Antimicrobial photodynamic therapy with Brazilian green propolis controls intradermal infection induced by methicillin-resistant Staphylococcus aureus and modulates the inflammatory response in a murine model.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of skin and soft tissue infections worldwide. This microorganism has a wide range of antibiotics resistance, a fact that has made the treatment of infections caused by MRSA difficult. In this sense, antimicrobial photodynamic therapy (aPDT) with natural products has emerged as a good alternative in combating infections caused by antibiotic-resistant microorganisms. The objective of the present study was to evaluate the effects of aPDT with Brazilian green propolis against intradermal MRSA infection in a murine model. Initially, 24 Balb/c mice were infected intradermally in the ears with 1.5 × 108 colony-forming units of MRSA 43300. After infection, they were separated into 4 groups (6 animals per group) and treated with the vehicle, only Brazilian green propolis, only blue LED light or with the aPDT protocol (Brazilian green propolis + blue LED light). It was observed in this study that aPDT with Brazilian green propolis reduced the bacterial load at the site of infection. Furthermore, it was able to inhibit weight loss resulting from the infection, as well as modulate the inflammatory response through greater recruitment of polymorphonuclear cells/neutrophils to the infected tissue. Finally, aPDT induced an increase in the cytokines IL-17A and IL-12p70 in the draining retromaxillary lymph node. Thus, aPDT with Brazilian green propolis proved to be effective against intradermal MRSA infection in mice, reducing bacterial load and modulating the immune response in the animals. However, more studies are needed to assess whether such effects are repeated in humans.

Characterization of Brazilian green propolis as a photosensitizer for LED light-induced antimicrobial photodynamic therapy (aPDT) against methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-intermediate Staphylococcus aureus (VISA).

Staphylococcus aureus is the primary cause of skin and soft tissue infections. Its significant adaptability and the development of resistance are the main factors linked to its spread and the challenges in its treatment. Antimicrobial photodynamic therapy emerges as a promising alternative. This work aimed to characterize the antimicrobial photodynamic activity of Brazilian green propolis, along with the key bioactive compounds associated with this activity. Initially, a scanning spectrometry was conducted to assess the wavelengths with the potential to activate green propolis. Subsequently, reference strains of methicillin-resistant Staphylococcus aureus (MRSA ATCC 43300) and vancomycin-intermediate Staphylococcus aureus (VISA ATCC 700699) were exposed to varying concentrations of green propolis: 1 µg/mL, 5 µg/mL, 10 µg/mL, 50 µg /mL and 100 µg/mL and were stimulated by blue, green or red LED light. Finally, high-performance liquid chromatography coupled with a diode array detector and tandem mass spectrometry techniques, along with classic molecular networking analysis, was performed to identify potential bioactive molecules with photodynamic activity. Brazilian green propolis exhibits a pronounced absorption peak and heightened photo-responsiveness when exposed to blue light within the range of 400 nm and 450 nm. This characteristic reveals noteworthy significant photodynamic activity against MRSA and VISA at concentrations from 5 µg/mL. Furthermore, the propolis comprises compounds like curcumin and other flavonoids sourced from flavone, which possess the potential for photodynamic activity and other antimicrobial functions. Consequently, Brazilian green propolis holds promise as an excellent bactericidal agent, displaying a synergistic antibacterial property enhanced by light-induced photodynamic effects.

Inflammaging and body composition: New insights in diabetic and hypertensive elderly men.

