Leprosy is a curable chronic granulomatous infectious disease caused by the bacillus Mycobacterium leprae. This organism has a high affinity for skin and peripheral nerve cells. In the evolution of infections, the immune status of patients determines the disease expression. Dendritic cells are antigen-presenting cells that phagocytose particles and microorganisms. In skin, dendritic cells are represented by epidermal Langerhans cells and dermal dendrocytes, which can be identified by expression of CD1a and factor XIIIa (FXIIIa). In the present study, 29 skin samples from patients with tuberculoid (13 biopsies) and lepromatous (16 biopsies) leprosy were analyzed by immunohistochemistry using antibodies to CD1a and FXIIIa. Quantitative analysis of labeling pattern showed a clear predominance of dendritic cells in tuberculoid leprosy. Difference between the number of positive cells of immunohistochemistry for the CD1a and FXIIIa staining observed in this study indicates a role for dendritic cells in the cutaneous response to leprosy. Dendritic cells may be a determinant of the course and clinical expression of the disease.
The aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed. Cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection. The mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% ( = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% ( = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions ( = 0.026). The infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.
We evaluated the prevalence of human papillomavirus (HPV) infection in Amerindian women from a tribe in Brazilian Amazonia. Demographic data, pap smears and cervical samples for HPV DNA detection by polymerase chain reaction (PCR) were obtained for women aged above 10 years old. In total, 79 (85.9%) out of 92 eligible women who lived there were interviewed; all women already had engaged in sexual activity. Seventy-eight and 49 women allowed collection of pap smears and PCR samples, respectively. Cytological signs of HPV infection were observed in 11 patients; 6 of these were probed for HPV infection and 1 shown to be HPV 16. Overall prevalence of HPV infection detected by PCR was 14.3%. Three patients presented high-risk HPV DNA types:two HPV 16 and one co-infection of HPV 16 and 58. Cervical infection by oncogenic HPV types occurs in Amerindian women and cervical cancer screening should be a priority in this setting.
Objective To investigate the relation between oxidative stress markers, human papillomavirus infection and cervical cancer precursor lesions.Methods The study comprised women aged 14 to 60 years living in communities located by Amazon rivers in the state of Pará (Itaituba, Limoeiro do Ajuru and Bragança, 126, 68 and 43 women respectively). Papanicolau smears and polymerase chain reaction tests for human papillomavirus DNA detection were performed. Blood samples were collected to test malondialdehyde, total and oxidized glutathione levels.Results Malondialdehyde, total and oxidized glutathione concentrations did not differ significantly (p>0.05) between women with and without low-grade squamous intraepithelial lesions across communities. Malondialdehyde levels (8.02nmols/mL) were almost five times higher in human papillomavirus-positive compared to human papillomavirus-negative women (1.70nmols/mL) living in Itaituba (statistically significant difference; p<0.05). Malondialdehyde levels did not differ significantly (p>0.05) between human papillomavirus-positive and human papillomavirus-negative women living in remaining communities. Significant (p<0.05) differences in total glutathione levels between human papillomavirus-positive and human papillomavirus-negative women (8.20μg/mL and 1.47μg/mL, respectively) were limited to those living in Bragança.Conclusion Malondialdehyde and total glutathione levels were significantly associated with human papillomavirus infection. However, lack of similar associations with squamous lesions suggest oxidative stress alone does not explain correlations with cervical carcinogenesis. Other factors may therefore be involved.
