Developing One Health surveillance systems.

The health of humans, domestic and wild animals, plants, and the environment are inter-dependent. Global anthropogenic change is a key driver of disease emergence and spread and leads to biodiversity loss and ecosystem function degradation, which are themselves drivers of disease emergence. Pathogen spill-over events and subsequent disease outbreaks, including pandemics, in humans, animals and plants may arise when factors driving disease emergence and spread converge. One Health is an integrated approach that aims to sustainably balance and optimize human, animal and ecosystem health. Conventional disease surveillance has been siloed by sectors, with separate systems addressing the health of humans, domestic animals, cultivated plants, wildlife and the environment. One Health surveillance should include integrated surveillance for known and unknown pathogens, but combined with this more traditional disease-based surveillance, it also must include surveillance of drivers of disease emergence to improve prevention and mitigation of spill-over events. Here, we outline such an approach, including the characteristics and components required to overcome barriers and to optimize an integrated One Health surveillance system.

Cardiovascular disease risk among male workers of a regional electricity distribution company in Brazil.

BACKGROUND: At energy distribution companies, office and operational employees work in different occupational environments. Cardiovascular diseases (CVD) can develop due to occupational factors and can often lead to morbidity and disability. OBJECTIVE: To evaluate the risk of CVD in workers with different occupations in an energy distribution company, using cardiometabolic indices. METHODS: Workers (men), aged between 20 and 70 years, were divided into two groups: operational (n = 78) and office (n = 106) workers. Their metabolic profiles were analyzed using anthropometric and laboratory data to obtain the atherogenic plasma index (AIP) and insulin resistance index (TyG), and to identify the hypertriglyceridemic waist (HTGW) phenotype as cardiometabolic indicators. RESULTS: There was no difference in CVD risk between the two groups. However, 82% of the test subjects presented a high risk for the development of atherosclerosis based on the AIP, and 11.4% presented the HTGW phenotype, along with the presence of dyslipidemia, insulin resistance, and being overweight as risk factors for CVD. CONCLUSIONS: Although the identified risk factors are not related to the type of occupation at work, companies in the electricity sector can invest in the implementation of measures for health promotion to protect and prevent diseases and improve labor productivity and quality.

A retrospective study of porcine reproductive and respiratory syndrome virus infection in Brazilian pigs from 2008 to 2020.

Porcine reproductive and respiratory syndrome (PRRS) is a viral disease characterized by reproductive impairment or failure in breeding animals, and a respiratory disease in pigs of any age. Brazil is the fourth largest pork producer and exporter globally, and PRRS virus (PRRSV) infection has never been reported in the country. This study aimed to investigate the status of porcine biological samples from commercial swine herds, quarantined imported boars, wild boars and feral pigs to update PRRS information in Brazil. A total of 14,382 samples were collected from 2008 to 2020, including sera (n = 12,841), plasma (n = 1,000) and oral fluids (n = 541), comprehending 137 herds and free-living pigs in eight Brazilian states. One out of 1,000 (0.1%) plasma and 15 out of 12,841 (0.11%) serum samples tested positive for PRRSV antibodies through ELISA. Upon ELISA retesting, only the plasma sample, from one 8-day-old piglet remained positive. All sixteen previously PRRSV antibody-positive samples were tested through RT-PCR and found to be negative. The presence of false-positive or singleton reactors are quite expected. Thus, the use of different/alternative diagnostic tests is indicated for an efficient PRRSV detection. Taken together, our findings demonstrated no conclusive evidence of PRRSV infection in the tested pigs, highlighting the importance to reinforce the surveillance program to prevent the introduction and eventual dissemination of PRRSV in Brazil.

Investigation of hemotropic Mycoplasmas in fetuses and sows with reproductive failure.

Swine eperythrozoonosis or porcine hemoplasmosis is an infectious disease caused mainly by Mycoplasma suis and is distributed worldwide. This study investigated the occurrence of porcine hemothropic mycoplasmas (PHMs) in fetuses and sows with reproductive failure. Two hundred and seventy-six samples (80 sows' blood and 196 fetal tissue samples) from 27 farms with reproductive disorders were evaluated. The PHMs DNA was detected in 15 out of 80 (18.7%) sows but it was not detected in the fetuses. The bacterial load ranged from 1.32 × 102 to 2.61 × 105 copies/µL. From the 27 tested herds, 11 (40.7%) showed at least one positive sow per farm. The majority of the reproductive problems observed in PMHs positive sows were stillborn fetuses (46.7%) and stillborn associated with fetal mummification (26.7%). So, we evidenced that porcine hemoplasmas circulate among sows in Brazilian herds, however, its real impact on reproductive problems remains unknown.

