Abstract. The question of whether Chlamydia trachomatis (Ct) is a cofactor for human Papillomavirus (HPV) in cervical carcinogenesis is still controversial. We conducted a molecular detection study of both infections in 622 Brazilian women, including 252 women with different grades of abnormal cervical cytology and cervical cancer (CC; cases) and 370 women with normal cytology (controls). Although Ct infection did not seem related to CC carcinogenicity, women with abnormal cytology had a significant high rate of Ct infection. Therefore, it is important to adopt protocols for diagnosis and treatment of this bacterium in conjunction with screening for CC in this population.At present, cervical cancer (CC) is the second leading cause of cancer affecting women, 1,2 preceded only by breast cancer; it develops over a long period through precursor lesions that can be detected by cytological screening.3 Its frequency varies in different regions of the world, and it is much higher in underdeveloped or developing than developed countries.1 In Brazil, CC is the third most common cancer among women, with 17,000-18,000 new cases annually. 4 It is well-established that persistent infection by high-risk (HR) human Papillomavirus (HPV) is a necessary but not sufficient cause of CC.5 Considering that a small proportion of HR-HPV-infected women actually develop CC, 6 additional risk factors that may be involved in the development of the disease have been investigated.Among other sexually transmitted infections (STIs) that can increase the risk of CC, Chlamydia trachomatis (Ct) is among the leading factors. Some investigators have proposed that Ct infection could affect HPV acquisition and persistence, increase the rate of transformation to early precursor lesions, and also increase the likelihood that precursor lesions lead to CC.7 However, the association of Ct as a cofactor for HPV in cervical carcinogenesis is still controversial. 8 This information directly affects the adoption of efforts to control CC, because a Ct-HPV association would require not only HPV vaccination but also adoption of protocols for diagnosis and treatment of the bacteria. Considering that, in Brazil and Latin America in general, few studies have examined this possibility, we conducted a molecular detection study of HPV and Ct infections in Brazilian women with different grades of abnormal cervical cytology and CC in an attempt to contribute to elucidating the involvement of Ct in cervical carcinogenesis.Six hundred twenty-two women of low socioeconomic status, ages 15-83 years, were recruited between August 1, 2009 and March 31, 2012 in three cities of the state of Paraná , southern Brazil: Maringá , Paiçandú , and Uniã o da Vitó ria. The epidemiological characteristics were obtained through the analysis of data from a standard registration form for each woman. Each woman involved signed the authorization, and the execution of this project was approved by the Committee for Ethics in Research Involving Humans at the State University of Maringá /Paraná , ...

For cytologic HSIL, the benefits of the strategy of "see and treat" by LEEP outweighed the risk of overtreatment. Patients with both positive and negative margins on LEEP should be followed carefully.

Background During pneumonia, normal alveolar areas coexist adjacently with consolidated areas, and high inspiratory efforts may predispose to lung damage. To date, no study has evaluated different degrees of effort during Biphasic positive airway pressure (BIVENT) on lung and diaphragm damage in experimental pneumonia, though largely used in clinical setting. We aimed to evaluate lung damage, genes associated with ventilator-induced lung injury (VILI) and diaphragmatic injury, and blood bacteria in pressure-support ventilation (PSV), BIVENT with low and high inspiratory efforts in experimental pneumonia. Material and methods Twenty-eight male Wistar rats (mean ± SD weight, 333±78g) were submitted Pseudomonas aeruginosa-induced pneumonia. After 24-h, animals were ventilated for 1h in: 1) PSV; 2) BIVENT with low (BIVENTLow-Effort); and 3) BIVENT with high inspiratory effort (BIVENTHigh-Effort). BIVENT was set at Phigh to achieve VT = 6 ml/kg and Plow at 5 cmH2O (n = 7/group). High- and low-effort conditions were obtained through anaesthetic infusion modulation based on neuromuscular drive (P0.1). Lung mechanics, histological damage score, blood bacteria, and expression of genes related to VILI in lung tissue, and inflammation in diaphragm tissue. Results Transpulmonary peak pressure and histological damage score were higher in BIVENTHigh-Effort compared to BIVENTLow-Effort and PSV [16.1 ± 1.9cmH2O vs 12.8 ± 1.5cmH2O and 12.5 ± 1.6cmH2O, p = 0.015, and p = 0.010; median (interquartile range) 11 (9–13) vs 7 (6–9) and 7 (6–9), p = 0.021, and p = 0.029, respectively]. BIVENTHigh-Effort increased interleukin-6 expression compared to BIVENTLow-Effort (p = 0.035) as well as expressions of cytokine-induced neutrophil chemoattractant-1, amphiregulin, and type III procollagen compared to PSV (p = 0.001, p = 0.001, p = 0.004, respectively). Tumour necrosis factor-α expression in diaphragm tissue and blood bacteria were higher in BIVENTHigh-Effort than BIVENTLow-Effort (p = 0.002, p = 0.009, respectively). Conclusion BIVENT requires careful control of inspiratory effort to avoid lung and diaphragm damage, as well as blood bacteria. P0.1 might be considered a helpful parameter to optimize inspiratory effort.

No abstract