ABSTRACT
No Brasil, o câncer de colo de útero é a segunda causa de morte por neoplasias malignas ginecológicas na mulher. É uma preocupação crescente para as pessoas infectadas pelo HIV. O câncer de colo de útero é considerado uma doença definidora de AIDS. Objetivos: Comparar a evolução de lesões HPV-induzidas de alto grau de colo uterino entre pacientes HIV+ e HIV-. Métodos: Incluídas pacientes HIV+ e HIV- de uma coorte após terem sido submetidas à conização e acompanhadas por até 10 anos do programa de rastreamento de lesões cervicais de alto grau do município de Itajaí SC e no Hospital AC Camargo SP, e seguidas por período de 10 anos. Realizou-se a avaliação da evolução das lesões HPV-induzidas em mulheres infectadas pelo HIV, em comparação com a população em geral. Os grupos foram comparados considerando-se variáveis de dados clínicos, cirúrgicos e anatomopatológicos. Estudadas as variáveis possivelmente confundidoras: idade no tratamento e ao final do seguimento, grau histológico da doença intraepitelial tratada, comprometimento de margens, adequação da colposcopia no seguimento, contagem de linfócitos CD4+, adesão a terapia antirretroviral e recorrência o diagnóstico histopatológico de LIEAG. Resultados: Das 195 pacientes, 51 eram HIV+ (26,2%) e 144 HIV- (73,8%). A idade da menarca e da sexarca foram mais precoces para as HIV+. Paridade e número de gestações em maior número para HIV+. A escolaridade foi menor para HIV+. O tabagismo foi mais frequente entre HIV+. Margem cirúrgica comprometida encontrada em 33,3% das HIV+ e em 16,7% das HIV-. Risco de recorrência de 37,3% HIV+ e 13,9% para HIV-. Sobrevida menor para HIV+. Conclusão: Mulheres HIV+ nesta coorte apresentaram risco de recorrência significativamente maior do que mulheres HIV+, além de menor sobrevida geral
Context: In Brazil, cervical-uterine cancer is the second leading cause of death from malignant neoplasms in women. It is a growing concern for people infected with HIV. Cervical cancer is considered an AIDS-defining disease. Objectives: To compare the evolution of high-grade HPV-induced cervical lesions between HIV+ and HIV- patients. Methods: HIV+ and HIV- patients were included in a cohort after undergoing EZT (excision of the transformation zone) in the period from: 01/01/2008 to 12/31/2017 participants in the high-grade cervical lesions screening program in the municipality of Itajaí SC and at Hospital AC Camargo SP for a period of 10 years. An evaluation of the evolution of HPV lesions induced in HIV-infected women was carried out, in comparison with the general population. The possibly confounding variables were studied: age at treatment and at the end of follow-up, histological grade of treated intraepithelial disease, compromised margins, adequacy of colposcopy during follow-up, CD4+ lymphocyte count, adherence to antiretroviral therapy and recurrence of the histopathological diagnosis of SAIL. Results: Of the 195 patients, 51 were HIV+ (26.2%) and 144 HIV- (73.8%). The age of menarche and sexarche were earlier for HIV+ women. Parity and number of pregnancies in greater numbers for HIV+. Schooling was lower for HIV+. Smoking was more frequent among HIV+. Compromised surgical margin found in 33.3% of HIV+ and 16.7% of HIV-. Recurrence risk of 37.3% for HIV+ and 13.9% for HIV-. Shorter survival for HIV+. Conclusion: HIV+ women in this cohort had a significantly higher risk of recurrence than HIV+ women, in addition to lower overall survival
Subject(s)
Uterine Cervical Neoplasms , HIV , PapillomaviridaeABSTRACT
OBJECTIVE: This study aimed to evaluate the effects of the methanol extract of Synadenium grantii Hook f. stems and its main isolated compound Query3,4,12,13-tetraacetylforbol-20-phenylacetate (1) on experimental dysmenorrhea in mice. METHODS: Female Swiss mice (n = 6-15) of 6-8 weeks old were used, selected according to the period of the estrous cycle. Animals in proestrus were treated intraperitoneally (i.p.) for 3 days with estradiol. They orally received, on the 4th day, S. grantii extract, the compound 1, ibuprofen or hyoscine butylbromide (Buscopan compound®). Then they were injected (i.p.) with oxytocin 1 h later and individually observed regarding the abdominal writhing for 45 min. The uterus was weighed, photographed and fixed in paraffin for histological analysis. KEY FINDINGS: The extract inhibited the abdominal writhing and similar results were obtained with compound 1 and the positive control drugs Ibuprofen and hyoscine butylbromide. Reduction of uterus volume and histological inflammatory parameters, such as oedema and leukocyte infiltrate, were observed in animals treated with the extract and compound 1. CONCLUSIONS: Our data show promising activity of the extract against dysmenorrhea, indicating important anti-inflammatory activity. Compound 1 appears to be, at least in part, the main responsible for this promising biological effect.