Age-related changes in the body's physiological responses play a critical role in systemic arterial hypertension (SAH) and type 2 Diabetes mellitus (T2DM). SAH and T2DM have clinically silent low-grade inflammation as a common risk factor. This inflammation has a relevant element, the excess of fatty tissue. In this scenario, little is known about how inflammatory markers interact with each other. Therefore, this work evaluated the interplay among anthropometric, biochemical, and inflammatory markers in the elderly with SAH and T2DM. Men aged 60-80 years old with SAH and T2DM were classified by body mass index (BMI) as eutrophic elderly (EE, 24 individuals) or overweight elderly (OE, 25 individuals). Body composition analysis was performed using bioimpedance. Blood samples were collected to perform inflammatory and biochemical evaluations. The cytokines IL-17A, IL-1ß, IFN-y, TNF-α, and IL-10, were evaluated by ELISA. Triglycerides, total and fractions of cholesterol, and glucose were measured by spectrophotometry. Overweight elderly men had a higher glycemic index and an increase in most anthropometric markers, as well as higher means for all pro-inflammatory cytokines analyzed (IL-17A, IL-1ß, IFN-y, and TNF-α) in comparison to their eutrophic elderly counterparts. However, there was a decrease in IL-10 anti-inflammatory cytokine and IL-10/IL-17A ratio compared to their eutrophic elderly counterparts. Although overweight elderly men have worsening inflammatory parameters, the magnitude of their correlations with anthropometric and biochemical parameters becomes less evident. The Bayesian networks highlight that in the eutrophic elderly, IL-17A and TNF-α are the cytokines most associated with interactions, and most of these interactions occur with biochemical parameters. It is worth highlighting the role of IFN-y in overweight elderly men. This cytokine influences IL-10 and TNF-α production, contributing to the inflammatory profile exacerbated in this group.

The sweet fuel of inflammation: New perspectives on the complex web that interconnects diabetes.

Due to the inflammatory nature of type 2 diabetes mellitus (T2DM) and the increased cardiovascular risk, there is a growing need for innovative strategies to change our identification and treatment approach to avoid clinical complications. One approach would be the use of circulating biomarkers to track disease progression and management. Thus, this study aimed to evaluate the concentrations of inflammatory biomarkers in patients diagnosed with type 2 diabetes mellitus and systemic arterial hypertension, correlating inflammatory cytokines and disease severity. Initially, 259 individuals were stratified into different degrees of disease: low risk, moderate risk, high risk, and very high risk, according to the European Society of Cardiology, which correlates blood pressure values with the presence of cardiovascular risk factors. For this stratification, analysis of body composition, blood pressure measurement, and questionnaires were applied. Blood was collected for biochemical measurements and for ELISA to detect concentrations of cytokines IL-17, IL-1ß, IFN-Y, TNF-α, and IL-10. The findings suggest that inflammation is present, contributing to the worsening of systemic arterial hypertension and type 2 diabetes mellitus. Through Bayesian analysis, we found that hyperglycemia plays a role in fueling inflammation, contributing to the maintenance of the state of dysregulation and persistent inflammation, which can contribute to systemic damage. Our work correlates biochemical, glycemic, body composition, blood pressure and inflammatory profiles, showing how they participate together in worsening the prognosis of patients diagnosed with chronic non-communicable diseases. We have seen that all these parameters can be changed with the practice of physical activity, even in conditions of obesity, hyperglycemia or dyslipidemia, when patients do not control the changes with standard pharmacological treatment. Thus, the management measures of these chronic non-communicable diseases must take into account the crosstalk between the systems, and the dysregulation of just one of these systems is enough to generate consequences in all the other systems.

Renal and cardiovascular repercussions in preeclampsia and their impact on fluid management: a literature review.

Preeclampsia is a multifactorial condition associated with significant morbidity and mortality. Fluid therapy in these patients is challenging since volume expansion may precipitate pulmonary edema, and fluid restriction may worsen renal function. Furthermore, cardiac impairment may introduce an additional component to the hemodynamic management. This article reviews the repercussions of preeclampsia on renal and cardiovascular systems and the development of pulmonary edema, as well as to discuss fluid management, focusing on the mitigation of adverse outcomes and monitoring alternatives. The literature review was carried out using PubMed, Embase, and Google Scholar databases from May 2019 to March 2020. Papers addressing the subjects of interest were included regardless of the publication language. There is a current trend towards restricting the administration of fluids in women with non-complicated preeclampsia. However, patients with preeclampsia may experience hemorrhagic shock, requiring volume resuscitation. In this case, hemodynamic monitoring is recommended to guide fluid therapy while avoiding complications.