Analysis of the surgical management of patients with recurrent cervical cancer after radiotherapy and chemotherapy. / Análise do manejo cirúrgico de pacientes com câncer cervical recidivado após radioterapia e quimioterapia.

OBJECTIVE: To analyze the results of morbidity and survival after curative and palliative surgery in recurrent cervical cancer patients who underwent chemoradiation as their primary treatment. Another goal was to assess the factors associated with curative and non-curative procedures. METHODS: This was a retrospective cohort consisting of patients undergoing surgery curative and palliative from January 2011 to December 2017 at a high complexity oncology center. Outcome of morbidity was reported according to the Clavien-Dindo classification, and survival analysis was carried out using the Kaplan-Meir method. To assess the factors associated with the procedures, a univariate analysis using the Mann-Whitney U test was performed. RESULTS: Two radical hysterectomies, three pelvic exenterations with curative intent, and five palliatives pelvic exenterations were performed. In the curative group, there were major complications in 40% of the cases, and the median survival time was 16 months. In the palliative group, there were major complications in 60% of the cases, and the median survival time was 5 months. Advanced staging (p-value= 0.02), symptoms (p-value=0.04), tumor size greater than five centimeters (p-value=0.04), and more than three organs involved (p-value=0.003) were factors significantly associated with non-curative surgery. CONCLUSIONS: The morbidity rates of this study were higher in palliative group, and the median survival time was lower in the palliative group than the curative group, but this difference in survival was not statistically significant. Advanced stage, symptoms, tumor size and number of organs involved are factors that should be taken into consideration when indicating surgical salvage.

OBJETIVOS: Analisar os resultados de morbidade e sobrevida após cirurgias curativas e paliativas em pacientes com câncer cervical recidivado após tratamento primário com radioterapia e quimioterapia. Outro objetivo foi avaliar os fatores associados aos procedimentos curativos e não curativos. MÉTODOS: Coorte retrospectiva de pacientes submetidos à cirurgias curativas e paliativas, entre janeiro de 2011 a dezembro de 2017, em um centro de alta complexidade em oncolologia. O desfecho da morbidade foi relatado de acordo com a classificação de Clavien-Dindo e a análise de sobrevida foi realizada pelo método de Kaplan-Meir. Para avaliar os fatores associados aos procedimentos, foi realizada análise univariada pelo teste U de Mann-Whitney. RESULTADOS: Foram realizadas duas histerectomias radicais, três exenterações pélvicas com intenção curativa e cinco exenterações pélvicas paliativas. No grupo curativo, houve complicações maiores em 40% dos casos, e o tempo mediano de sobrevida foi 16 meses. No grupo paliativo, houve complicações maiores em 60% dos casos, e o tempo mediano de sobrevida foi 5 meses. Estadiamento avançado (p=0,02), sintomas (p=0,04), tamanho do tumor maior que cinco centímetros (p=0,04) e mais de três órgãos envolvidos (p=0,003) foram fatores significativamente associados a cirurgia não curativa. CONCLUSÕES: As taxas de morbidade foram maiores no grupo paliativo, e o tempo mediano de sobrevida foi menor no grupo paliativo do que no grupo curativo, entretanto esta diferença na sobrevida não teve significância estatística. Estádio avançado, sintomas, tamanho tumoral e número de órgãos envolvidos são fatores que devem ser levados em consideração na indicação de resgate cirúrgico.

Peeling with 70% glicolic acid followed by 5% 5-fluorouracil as well as 5% 5-fluorouracil cream are effective methods for the treatment of actinic keratoses on upper limbs: A randomized clinical trial.

The 5% 5-fluorouracil (5-FU) cream, considered the gold standard topical treatment, and peeling using 70% glycolic acid (GA) followed by 5% 5-FU are methods for the treatment of actinic keratoses (AKs). However, the comparison of these two treatments had not yet been described and therefore was the objective of this study. A randomized clinical trial, intrapatient study in which 17 patients received a type of treatment in the right and left upper limb with 5% 5-FU cream (twice daily) or a peeling application of 70% GA (every 15 days) followed by 5% 5-FU cream. There was a significant reduction of 75% and 85.71% in the mean number of AK lesions and of 74.5% and 85.71% in the size of lesions on the upper limbs of patients treated with peeling and 5% 5-FU cream (P-value ≤.001), respectively. Neither treatment was superior to the other since there was no significant difference (P-value ≥.05) between the treatments, both at the post-intervention period as well as when comparing the difference between the pre and post-intervention periods. The peeling with 70% GA followed by 5% 5-FU as well as 5% 5-FU cream are effective methods for the treatment of AKs on upper limbs.

