged , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Dysplasia/diagnosis
14.
Parasitology ; 131(Pt 5): 627-34, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16255821

ABSTRACT

Neuronal lesions have been considered the hallmark of chagasic megaesophagus, but the role of Trypanosoma cruzi and the participation of the inflammatory cells in this process are still debated. In the present study we counted neurons in the oesophagus from patients with and without megaesophagus and further examined these samples for the presence of parasite kDNA and cells with cytolytic potential (Natural Killer cells, cytotoxic lymphocytes and macrophages). The presence of parasite kDNA was demonstrated in 100% of cases with megaesophagus and in 60% of patients without megaesophagus. When analysed for the number of neurons, the patients without megaesophagus could be classified into 2 groups, as having normal or a decreased number of neurons. The former group did not show any inflammatory process, but interestingly, all patients without megaesophagus presenting decreased number of neurons also presented both parasite kDNA and inflammatory process in the organ. We further observed that the numbers of cytotoxic cells in the myenteric plexus region inversely correlate with the number of neurons. These data together strongly suggest that chronic lesions in chagasic megaesophagus might be a consequence of immune-mediated mechanisms, that last until the chronic phase of infection, and are dependent on the persistence of parasite in the host's tissue.


Subject(s)
Chagas Disease/pathology , Chagas Disease/parasitology , DNA, Kinetoplast/analysis , DNA, Kinetoplast/genetics , Esophageal Achalasia/complications , Neurons/pathology , Trypanosoma cruzi/genetics , Adult , Aged , Animals , Chagas Disease/complications , Esophageal Achalasia/parasitology , Esophagus/innervation , Esophagus/pathology , Humans , Inflammation/complications , Inflammation/parasitology , Inflammation/pathology , Middle Aged , Myenteric Plexus/parasitology , Myenteric Plexus/pathology
15.
Eur J Gynaecol Oncol ; 25(5): 587-90, 2004.
Article in English | MEDLINE | ID: mdl-15493171

ABSTRACT

PURPOSE OF INVESTIGATION: The hypothesis that cold-knife conization performed in women with high-grade squamous intraepithelial lesions (HSIL) and unsatisfactory colposcopy is a better procedure than the loop electrosurgical procedure (LEEP) is tested. METHODS: A retrospective study was conducted in conization specimens of women submitted to LEEP (n = 102) or conization (n = 245) due to HSIL. Age, biopsy, compromised surgical margins in conization, and recurrence were analysed. RESULTS: The frequency of invasion, non-compromised margins, and recurrence in conization and LEEP were, respectively, 7.7% versus 2.9%, 64.1% versus 48% (p = 0.008), and 33.8% versus 24.1%. Eight (42.1%) and five (26.3%) of 19 women submitted to conization where invasion was found in surgical specimens were, respectively, menopausal or had unsatisfactory colposcopy. Twenty-five (96.2%) of 26 and 23 (95.8%) of 24, respectively, undergoing conization and LEEP had recurrence in the first five years. CONCLUSION: We recommend the use of cold-knife conization in cases where the lesion is located deep in the cervical canal.


Subject(s)
Carcinoma, Squamous Cell/surgery , Colposcopy/methods , Conization/methods , Neoplasm Recurrence, Local/surgery , Uterine Cervical Dysplasia/surgery , Uterine Cervical Neoplasms/surgery , Adult , Biopsy/methods , Brazil/epidemiology , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Female , Humans , Medical Records , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Retrospective Studies , Treatment Outcome , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/pathology , Uterine Cervical Dysplasia/mortality , Uterine Cervical Dysplasia/pathology
16.
Eur J Gynaecol Oncol ; 25(5): 600-2, 2004.
Article in English | MEDLINE | ID: mdl-15493175

ABSTRACT

The purpose of this retrospective study was to determine the regression rate and management of low-grade squamous intraepithelial lesions (LSIL) in pregnancy. Seventy-four women with cytological findings of LSIL were analysed during the pregnant-puerperal period (until 12 months postpartum). Age, parity, cytological and colposcopic findings, route of delivery, and postpartum follow-up were studied. The age and parity of patients ranged (average) from 12 to 32 years (21.2 +/- 4.9), 0-5 (0.89 +/- 1.14), and 9-32 years (16.1 +/- 3.5), respectively. Thirty-nine of 55 (70.9%) and 12 of 19 (63.1%) pregnant women had normal cytology after vaginal delivery and caesarean section, respectively (p > 0.05). In postpartum, eight patients (10.8%) persisted with LSIL and ten (13.5%) presented high-grade squamous intraepithelial lesions. No case of unsatisfactory colposcopy and invasive carcinoma were found. LSIL during pregnancy has a high rate of regression, regardless of the route of delivery. Conservative management with colposcopic evaluation is proposed during gestation.