Modelagem da vegetação aquática em estudos de dinâmica dos fluidos computacional / Modeling aquatic vegetation in computational fluid dynamics studies

RESUMO O objetivo deste trabalho foi apresentar, por meio da técnica dinâmica dos fluidos computacional (CFD), dois métodos utilizados nas representações conceitual e física da vegetação em meio aquático: meio poroso e elementos geométricos simplificados. Três estudos de caso, que incluem um wetland flutuante e manchas de vegetação, exemplificam a aplicação dos métodos, mostrando suas vantagens e desvantagens. Nas etapas da geometria e da malha, a representação da vegetação como meio poroso é mais simples, prática e rápida do que a da vegetação como elementos geométricos simplificados. Porém, na parte da modelagem das equações, o método do meio poroso não consegue capturar os processos de mistura no interior da vegetação, enquanto o método dos elementos geométricos simplificados consegue.

ABSTRACT The goal of this work was to present, through computation fluid dynamics (CFD), two methods used in the conceptual and physical representation of vegetation in aquatic environments: the porous media approach and the simplified geometric elements. Three case studies, including a floating wetland and patches of vegetation, exemplify how the methods are applied, showing their advantages and disadvantages. At the geometry and meshing stage, the porous media approach shows to be simpler, faster, and more practical than the simplified geometric elements. However, in the equation modeling, the porous media approach is not able to capture the mixing processes inside the vegetation, while the simplified geometric elements method can capture those processes.

Polycyclic aromatic hydrocarbons in soils and sediments in Southwest Nigeria.

Polycyclic Aromatic Hydrocarbons are strongly associated with agricultural, residential, transportation, and industrial activities. This study determined by GC-MS the concentration of 15 PAHs in soil and sediments at different sites from the Awotan-Asunle dumpsite area in the Southwestern region of Nigeria, which is one of the largest dumpsites in Africa. The sources of contamination, toxicity and associated risks for human health were also evaluated. Total PAHs concentrations were from 489 to 5616 µg kg-1, and 642-2159 µg kg-1, for soil and sediment, respectively. For soils, the highest values were observed for indeno[1,2,3-c,d]pyrene, coronene, and phenanthrene, while for sediments, the most abundant species were pyrene, fluoranthene and phenanthrene. Diagnostic ratios were used to determine the sources of PAHs and suggested that the compounds were mainly emitted from non-traffic sources. The total BaP-TEQ and BaP-MEQ for soils did not exceed the value recommended by the Canadian guideline since the country does not present guidelines. The analysis of incremental lifetime cancer risk was high mostly for dermal and ingestion exposures in the population. This study might provide valuable information regarding exposure to PAHs in soils of a Nigerian community.

Cost-Utility Analysis of Imaging for Surveillance and Diagnosis of Hepatocellular Carcinoma.

OBJECTIVE. The purpose of this study is to compare imaging-based surveillance and diagnostic strategies in patients at risk for hepatocellular carcinoma (HCC) while taking into account technically inadequate examinations and patient compliance. MATERIALS AND METHODS. A Markov model simulated seven strategies for HCC surveillance and diagnosis in patients with cirrhosis: strategy A, ultrasound (US) for surveillance and CT for diagnosis; strategy B, US for surveillance and complete MRI for diagnosis; strategy C, US for surveillance and CT for inadequate or positive surveillance; strategy D, US for surveillance and complete MRI for inadequate or positive surveillance; strategy E, surveillance and diagnosis with CT followed by complete MRI for inadequate surveillance; strategy F, surveillance and diagnosis with complete MRI followed by CT for inadequate surveillance; and strategy G, surveillance with abbreviated MRI followed by CT for inadequate surveillance or complete MRI for positive surveillance. Two compliance scenarios were evaluated: optimal and conservative. For each scenario, the most cost-effective strategy was based on a willingness-to-pay threshold of $50,000 (Canadian) per quality-adjusted life year (QALY). Sensitivity analyses were performed. RESULTS. Base-case analysis revealed that strategy E was the most cost-effective when compliance was optimal ($13,631/QALY), and strategy G was the most cost-effective when compliance was conservative ($39,681/QALY). Sensitivity analyses supported the base-case analysis in the optimal compliance scenario, but several parameters altered the most cost-effective strategy in the conservative compliance scenario. CONCLUSION. In an optimal compliance scenario, CT for HCC surveillance and diagnosis and complete MRI for inadequate CT was most cost-effective. In a conservative compliance scenario, abbreviated MRI may be an alternative to US-based surveillance.