Análise do manejo cirúrgico de pacientes com câncer cervical recidivado após radioterapia e quimioterapia / Analysis of the surgical management of patients with recurrent cervical cancer after radiotherapy and chemotherapy

RESUMO Objetivos: Analisar os resultados de morbidade e sobrevida após cirurgias curativas e paliativas em pacientes com câncer cervical recidivado após tratamento primário com radioterapia e quimioterapia. Outro objetivo foi avaliar os fatores associados aos procedimentos curativos e não curativos. Métodos: Coorte retrospectiva de pacientes submetidos à cirurgias curativas e paliativas, entre janeiro de 2011 a dezembro de 2017, em um centro de alta complexidade em oncolologia. O desfecho da morbidade foi relatado de acordo com a classificação de Clavien-Dindo e a análise de sobrevida foi realizada pelo método de Kaplan-Meir. Para avaliar os fatores associados aos procedimentos, foi realizada análise univariada pelo teste U de Mann-Whitney. Resultados: Foram realizadas duas histerectomias radicais, três exenterações pélvicas com intenção curativa e cinco exenterações pélvicas paliativas. No grupo curativo, houve complicações maiores em 40% dos casos, e o tempo mediano de sobrevida foi 16 meses. No grupo paliativo, houve complicações maiores em 60% dos casos, e o tempo mediano de sobrevida foi 5 meses. Estadiamento avançado (p=0,02), sintomas (p=0,04), tamanho do tumor maior que cinco centímetros (p=0,04) e mais de três órgãos envolvidos (p=0,003) foram fatores significativamente associados a cirurgia não curativa. Conclusões: As taxas de morbidade foram maiores no grupo paliativo, e o tempo mediano de sobrevida foi menor no grupo paliativo do que no grupo curativo, entretanto esta diferença na sobrevida não teve significância estatística. Estádio avançado, sintomas, tamanho tumoral e número de órgãos envolvidos são fatores que devem ser levados em consideração na indicação de resgate cirúrgico.

ABSTRACT Objectives: To analyze the results of morbidity and survival after curative and palliative surgery in recurrent cervical cancer patients who underwent chemoradiation as their primary treatment. Another goal was to assess the factors associated with curative and non-curative procedures. Methods: This was a retrospective cohort consisting of patients undergoing surgery curative and palliative from January 2011 to December 2017 at a high complexity oncology center. Outcome of morbidity was reported according to the Clavien-Dindo classification, and survival analysis was carried out using the Kaplan-Meir method. To assess the factors associated with the procedures, a univariate analysis using the Mann-Whitney U test was performed. Results: Two radical hysterectomies, three pelvic exenterations with curative intent, and five palliatives pelvic exenterations were performed. In the curative group, there were major complications in 40% of the cases, and the median survival time was 16 months. In the palliative group, there were major complications in 60% of the cases, and the median survival time was 5 months. Advanced staging (p-value= 0.02), symptoms (p-value=0.04), tumor size greater than five centimeters (p-value=0.04), and more than three organs involved (p-value=0.003) were factors significantly associated with non-curative surgery. Conclusions: The morbidity rates of this study were higher in palliative group, and the median survival time was lower in the palliative group than the curative group, but this difference in survival was not statistically significant. Advanced stage, symptoms, tumor size and number of organs involved are factors that should be taken into consideration when indicating surgical salvage.

Transvaginal ultrasound in deep endometriosis: pictorial essay.

Endometriosis is characterized by the presence of endometrial tissue outside the uterus. When endometrial implants penetrate more than 5 mm into the peritoneum, the condition is referred to as deep pelvic endometriosis. Although laparoscopy is the gold standard test to establish a diagnosis of deep endometriosis, transvaginal ultrasound represents an alternative that can contribute to detection of the disease, because it is an accessible, low-cost, noninvasive examination that allows preoperative planning in cases requiring surgical treatment. However, in clinical practice, transvaginal ultrasound is still not widely used as the first-line examination in suspected cases of endometriosis. This essay describes the findings of deep endometriosis on transvaginal ultrasound, in order to disseminate knowledge of the utility of the technique for the diagnosis of this disease.