Introduction:The genomic heterogeneity of hepatitis C virus (HCV) influences liver disorders. This study aimed to determine the prevalence of HCV genotypes and to investigate the influence of these genotypes on disease progression. Methods: Blood samples and liver biopsies were collected from HCV-seropositive patients for serological analysis, biochemical marker measurements, HCV genotyping and histopathological evaluation. Results: Hepatitis C virus-ribonucleic acid (HCV-RNA) was detected in 107 patients (90.6% with genotype 1 and 9.4% with genotype 3). Patients infected with genotype 1 exhibited higher mean necroinflammatory activity and fibrosis. Conclusions: HCV genotype 1 was the most prevalent and was associated with greater liver dysfunction.Keywords: Hepatitis C virus. Genotype. Histopathology.Hepatitis C virus (HCV) infection is often asymptomatic, but it is chronic in a large (85%) proportion of cases. Approximately 20% of individuals with chronic HCV develop liver damage, cirrhosis or cancer 1 .In Brazil, the seroprevalence of HCV is moderate, although rates vary among different regions of the country 2 . Genotype 1 is predominant, followed by genotypes 3 and 2 3 . In the State of Pará, the overall prevalence ranges from 0.5 to 2% among blood donor candidates 4 , and the genotype distribution is similar to that reported elsewhere in Brazil 5 .Hepatitis C virus genotype 1 has been associated with severe liver damage and the response to treatment 6 . However, other studies were unable to confirm this association 7 . Brazilian studies correlating the different HCV genotypes with histological and clinical presentation are scarce and have not confirmed an association between liver disease severity and HCV genotype 8,9 .The objectives of this study were to determine the prevalence of HCV genotypes in patients with chronic hepatitis C in the State of Pará, Brazil and to investigate the influence of these genotypes on the biochemical and histopathological parameters of the disease.
RESUMO Células escamosas atípicas de significado indeterminado são definidas pela presença de anormalidades mais acentuadas que aquelas atribuídas às alterações reativas. Objetivou-se analisar o perfil das mulheres atendidas em unidades de saúde da SESMA, no período de janeiro de 2013 a dezembro de 2015, diagnosticadas com ASCUS. Estudo transversal, incluídos 250 casos com taxa de 2,31% a uma amostragem de 10.808 exames. Observou-se: faixa etária de 51-60 anos 27%, grau de instrução 1º incompleto 48%, e informaram estar na menopausa 43,7%. Foi possível traçar o perfil das pacientes diagnosticadas com ASCUS. Conclui-se que há necessidade de complementação diagnóstica, pelos métodos de citopatologia em meio líquido e colposcopica após tratamento hormonal tópico, concedendo a estas mulheres da rede SUS um benefício do esclarecimento desses casos e melhor qualidade de vida.
Main human papillomavirus genotypes in riparian women from the brazilian Amazon Principales genotipos del virus de papiloma humano de mujeres ribereñas de la Amazonia brasileña RESUMO Objetivo: Avaliar a distribuição dos principais genótipos do papilomavírus humano (HPV) oncogênicos em mulheres de áreas ribeirinhas e pesqueiras de diferentes regiões geográficas da Amazônia brasileira. Métodos: Estudo transversal, realizado no período de 2013 a 2014. Participaram 516 ribeirinhas e pesqueiras maiores de 13 anos, inscritas no Programa de Prevenção do Câncer de Colo Uterino (PCCU) e submetidas à coleta de material cervicovaginal para o Teste Papanicolau, realizado in loco por médico membro da equipe de pesquisadores, pesquisa de DNA/HPV e genotipagem pela Reação em Cadeia da Polimerase (PCR), realizados no Laboratório de Imunopatologia da Universidade Federal do Pará por pesquisadores da mesma equipe, além da coleta de informações como a idade e o tipo de atendimento, também coletados pelos pesquisadores. Todos os dados foram analisados através do Programa Biostat 5.0, considerando diferença significativa quando p<0,05. Resultados: A média de idade das mulheres nas comunidades A e B foram, respectivamente, 40 e 39 anos, enquanto nas comunidades C, D e E foi de 37 anos. A prevalência da infecção pelo HPV variou de 7,6% a 29,2%. Dentre os tipos oncogênicos pesquisados, os mais frequentes foram HPV52 (n=5; 5,15%), HPV35 (n=4; 4,12%) e HPV58 (n=3; 3,09%). Os principais tipos oncogênicos encontrados estão concentrados na região de Itaituba (comunidades A, B) e Bragança (comunidade E). Conclusão: Em todas as localidades estudadas foi encontrado um elevado percentual de infecção, cujo tipo de HPV não foi identificado entre os testados, destacando-se as comunidades C e D, com 100% dos casos.
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