O quarto de Jack: tecendo símbolos da relação primal à luz da teoria de Erich Neumann / 'Room': forging symbols from the primal relationship according to the Erich Neumann's theory / 'La Habitación': tejiendo símbolos de la relación primal a la luz de la teoría de Erich Neumann

Este ensaio propõe a análise simbólica da obra cinematográfica 'O quarto de Jack', entendendo-a como uma alegoria para explicitar a relação primal entre mãe e bebê, descrita por Neumann. Elementos dessa história, tais como a inconsciência do mundo externo pela criança e o período de isolamento em que se mantém circunscrito a seu mundo privado, semelhante a um útero psíquico, característico desta fase, levaram-nos a concluir que ela pode ser considerada um excelente representante simbólico desta teoria, tanto pelos aspectos visuais e linguísticos quanto pelo desenvolvimento cronológico (AU)

This essay suggests the symbolic analysis of the cinematographic work 'Room', as an allegory to explain the primal relationship between mother and baby, described by Neumann. Features to this novel - as the child's unconsciousness of the external world and the confinement in which his world is circumscribed, similar to a psychic uterus of this phase - led us to the conclusion that 'Room' can be considered an excelent symbolic nominee of this theory, as much by its visual and linguistic aspects as by the chronological development (AU)

Este ensayo propone un análisis simbólico de la obra cinematográfica 'La habitación', entendiéndola como una alegoría para explicitar la relación primal entre madre y bebé, descrita por Neumann. Características - tales como la inconsciencia del niño en relación al mundo externo y el período de aislamiento en que se mantiene circunscrito en su mundo privado, semejante al útero psíquico característico de esa fase - , nos han llevado a concluir que esta obra puede ser considerada una excelente representante simbólica de esa importante teoría, tanto por los aspectos visuales y lingüísticos, como por el desarrollo cronológico (AU)

Sequencing and comparative analysis of the Amblyomma sculptum mitogenome.

The mitogenome of Amblyomma sculptum was sequenced, providing important information for understanding the evolutionary relationships among species of the A. cajennense complex. The mitochondrial genome has a circular structure with 37 genes, including 13 coding DNA sequences, two ribosomal RNA genes (12S rRNA and 16S rRNA) and 22 tRNA genes. Comparative analysis with the mitogenomes of six reference species of the genus Amblyomma revealed that the ND5 gene, which is related to energy metabolism, and control regions 1 and 2 of the mitogenomes have polymorphisms that can be exploited as molecular markers to differentiate A. sculptum from other tick species in the Amblyomma cajennense complex as well as other Amblyomma species.

Safety of Human Papillomavirus 9-Valent Vaccine: A Meta-Analysis of Randomized Trials.

Vaccination against human papillomavirus (HPV) has been progressively implemented in most developed countries for approximately 10 years. In order to increase the protection of the vaccines, a 9-valent vaccine (HPV9) was developed, which provides protection against nine types of the virus. Studies evaluating its safety are rare. Thus, we performed a meta-analysis of three clinical trials assessing adverse effects on women randomly vaccinated with HPV9 or tetravalent vaccine (HPV4), with the objective of analyzing whether the HPV9 is as safe as HPV4. An electronic data search was performed through the PubMed, Embase, Scopus, Web of Science, and SciELO databases. The studies selected 27,465 women who received one of the two vaccines. Pain (OR 1.72; 95% CI 1.62-1.82) and erythema (OR 1.29; 95% CI 1.21-1.36) occurred significantly more in the HPV9 group. However, there was no significant difference between the groups for the following adverse effects: headache (OR 1.07; 95% CI 0.99-1.15), dizziness (OR 1.09; 95% CI 0.93-1.27), and fatigue (OR 1.09; 95% CI 0.91-1.30), and the occurrence of serious events related to vaccination was similarly rare among those vaccinated. Therefore, our findings demonstrate that HPV9 in female patients is as safe as the tetravalent vaccine.

Immunohistochemical expression of p16, Ki-67 and p53 in cervical lesions - A systematic review.