A endometriose é caracterizada pela presença de tecido endometrial fora do útero. Quando os implantes endometriais penetram mais de 5 mm no peritônio, são definidos como endometriose pélvica profunda. O exame padrão ouro para estabelecer seu diagnóstico é a laparoscopia, mas a ultrassonografia transvaginal pode contribuir na detecção da doença, por ser um exame acessível, de menor custo, não invasivo e por possibilitar o planejamento pré-operatório nos casos em que é necessário o tratamento cirúrgico. Entretanto, este método como primeiro exame a ser solicitado na suspeita de endometriose precisa ser mais considerado na prática clínica. Este ensaio descreve os achados da endometriose profunda na ultrassonografia transvaginal, com o intuito de difundir a importância da técnica para o diagnóstico dessa doença.

Transvaginal ultrasound in deep endometriosis: pictorial essay / Ultrassonografia transvaginal na endometriose profunda: ensaio iconográfico

Abstract Endometriosis is characterized by the presence of endometrial tissue outside the uterus. When endometrial implants penetrate more than 5 mm into the peritoneum, the condition is referred to as deep pelvic endometriosis. Although laparoscopy is the gold standard test to establish a diagnosis of deep endometriosis, transvaginal ultrasound represents an alternative that can contribute to detection of the disease, because it is an accessible, low-cost, noninvasive examination that allows preoperative planning in cases requiring surgical treatment. However, in clinical practice, transvaginal ultrasound is still not widely used as the first-line examination in suspected cases of endometriosis. This essay describes the findings of deep endometriosis on transvaginal ultrasound, in order to disseminate knowledge of the utility of the technique for the diagnosis of this disease.

Resumo A endometriose é caracterizada pela presença de tecido endometrial fora do útero. Quando os implantes endometriais penetram mais de 5 mm no peritônio, são definidos como endometriose pélvica profunda. O exame padrão ouro para estabelecer seu diagnóstico é a laparoscopia, mas a ultrassonografia transvaginal pode contribuir na detecção da doença, por ser um exame acessível, de menor custo, não invasivo e por possibilitar o planejamento pré-operatório nos casos em que é necessário o tratamento cirúrgico. Entretanto, este método como primeiro exame a ser solicitado na suspeita de endometriose precisa ser mais considerado na prática clínica. Este ensaio descreve os achados da endometriose profunda na ultrassonografia transvaginal, com o intuito de difundir a importância da técnica para o diagnóstico dessa doença.

Porcine parvovirus VP1/VP2 on a time series epitope mapping: exploring the effects of high hydrostatic pressure on the immune recognition of antigens.

Porcine parvovirus (PPV) is a DNA virus that causes reproductive failure in gilts and sows, resulting in embryonic and fetal losses worldwide. Epitope mapping of PPV is important for developing new vaccines. In this study, we used spot synthesis analysis for epitope mapping of the capsid proteins of PPV (NADL-2 strain) and correlated the findings with predictive data from immunoinformatics. The virus was exposed to three conditions prior to inoculation in pigs: native (untreated), high hydrostatic pressure (350 MPa for 1 h) at room temperature and high hydrostatic pressure (350 MPa for 1 h) at - 18 °C, and was compared with a commercial vaccine produced using inactivated PPV. The screening of serum samples detected 44 positive spots corresponding to 20 antigenic sites. Each type of inoculated antigen elicited a distinct epitope set. In silico prediction located linear and discontinuous epitopes in B cells that coincided with several epitopes detected in spot synthesis of sera from pigs that received different preparations of inoculum. The conditions tested elicited antibodies against the VP1/VP2 antigen that differed in relation to the response time and the profile of structurally available regions that were recognized.

Serological surveillance and factors associated with influenza A virus in backyard pigs in Southern Brazil.

