RESUMO
Trichomoniasis presents a broad spectrum of clinical patterns ranging from asymptomatic to severe vaginitis and cervicitis. Despite its importance, very little is known about the genetic relatedness of its causative agent, Trichomonas vaginalis, and the clinical phenotypes. To address this question, analysis of restriction length polymorphism (RFLP) within the intergenic spacer of the ribosomal DNA (IGS) from 60 clinically defined isolates of T. vaginalis was performed. This is the first description of the IGS polymorphism of T. vaginalis. As expected, a considerable number of patients were asymptomatic (28%) while only 12% presented both leukorrhea and macular colpitis, the most evident symptoms of trichomoniasis. The IGS-RFLP with the use of eight restriction enzymes showed absence of correlation between the genetic relatedness of the isolates and symptomatology. Further studies are necessary to evaluate the importance of the IGS polymorphism to the parasite virulence and clinical phenotype.
Assuntos
DNA Espaçador Ribossômico/genética , Polimorfismo de Fragmento de Restrição , Vaginite por Trichomonas/parasitologia , Trichomonas vaginalis/genética , Animais , Colo do Útero/patologia , DNA Espaçador Ribossômico/química , Dispareunia/parasitologia , Feminino , Humanos , Leucorreia/parasitologia , Filogenia , Reação em Cadeia da Polimerase , RNA Ribossômico 16S/genética , RNA Ribossômico 28S/genética , Mapeamento por Restrição , Vaginite por Trichomonas/patologia , Vaginite por Trichomonas/fisiopatologia , Trichomonas vaginalis/classificação , Trichomonas vaginalis/patogenicidade , Transtornos Urinários/parasitologia , Vagina/patologia , Vulva/patologiaRESUMO
BACKGROUND: Trichomoniasis is the most prevalent nonviral sexually transmitted disease in humans worldwide. In addition to its pathologic implications, trichomoniasis is a risk factor for the transmission of the HIV and is associated with reproductive complications in females. Diagnosis of the disease is problematic due to inadequate accuracy of current diagnostic methods. Recently developed DNA-based techniques for detection of Trichomonas vaginalis seem to be promising alternatives. GOAL: The goal of this study was to evaluate the accuracy of the Papanicolaou test for the diagnosis of trichomoniasis by comparing polymerase chain reaction (PCR) with other current diagnostic methods. STUDY DESIGN: A total of 1008 cervicovaginal swab specimens from a randomized population attending a gynecological service were analyzed in this study. In addition to current diagnostic methods, two sets of specific primers were used for PCR detection of T vaginalis in the cervicovaginal DNA samples, with a PCR quality control. Different examiners conducted PCR and Papanicolaou analyses in a double-blind trial. RESULTS: The prevalence of trichomoniasis in this population was 6%. A considerable number of diagnostic results of the Papanicolaou test were false negative or false positive. Compared with PCR, specificity of the Papanicolaou test was 97.6%, whereas sensitivity was only 60.7%. The positive predictive value of the Papanicolaou smear was 61.7%. These results suggest that irregularly shaped parasites without clearly defined nuclei and flagella and bacteria-induced focal cytolysis limit the ability of the Papanicolaou test to detect T vaginalis. CONCLUSION: The Papanicolaou test, the most readily available cytologic method for screening sexually transmitted pathogens and cellular abnormalities in most developing countries, is inadequate for the diagnosis of trichomoniasis due to its inherent limitations. However, PCR is a highly sensitive and specific test for the diagnosis of trichomoniasis.
Assuntos
DNA de Protozoário/análise , Teste de Papanicolaou , Reação em Cadeia da Polimerase/normas , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/genética , Esfregaço Vaginal/normas , Adulto , Animais , Brasil/epidemiologia , Primers do DNA , Método Duplo-Cego , Reações Falso-Negativas , Feminino , Humanos , Valor Preditivo dos Testes , Prevalência , Sensibilidade e Especificidade , Trichomonas vaginalis/isolamento & purificaçãoRESUMO
Nossos índios já realizavam tratamentos dentários quando o País foi descoberto, e não se sabe desde quando essa prática era usada. Documentos dessa época indicam que eles tinham bons dentes. Passando pelas várias fases da história, a Odontologia brasileira chega aos dias de hoje com cerca de 145 mil profissionais, tecnologia avançada e muito trabalho pela frente na área de saúde bucal
Assuntos
Brasil , História da Odontologia , Índio/históriaRESUMO
Nossos índios já realizavam tratamentos dentários quando o País foi descoberto, e näo se sabe desde quando essa prática era usada. Documentos dessa época indicam que eles tinham bons dentes. Passando pelas várias fases da história, a Odontologia brasileira chega aos dias de hoje com cerca de 145 mil profissionais, tecnologia avançada e muito trabalho pela frente na área de saúde bucal (AU)