This study evaluated the immunohistochemical (IHC) expression of p16, p53 and Ki-67 in precancerous lesions and in cervical cancer (CC). Identification and review of publications assessing IHC expression in cervical intraepithelial neoplasia (CIN) and CC until February 15, 2017. Systematic review of studies in women with and without cervical lesions in order to evaluate whether there is overexpression of these biomarkers. A total of 28 publications met the criteria which included 6005 patients. The analysis showed that there is higher IHC expression of these biomarkers associated with the more severe lesions. Nineteen out of 22 evaluated studies have shown that there is a higher p16 expression in more severe lesions (CC), while in p53 expression only 4 out of the 9 studies showed a higher expression among more severe cases. Regarding the Ki-67 expression, it was observed that 9 out of 14 studies showed higher expression in more severe lesions. A complete absence of or just minimal IHC expression was observed in the normal cervical epithelium, whilst a significant increase in the expression of these biomarkers was detected according to the severity of lesions. Results suggest that these biomarkers can be considered useful tools for discriminating between the stages of the progressive cervical disease.

Isolation, biochemical characterization and antibiofilm effect of a lectin from the marine sponge Aplysina lactuca.

A new lectin was isolated from the marine sponge Aplysina lactuca (ALL) by combining ammonium sulfate precipitation and affinity chromatography on guar gum matrix. ALL showed affinity for the disaccharides α-lactose, ß-lactose and lactulose (Ka=12.5, 31.9 and 145.5M-1, respectively), as well as the glycoprotein porcine stomach mucin. Its hemagglutinating activity was stable in neutral acid pH values and temperatures below 60°C. ALL is a dimeric protein formed by two covalently linked polypeptide chains. The average molecular mass, as determined by Electrospray Ionization Mass Spectrometry (ESI-MS), was 31,810±2Da. ESI-MS data also indicated the presence of three cysteines involved in one intrachain and one interchain disulfide bond. The partial amino acid sequence of ALL was determined by tandem mass spectrometry. Eight tryptic peptides presented similarity with lectin I isolated from Axinella polypoides. Its secondary structure is predominantly ß-sheet, as indicated by circular dichroism (CD) spectroscopy. ALL agglutinated gram-positive and gram-negative bacterial cells, and it were able to significantly reduce the biomass of the bacterial biofilm tested at dose- dependent effect.

O quarto de Jack: tecendo símbolos da relação primal à luz da teoria de Erich Neumann / "Room": forging symbols from the primal relationship according to the Erich Neumann's Theory / "La Habitación": tejiendo símbolos de la relación primal a la luz de la teoría de Erich Neumann

Este ensaio propõe a análise simbólica da obra cinematográfica "O quarto de Jack", entendendo-a como uma alegoria para explicitar a relação primal entre mãe e bebê, descrita por Neumann. Elementos dessa história, tais como a inconsciência do mundo externo pela criança e o período de isolamento em que se mantém circunscrito a seu mundo privado, semelhante a um útero psíquico, característico desta fase, levaram-nos a concluir que ela pode ser considerada um excelente representante simbólico desta teoria, tanto pelos aspectos visuais e linguísticos quanto pelo desenvolvimento cronológico.

This essay suggests the symbolic analysis of the cinematographic work "Room", as an allegory to explain the primal relationship between mother and baby, described by Neumann. Features of this novel - as the child's unconsciousness of the external world and the confinement in which his world is circumscribed, similar to a psychic uterus of this phase - led us to the conclusion that "Room" can be considered an excellent symbolic nominee of this theory, as much by its visual and linguistic aspects as by the chronological development.

Este ensayo propone un análisis simbólico de la obra cinematográfica "La habitación", entendiéndola como una alegoría para explicitar la relación primal entre madre y bebé, descrita por Neumann. Características - tales como la inconsciencia del niño en relación al mundo externo y el período de aislamiento en que se mantiene circunscrito en su mundo privado, semejante al útero psíquico característico de esa fase -, nos han llevado a concluir que esta obra puede ser considerada una excelente representante simbólica de esa importante teoría, tanto por los aspectos visuales y lingüísticos, como por el desarrollo cronológico.