Backyard pig populations are not monitored for influenza A virus (IAV) in Brazil and there are limited data about seroprevalence and risk factors in these populations. Our goal was to assess possible factors associated with IAV seroprevalence in backyard pig populations using an indirect ELISA protocol based on a recombinant nucleoprotein. Following the IAV screening using NP-ELISA, subtype-specific serology based on hemagglutination inhibition (HI) assay of the ELISA-positive pigs was conducted. The survey comprised a total of 1,667 sera samples collected in 2012 and 2014 in 479 holdings and the estimated seroprevalence was 5.3% (3.84%-7.33%) and 2.3% (1.34%-3.71%) in the respective years. In both years, H1N1pdm09 was the most prevalent subtype. The multivariable analysis showed main factors such as "age," "sex," "number of suckling pigs" and "neighbours raising pigs" that presented the greatest effect on IAV seroprevalence in these pig populations. These factors may be associated with the low biosecurity measures and management of backyard holdings. In addition, the low IAV seroprevalences found in these backyard pig populations could be related to a low number of animals in each pig holding and low animal movement/replacement that do not favour IAV transmission dynamics. This low frequency of H1N1pdm09 seropositive pigs could also be due to sporadic human-to-pig transmission of what is now a human seasonal influenza A virus; however, these factors should be explored in future studies. Herein, these results highlight the importance of IAV continued surveillance in backyard pig holdings, since it is poorly known which IAVs are circulating in these populations and the risk they could pose to public health and virus transmission to commercial farms.

Clinical features, socio-demographic profile and ultrasound findings in women with endometriosis symptoms / Características clínicas, perfil sociodemográfico e achados ecográficos em mulheres com sintomas de endometriose

AIMS: To describe clinical and socio-demographic features, as well as transvaginal ultrasound results, of women with endometriosis symptoms. METHODS: A prospective cross-sectional study included patients who had at least one of the following symptoms: dyspareunia, dysmenorrhea, chronic pelvic pain, infertility, and urinary or bowel cyclic symptoms. The sample comprised women treated in a private gynecology clinic located in a small city in southern Brazil, from March to November 2016. All the participants, after signed an informed consent, were subjected to clinical anamnesis, transvaginal ultrasound with bowel preparation, and examination for the CA-125 antigen serum level. Association between two qualitative variables was assessed through Pearson's Chi-Square or Fisher's exact tests. Mean values of quantitative variables were compared through the two-tailed Student's t-test for independent samples. Significance level was set as p<0.05. RESULTS: A total of 85 women, aged 18-49 years, participated in the study. Most were married (75.3%), with children (51.8%), showed no family history of endometriosis (89.4%), had no knowledge about endometriosis (77.6%) and completed high school (43.5%). Ultrasound findings suggested endometriosis in 25 (29.4%) women. Dysmenorrhea was the most prevalent symptom (88.2%), followed by dyspareunia (61.2%). In comparison to those without ultrasound signs, the patients whose ultrasound findings suggested endometriosis had an older age (37.16±6.83 years vs. 30.37±6.80 years, p<0.001) and a longer duration of symptoms (9.06±6.49 years vs. 5.27±4.79 years, p=0.004). In addition, they presented higher mean serum CA-125 antigen levels (50.07±54.05 U/mL vs. 17.71±14.09 U/mL, p=0.011). Endometriosiscompatible lesions were mainly found in the ovaries (60%) and in the rectosigmoid region (52%). The disease was confirmed in the nine cases that were subjected to videolaparoscopy. CONCLUSIONS: Transvaginal ultrasound confirmed endometriosis in about one third of symptomatic patients, who were older, had symptoms for a longer time, and had higher serum CA-125 antigen levels in comparison to those without endometriosis diagnosis based on transvaginal ultrasound. Ovaries and rectosigmoid region were the sites with the highest frequency of ultrasound signs of endometriosis.

