What is the relationship between penile cancer and the microbiome? A scoping review.

INTRODUCTION: The microbiota is defined as the microorganisms in a particular environment. Conversely, the term microbiome is less firmly defined and is used to reference the habitat. OBJECTIVE: To identify the association between the microbiome and the penile cancer EVIDENCE ACQUISITION: We performed this scoping review according to the recommendations of the Joanna Briggs Institute. We found five articles that fulfilled the inclusion criteria. We focused on oncogenesis and factors that alter the penile microbiome. We were not limited to language or setting. We searched MEDLINE (Ovid), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS from inception to the present day. EVIDENCE SYNTHESIS: We found nine studies describing multiple factors that could disturb the microbiome, such as sexual behavior, anatomic alterations including circumcision, and inflammatory factors: lichen sclerosus, poor genital hygiene, compromised immune system, smoking, and HPV infection. CONCLUSION: Overall, knowledge of the composition of the penile microbiota and its role in penile cancer oncogenesis is minimal. PATIENT SUMMARY: Future studies should focus on the relationship between the microbiome and penile cancer to broaden this field of knowledge.

The early days of pandemic (H1N1) 2009 virus infection in the central region of Portugal.

BACKGROUND: The first case of pandemic (H1N1) 2009 virus infection was diagnosed in the central region of Portugal on June 16, 2009, in a woman infected in Canada. METHODS: The aim of our study was, first to characterize the clinical and epidemiologic aspects of all the patients with clinical manifestations included in the definition of case for investigation with samples submitted to diagnosis of the pandemic (H1N1) 2009 virus infection, in the central region of Portugal; second to assess the precision of the case definition of case for investigation considered in the study according to the presence or the absence of fever at the moment of clinical observation. We reviewed the medical records of all the patients presenting with Influenza like-illness classified as case for investigation and the first cases of patients infected with the new pandemic (H1N1) 2009 virus, diagnosed in the central region of Portugal during the pandemic period between June and August, 2009, were analyzed. Real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) testing was used to confirm the pandemic (H1N1) 2009 virus infection. Data collection was performed on a standardized paper format in agreement with the General Health Directorate. RESULTS AND DISCUSSION: Pandemic (H1N1) 2009 virus infection was confirmed in 255 patients. Overall, median age was 23 years and 42.7 % were included in the category of 20 to 29 years. Confirmed infection in patients with less than 2 years or greater than 50 years was a rare event. The first cases were imported from Europe, namely France, Spain and England. On a second phase, pandemic (H1N1) 2009 virus infection was acquired in the south of Portugal (Algarve), before de diagnosis of the first domestic case. The incidence rate for pandemic (H1N1) 2009 virus infection was 10.7 per 100,000 persons and was different according to the district. It was higher in the district of Coimbra and Guarda were the main roads connecting to Europe are. The median calculated incubation period for the for pandemic (H1N1) 2009 virus infection was 2 days. The length of the clinical manifestations until the patients look for medical observation had a median time of 2 days. All the cases were of mild to moderate severity. No deaths were observed. CONCLUSIONS: The early days of pandemic (H1N1) 2009 virus infection was mild in our region. Most affected patients were young adults, with the extreme categories ages of life being spared. Early detection and diagnosis, combined with stringent isolation and treatment procedures could have slowed the spread of the infection in our region.

Retención urinaria aguda por migración uretral de proyectil de arma de fuego / Acute urinary retention secondary to the migration of a shotgun projectile

Presentamos el caso clínico de un paciente masculino de 42 años quien sufrió herida por proyectil de arma de fuego con orificio de entrada localizado en región glútea derecha, quien posteriormente presentó retención urinaria por el proyectil, requiriendo para su resolución uretrotomia abierta. Es un caso infrecuente, probablemente secundario a las fuerzas de cavitación del proyectil, y que podría pasarse por alto si solo se consideran las lesiones habituales en estos pacientes

Molecular epidemiology and prevalence of drug resistance-associated mutations in newly diagnosed HIV-1 patients in Portugal.