Qualidade de vida de pessoas com pé diabético / Quality of life of people with diabetic foot

Avaliar a qualidade de vida de pessoas com pé diabético e sua associação com idade e sexo. Métodos:estudo transversal realizado com pessoas com pé diabético atendidas na clínica vascular de um hospitalmunicipal. Foram utilizados questionários sociodemográfico, clínico, de estilo de vida e de avaliação de qualidadede vida SF-36. Resultados: amostra de 48 pessoas, maioria idosa (58,4%), sexo feminino (56,3%), não tabagista(93,7%), não etilista (83,4%), com reincidência das úlceras (50,0%), secreção presente (54,2%) e odor fétidoausente (81,3%). Quanto à qualidade de vida, o melhor resultado foi no domínio vitalidade e pior no domínioaspectos físicos. Todos os domínios, exceto a vitalidade, apresentaram escore abaixo de 50 na mensuração daqualidade de vida. Não houve diferença significante na comparação da qualidade de vida entre faixas etárias esexo. Conclusão: os participantes apresentaram domínios de qualidade de vida que tendem a um pior estadode saúde...

Assessing the impact of HAART on the incidence of defining and non-defining AIDS cancers among patients with HIV/AIDS: a systematic review.

After highly active antiretroviral therapy (HAART) became widespread, several studies demonstrated changes in the incidence of defining and non-defining AIDS cancers among HIV/AIDS patients. We conducted a systematic review of observational studies evaluating the incidence of malignancies before and after the introduction of HAART in people with HIV/AIDS. Eligible studies were searched up to December 2012 in the following databases: Pubmed, Embase, Scielo, Cancerlit and Google Scholar. In this study, we determined the cancer risk ratio by comparing the pre- and post-HAART eras. Twenty-one relevant articles were found, involving more than 600,000 people with HIV/AIDS and 10,891 new cases of cancers. The risk for the development of an AIDS-defining cancer decreased after the introduction of HAART: Kaposi's sarcoma (RR=0.30, 95% CI: 0.28-0.33) and non-Hodgkin's lymphoma (RR=0.52, 95% CI: 0.48-0.56), in contrast to invasive cervical cancer (RR=1.46, 95% CI: 1.09-1.94). Among the non-AIDS-defining cancers, the overall risk increased after the introduction of HAART (RR=2.00, 95% CI: 1.79-2.23). The incidence of AIDS-defining cancers decreased and the incidence of non-AIDS-defining cancers increased after the early use of HAART, probably due to better control of viral replication, increased immunity and increased survival provided by new drugs.

Impacto da configuração de entrada e saída sobre a mistura em reservatórios de armazenamento de água / Impact of inlet and outlet configurations on the mixing behavior in water storage tanks

O impacto na qualidade da água causado por reservatórios é usualmente negativo. Essa deterioração se deve, na maioria dos casos, a uma mistura de baixa qualidade, sendo esta fortemente influenciada pelas características de entrada e saída dos reservatórios. Com o intuito de avaliar esse impacto, quatro configurações de reservatório foram testadas (variando a posição da entrada e/ou saída) por meio da ferramenta Computional Fluid Dynamics (CFD). Através dos resultados foi demonstrado, usando como critério a maior concentração média no interior dos reservatórios, que a melhor configuração entre as testadas foi aquela que apresenta a entrada no topo e a saída no fundo.

The impact of water quality caused by storage reservoirs is usually negative. This deterioration of water quality, in most cases, is due to a mixture of low quality water, which is strongly influenced by the inlet and outlet of the reservoirs. In order to evaluate this impact, four reservoir configurations were tested (by varying the position of the inlet and/or outlet) by means of Computational Fluid Dynamics (CFD). The mean concentration inside the reservoirs demonstrated that the best configuration among those tested was the arrangement that presents the input at the top and the output at the bottom.