OBJETIVOS: Descrever características clínicas e sociodemográficas, bem como resultados de ultrassonografia transvaginal, de mulheres com sintomas de endometriose. MÉTODOS: Um estudo transversal prospectivo incluiu pacientes que apresentaram pelo menos um dos seguintes sintomas: dispareunia, dismenorreia, dor pélvica crônica, infertilidade e sintomas urinários ou intestinais cíclicos. A amostra foi composta por mulheres atendidas em clínica privada de ginecologia, localizada em uma pequena cidade do sul do Brasil, de março a novembro de 2016. Todas as participantes, após assinatura do termo de consentimento livre e esclarecido, foram submetidas a anamnese clínica, ultrassonografia transvaginal com preparo intestinal e análise do nível sérico do antígeno CA-125. A associação entre duas variáveis qualitativas foi avaliada pelos testes Qui-Quadrado de Pearson ou Exato de Fisher. Os valores médios das variáveis quantitativas foram comparados através do teste t de Student bicaudal para amostras independentes. O nível de significância foi estabelecido como p<0,05. RESULTADOS: Um total de 85 mulheres, com idade entre 18 e 49 anos, participou do estudo. A maioria era casada (75,3%), com filhos (51,8%), não apresentava história familiar de endometriose (89,4%), não tinha conhecimento sobre endometriose (77,6%) e tinha ensino médio completo (43,5%). Achados ultrassonográficos sugeriram endometriose em 25 (29,4%) mulheres. A dismenorreia foi o sintoma mais prevalente (88,2%), seguida pela dispareunia (61,2%). Em comparação com aquelas sem sinais ultrassonográficos, as pacientes cujos achados ultrassonográficos sugeriram endometriose tinham idade mais avançada (37,16±6,83 anos vs. 30,37±6,8 anos, p<0,001) e maior duração dos sintomas (9,06±6,49 anos vs. 5,27±4,79 anos, p=0,004). Além disso, apresentaram níveis séricos de antígeno CA-125 mais elevados (50,07±54,05 U/mL vs. 17,71±14,09 U/mL, p=0,011). Lesões compatíveis com endometriose foram encontradas principalmente nos ovários (60%) e na região retossigmoide (52%). A doença foi confirmada nos nove casos que foram submetidos a videolaparoscopia. CONCLUSÕES: A ultrassonografia transvaginal confirmou a endometriose em cerca de um terço das pacientes sintomáticas, que eram mais velhas, apresentavam sintomas por mais tempo e tinham níveis mais altos de antígeno CA-125 sérico, em comparação àquelas sem diagnóstico de endometriose com base na ultrassonografia transvaginal. Ovários e região retossigmoide foram os locais com maior frequência de sinais ultrassonográficos de endometriose.

Screening anal cancer in women living with HIV/AIDS / Rastreamento do câncer anal em mulheres vivendo com HIV/AIDS

ABSTRACT Aim: Addressing the main methodologies published in the scientific literature and used to screen anal cancer in women living with HIV/AIDS. Methodology: The current study is an integrative literature review applied to articles published between 2013 and 2017 in databases such as PUBMED, EBSCO and LILACS. Results: Eight studies were selected to compose the current review after the inclusion and exclusion criteria were applied. All the articles had evidence level IV. Anal cytology and the DNA-HPV test were the methodologies prevailing in the studies. The number of participants in the studies ranged from 35 to 863, and all the studies involved women living with HIV/AIDS. The aim of most of the herein reviewed studies was to assess the prevalence of anal cytologic changes or HPV infection in women living with HIV/AIDS (WLHA). Conclusion: Studies have pointed out that there is concern about high anal cancer and anal HPV infection rates. They also highlighted the importance of the screening procedure for anal cancer prevention through cytology associated, or not, with molecular HPV detection methods.

RESUMO Objetivo: Abordar as principais metodologias que podem ser utilizadas para o rastreamento do câncer anal em mulheres vivendo com HIV/AIDS, que têm sido publicadas atualmente na literatura científica. Metodologia: Trata-se de uma revisão integrativa de literatura, realizada através de pesquisa de artigos nas bases de dados PUBMED, EBSCO e LILACS, publicados entre os anos de 2013 a 2017. Resultados: A partir da aplicação dos critérios de inclusão e exclusão, foram selecionados oito estudos para compor essa revisão. Todos possuíam nível de evidência IV. As metodologias que predominaram nos estudos foram a citologia anal e o teste DNA-HPV. O número de participantes nos estudos variou de 35 até 863, e todos envolveram mulheres vivendo com HIV/AIDS. A maioria tinha o objetivo de avaliar a prevalência de alterações citológicas anais ou infecção pelo HPV em mulheres vivendo com HIV/AIDS. Conclusão: Os estudos apontaram que há uma preocupação com os altos índices de câncer anal e infecção anal por HPV. Também registram a importância do rastreamento para prevenção do câncer anal, através da citologia associada ou não a métodos moleculares de detecção do HPV.