Subject(s)
Pregnancy Complications, Neoplastic/therapy , Uterine Cervical Dysplasia/therapy , Uterine Cervical Neoplasms/therapy , Adolescent , Adult , Brazil/epidemiology , Child , Colposcopy , Female , Humans , Medical Records , Postpartum Period , Pregnancy , Pregnancy Complications, Neoplastic/epidemiology , Pregnancy Complications, Neoplastic/pathology , Prenatal Care , Retrospective Studies , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/pathology , Vaginal Smears , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Dysplasia/pathology
17.
Arch Gynecol Obstet ; 266(3): 154-6, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12197555

ABSTRACT

Abnormal Papanicolaou smears has increased in adolescents. Our objective was to analyze the frequency of cervical intraepithelial neoplasia (CIN) in adolescents (< 20 years of age) over the last 12 years, comparing to adult (> or = 20 years of age). We studied 110,283 (10.85% of adolescents) reports from Papanicolaou smears between 1987 and 1999 in a public university hospital that has a screening program for cervical cancer prevention. The tests were divided into 3 periods (1987-1991, 1992-1995 and 1996-1999) for studying the evolution of frequencies. CIN I was more frequent among adolescents (1.73% vs. 0.99%) and CIN III and invasive cancer among adult women (0.62% vs. 0.05%, and 0.39% vs. 0.0083%, respectively). Between the periods 1987-1991 and 1996-1999 there was an increased in the frequency of CIN I among adolescents (from 0.78-2.17%) and adults (from 0.72-1.16%); CIN II decreased among adult patients (from 0.52-0.28%) and tripled among adolescents over recent years (from 0.15-0.47%), and CIN III increased in both group, although without statistical significance. One case of invasive carcinoma among adolescents occurred in the period from 1996-1999. We strongly recommend the inclusion of adolescent populations in the screening programs, from the time that they begin sexual activity.


Subject(s)
Papanicolaou Test , Uterine Cervical Dysplasia/diagnosis , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Vaginal Smears/statistics & numerical data , Adolescent , Adult , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/epidemiology , Female , Humans , Mass Screening , Retrospective Studies , Urban Population
18.
Sao Paulo Med J ; 119(6): 200-5, 2001 Nov 01.
Article in English | MEDLINE | ID: mdl-11723534

ABSTRACT

CONTEXT: Vaginitis is one of the principal motives that lead women to seek out an obstetrician or gynecologist. Bacterial vaginosis, candidiasis and trichomoniasis are responsible for 90% of the cases of infectious vaginitis. OBJECTIVE: To verify the frequency of the three main causative agents of vaginitis, Trichomonas vaginalis, Candida sp and Gardnerella vaginalis, in four different decades (1960's, 1970's, 1980's and 1990's). DESIGN: Retrospective. PLACE: A tertiary referral center. PARTICIPANTS: Patients attended to as gynecology and obstetrics outpatients at the Faculdade de Medicina do Triângulo Mineiro during the years 1968, 1978, 1988, 1998, taken as samples of each decade. MAIN MEASUREMENTS: Diagnoses of infection by Trichomonas vaginalis, Candida sp and Gardnerella vaginalis were gathered from 20,356 cervical-vaginal cytology tests on patients attended to as gynecology outpatients at Faculdade de Medicina do Triângulo Mineiro during the years 1968, 1978, 1988, 1998, representing the four decades. The results were grouped according to the age group of the patients: under 20, between 20 and 29, between 30 and 39, between 40 and 49, and 50 or over. Statistical analysis was done via the chi-squared (Mantel-Haentzel) test with a significance level of 5%. RESULTS: In 1968 infections by Trichomonas vaginalis and Candida sp were diagnosed in 10% and 0.5% of the cytology tests and in 1978, 5.1% and 17.3%, respectively (P < 0.0001). Infection by Gardnerella vaginalis could only be evaluated in the latter two decades. In 1988, 19.8% of the women had positive tests for Gardnerella vaginalis, which was the most frequent agent in that year, diminishing in the subsequent decade to 15.9% (P < 0.0001). Candidiasis was the most frequent infection in 1998, detected in 22.5% of the tests (P < 0.0001). In a general manner, all the infections were most frequent among younger patients, especially those aged under 20, in all decades, whereas infections were least frequent among patients aged 50 or over (P < 0.05). CONCLUSION: There was a reduction in the frequency of cervical-vaginal infection by Trichomonas vaginalis and an increase in the frequency of Candida sp over the four decades studied. All the infections were most frequent in patients aged under 20 years.


Subject(s)
Vaginal Smears , Vaginitis/microbiology , Adult , Animals , Brazil/epidemiology , Candida/isolation & purification , Candidiasis, Vulvovaginal/epidemiology , Female , Gardnerella vaginalis/isolation & purification , Humans , Middle Aged , Retrospective Studies , Trichomonas Vaginitis/epidemiology , Trichomonas vaginalis/isolation & purification , Vaginitis/epidemiology , Vaginosis, Bacterial/epidemiology , Vaginosis, Bacterial/microbiology
19.
Mem Inst Oswaldo Cruz ; 96(4): 545-8, 2001 May.
Article in English | MEDLINE | ID: mdl-11391429

ABSTRACT

We carried out a morphometric study of the esophagus of cross-bred dogs experimentally infected or consecutively reinfected with Trypanosoma cruzi 147 and SC-1 strains, in order to verify denervation and/or neuronal hypertrophy in the intramural plexus. The animals were sacrificed in the chronic stage, 38 months after the initial infection. Neither nests of amastigotes, nor myositis or ganglionitis, were observed in all third inferior portions of esophageal rings analyzed. No nerve cell was identified in the submucous of this organ. There was no significant difference (p>0.05) between the number, maximum diameter, perimeter, or area and volume of the nerve cells of the myenteric plexus of infected and/or reinfected dogs and of the non-infected ones. In view of these results we may conclude that the 147 and SC-1 strains have little neurotropism and do not determine denervation and/or hypertrophy in the intramural esophageal plexuses in the animals studied, independent of the reinfections.


Subject(s)
Chagas Disease/veterinary , Dog Diseases/pathology , Esophagus/innervation , Myenteric Plexus/pathology , Submucous Plexus/pathology , Animals , Chagas Disease/pathology , Dogs , Esophagus/pathology , Female , Male , Recurrence , Trypanosoma cruzi
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