Relação entre ducha vaginal e vaginose bacteriana, doenças sexualmente transmissíveis e infecção por HIV: uma revisão sistemática / Relationship between vaginal douching and bacterial vaginosis, sexually transmitted diseases and HIV infection: a systematic review

Apesar de ducha vaginal estar fortemente condenada pela maioria dos profissionais de saúde; esta prática continua a ser um hábito muito comum entre as mulheres, por diversas razões. Objetivo: Avaliar se há relação entre a prática de duchas vaginais e vaginose bacteriana, DST e HIV.Métodos: Foi realizada uma revisão sistemática e meta-análise para avaliar a relação entre a ducha vaginal e vaginose bacteriana, doenças sexualmente transmissíveis e infecção pelo HIV. Os seguintes bancos de dados foram pesquisados utilizando descritores: PubMed, Embase, Scielo e Google Scholar.Os critérios de seleção: (1) estudos prospectivos de mulheres que usam ducha vaginal; (2) mulheres com 12 anos ou mais e (3) estudos publicados de 2000a outubro de 2011. Estudos envolvendo mulheres grávidas foram excluídos. A qualidade metodológica foi avaliada usando a escala de Newcastle-Ottawa.Coleta de dados e análise: Review Manager 5.1 foi utilizado para análise estatística. Resultados: Sete estudos (2 STD, 3 vaginose bacteriana e 2 HIV)foram incluídos com base nos critérios escolhidos: 9,796 mulheres foram incluídos. A razão de risco global para a vaginose bacteriana, DST e aquisição do HIV foram, (IC95% 1,12-1,43) 1,24 (IC95% 0,94-1,32) 1,12 e (IC95% 0,92-2,01) 1,36, respectivamente. Conclusão: Há poucos estudos para verificar a associação entre a ducha vaginal e STD, VB e infecção pelo HIV. Foi encontrada uma correlação positiva entre a ducha vaginal e vaginose bacteriana, mas não para DST e infecção pelo HIV

Despite of vaginal douching has been strongly condemned by most of health care professionals; this practice remains a very common habit among women for several reasons. Objective: To assess if there is any association between vaginal douching and bacterial vaginoses, STD and HIV Methods: We conducted a systematic review and metanalysis to evaluate the relation ship between vaginal douching and bacterial vaginosis, sexually transmitted diseases and HIV infection. The following databases were searched using Mesh terms: PubMed, Embase, Scielo and Google Scholar. Selection criteria: (1) prospective cohort studies of women using vaginal douching; (2) women 12 years or older and (3) studies published from 2000 to October2011. Studies involving pregnant women were excluded. Methodological quality was assessed using Newcastle-Ottawa scale. Data collection and analysis:Review Manager 5.1 was used for statistical analysis. Results: Seven studies (2 STD, 3 Bacterial Vaginosis and 2 HIV) were included based on the chosen criteria: 9.796 women were enrolled. The global Risk Ratios for Bacterial Vaginosis, STD and HIV acquisition were, 1.24 (95%CI 1.12?1.43), 1.12 (95%CI0.94?1.32), and 1.36 (95%CI 0.92?2.01) respectively. Conclusion: There are few studies checking the association between vaginal douching and STD, BVand HIV infection. A weak positive correlation was found between vaginal douching and bacterial vaginosis, but not to STD and HIV infection.

Comparative incidence of cancer in HIV-AIDS patients and transplant recipients.

BACKGROUND: Studies have found a relationship between decreased immunity and increased incidence of cancer. METHODS: A systematic review of observational studies evaluating the incidence of cancer in both organ recipients and people with HIV/AIDS compared with the general population. Eligible studies were searched up to March 2011 in the following databases: Pubmed, Embase, Scielo, Cancerlit and Google scholar. In this study, the standardized incidence ratios (SIR) of cancer in people with HIV/AIDS and of organ transplant recipients were compared with those found among the general population. RESULTS: Twenty-five studies of transplant and HIV-associated cancer risk, involving 866776 people with HIV/AIDS or organ recipients and 21260 new cases of cancer, were included. The risk for the development of new cancer cases was higher among people with HIV/AIDS (SIR=4, IC95% 3.78-4.24) and who received organs (SIR=3.28, IC95% 3.06-3.52) when compared with the general population. CONCLUSION: Similar SIR in both immunocompromised populations suggests that the weakened immune system is responsible for the increased risk of new cases of cancer among these groups. Research investments are needed to develop effective cancer prevention strategies in these populations.