Structure analysis of capsid protein of Porcine circovirus type 2 from pigs with systemic disease

Abstract Economic losses with high mortality rate associated with Porcine circovirus type 2 (PCV2) is reported worldwide. PCV2 commercial vaccine was introduced in 2006 in U.S. and in 2008 in Brazil. Although PCV2 vaccines have been widely used, cases of PCV2 systemic disease have been reported in the last years. Eleven nursery or fattening pigs suffering from PCV2 systemic disease were selected from eight PCV2-vaccinated farms with historical records of PCV2 systemic disease in Southern Brazil. PCV2 genomes were amplified and sequenced from lymph node samples of selected pigs. The comparison among the ORF2 amino acid sequences of PCV2 isolates revealed three amino acid substitutions in the positions F57I, N178S and A190T, respectively. Using molecular modeling, a structural model for the capsid protein of PCV2 was built. Afterwards, the mutated residues positions were identified in the model. The structural analysis of the mutated residues showed that the external residue 190 is close to an important predicted region for antibodies recognition. Therefore, changes in the viral protein conformation might lead to an inefficient antibody binding and this could be a relevant mechanism underlying the recent vaccine failures observed in swine farms in Brazil.

Structure analysis of capsid protein of Porcine circovirus type 2 from pigs with systemic disease.

Economic losses with high mortality rate associated with Porcine circovirus type 2 (PCV2) is reported worldwide. PCV2 commercial vaccine was introduced in 2006 in U.S. and in 2008 in Brazil. Although PCV2 vaccines have been widely used, cases of PCV2 systemic disease have been reported in the last years. Eleven nursery or fattening pigs suffering from PCV2 systemic disease were selected from eight PCV2-vaccinated farms with historical records of PCV2 systemic disease in Southern Brazil. PCV2 genomes were amplified and sequenced from lymph node samples of selected pigs. The comparison among the ORF2 amino acid sequences of PCV2 isolates revealed three amino acid substitutions in the positions F57I, N178S and A190T, respectively. Using molecular modeling, a structural model for the capsid protein of PCV2 was built. Afterwards, the mutated residues positions were identified in the model. The structural analysis of the mutated residues showed that the external residue 190 is close to an important predicted region for antibodies recognition. Therefore, changes in the viral protein conformation might lead to an inefficient antibody binding and this could be a relevant mechanism underlying the recent vaccine failures observed in swine farms in Brazil.

Lesão anal por papilomavírus humano em mulher vivendo com HIV/aids / Anal lesion caused by human papillomavirus in a woman living with HIV/AIDS

OBJETIVOS: Descrever um caso de lesão anal causada por infecção pelo papilomavírus humano em uma mulher vivendo com HIV/aids. DESCRIÇÃO DO CASO: Mulher de 35 anos, diagnosticada há cinco anos com HIV, relatou prurido e sangramento anal, dor ao defecar e visualização de pequenas verrugas na região perianal. Atendida em um serviço de atenção especializada, foi submetida a exame clínico com inspeção visual, o qual revelou condiloma na região perianal. O exame histopatológico confirmou a presença de displasia de grau moderado a acentuado associado a alterações compatíveis com infecção pelo papilomavírus humano. A paciente foi encaminhada para exérese da lesão. No início dos sintomas, a paciente ainda não fazia uso da terapia antirretroviral e apresentava a maior carga viral do HIV de seu histórico laboratorial, com 2.951 cópias/ml. Também havia passado por estresse emocional e estava com infecções genitais recorrentes pelo vírus Herpes simplex. Esses fatores podem ter contribuído para o desenvolvimento do condiloma anal. CONCLUSÕES: A possibilidade de que a infecção pelo HIV possa alterar a história da infecção pelo HPV alerta para que nessas situações sejam adotadas estratégias rigorosas de rastreamento através do exame citológico, tanto do colo do útero como da região anal.

AIMS: To describe a case of anal lesion caused by human papillomavirus (HPV) infection in a woman living with HIV/AIDS. CASE DESCRIPTION: A 35-year-old woman, diagnosed with HIV five years ago, reported pruritus ani, anal bleeding, painful defecation, and presence of small warts in the perianal region. The patient was seen at a specialized care center and was subjected to clinical examination with visual inspection, which revealed perianal condyloma. Histopathological examination confirmed the presence of moderate to severe dysplasia associated with HPV-compatible changes. The anal lesion was excised. At the onset of the symptoms, the patient was not on antiretroviral therapy and her HIV viral load was at its highest (2,951 copies/mL) compared with her previous laboratory tests. She had gone through emotional stress and presented with recurrent genital herpes simplex virus infections. These factors may have predisposed her to the development of anal condyloma. CONCLUSIONS: Since HIV infection may alter the history of HPV infection, it is important that screening strategies include cytological analysis of both the cervix and the anal region.