BACKGROUND: Drug resistance transmission in newly diagnosed, drug-naïve HIV-1 infected individuals has been previously reported, with rates ranging from 5 to 27%. The aim of this study is to investigate the prevalence of resistance-associated mutations in drug-naïve, newly diagnosed patients, as well as monitoring the diversity of HIV-1 strains circulating in Portugal. METHODS: One hundred eighty samples from newly diagnosed patients were prospectively collected during 2003, according to the distribution of HIV-1 infections in Portugal. Epidemiological, clinical and laboratory data was collected using a standardized form. Population sequencing was performed using an automated sequencer (ABI Prism 3100, Applied Biosystems) and a commercially available assay (ViroSeq HIV-1 Genotyping System, v2.0, Abbott). Stanford HIV Sequence Database was used for interpretation of resistance data; subtyping was performed using the REGA Subtyping Tool. When subtype was unassigned, further analysis was done using an alignment with reference sequences, and phylogenetic tools like Simplot and PHYLIP. Mutations listed by the International AIDS Society-USA were considered, except E44D and V118I. RESULTS: Patient population included 124 males (69%) and 56 females (31%), the median age being 35. Western Europe was the main region of origin (77.2%), followed by Africa (18.3%), South America (2.8%) and Asia (1.1%). The most common route of transmission was heterosexual contact (54.4%), followed by intravenous drug use (20%), homo/bisexual individuals (19.4%) and blood transfusion (0.6%). The commonest subtypes were B (41.7%) and G (29.4%), while other non-B subtypes rated 12.8% and recombinant forms represented 16.1% of the samples. Fourteen patients (7.78%) were identified as carrying resistance-associated mutations. Ten were resistant to drugs from one class, three to drugs from two classes and one to drugs from all three classes. No statistically significant associations were found between age, gender, route of transmission, subtype and resistance. CONCLUSIONS: The identification of newly diagnosed individuals carrying resistance-associated mutations confirms that drug resistance transmission is a public health problem in Portugal, with a possible impact on prevention, treatment and monitoring of HIV-1 infections.

Frequência de enteroparasitas em amostras fecais de cães e gatos dos municípios do Rio de janeiro e Niterói / Frequency of enteric parasites in fecal samples of dogs and cats in Rio de Janeiro and Niterói

Foram analisadas 252 amostras de fezes de cães e gatos provenientes dos municípios do Rio de Janeiro e Niterói no período de 1999 a 2000. Foram 212 (84,12

Freqüência de enteroparasitas em amostras fecais de cães e gatos dos municípios do Rio de Janeiro e Niterói

Foram analisadas 252 amostras de fezes de cães e gatos provenientes dos municípios do Rio de Janeiro e Niterói no períodode 1999 a 2000. Foram 212 (84,12%) amostras de cães e 40 (15,87%) de gatos. Do total de amostras examinadas 81(32,14%), foram positivas para pelo menos uma espécie de parasita. Dos 212 exames de material fecal canino, 70 (33,01%)estavam positivos e de felinos 11 (27,5%). As infecções mistas foram observadas em 10 amostras caninas (14,28%) e quatrofelinas (36,36%). Nas amostras caninas, ovos de ancilostomídeos foram os mais encontrados em 43 (61,43%) amostras,enquanto os coccídeos foram mais freqüentemente observados nas fezes de felinos em três (27,27%) amostras. Quanto àidade dos animais, 37 (52,85%) amostras positivas eram provenientes de animais com mais de 1 ano de idade, indicandoprovável vermifugação dos filhotes, enquanto nos gatos a faixa etária mais parasitada foi de menos de seis meses, com 7(63,63%) positivos.

Human immunodeficiency virus type 1 recombinant B/G subtypes circulating in Coimbra, Portugal.

An increasing prevalence of HIV-1 non-B variants is being noticed in several European regions, particularly in countries such as Portugal, which have closer contacts with African endemic areas, where multiple HIV subtypes cocirculate. HIV-1 subtyping by phylogenetic analyses of reverse transcriptase, protease and env (C2-V3) genomic regions was carried out in plasma collected from 18 HIV-1-infected subjects living in Coimbra, Portugal, and suspected to be infected with non-B variants. Three (16.7%) subjects carried recombinant B/G viruses (BV3/BRT/Gpro; GV3/URT/Bpro; AV3/GRT/Bpro), whereas all the remaining individuals were infected with HIV-1 subtype B. This is the first report of recombinant B/G subtypes in Portugal.

[The treatment of cytomegalovirus retinitis in human immunodeficiency virus infection]. / Tratamento da retinite pelo virus citomegálico na infecção pelo vírus da imunodeficiência humana.

Most of the patients with immunodeficiency virus infection (75%-85%) are coinfected with cytomegalovirus. It is estimated that cytomegalovirus disease develops in 45% of them, mainly those presenting low CD4 cell counts (< 100/mm3). Retinitis is the most common manifestation of reactivated cytomegalovirus disease (85%), followed by other extra ocular sites (central nervous system, lungs, gastrointestinal system, adrenal glands, etc.). The particularly high incidence of cytomegalovirus retinitis, the difficulties concerning its therapeutical approach and the relatively unsatisfactory results, justify this review, according to the new treatment options presented in recent literature.