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Tornatore M, Amaral SC, Alves BM, de Oliveira GR, Finger-Jardim F, Avila EC, Pivato AF, Lobato RC, Chies JAB, Ellwanger JH, Soares EA, Sánchez-Luquez K, Gonçalves CV, Martínez AMBD, Soares MA, da Hora VP. HLA-G alleles and their impacts on placental HSV-1 infection in women from southern Brazil. J Reprod Immunol 2023; 159:104134. [PMID: 37634319 DOI: 10.1016/j.jri.2023.104134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/29/2023]
Abstract
The Human Leukocyte Antigen G (HLA-G) is an immunoregulatory molecule with a critical role in pregnancy success. HLA-G alleles are associated with differential susceptibility to multiple conditions, including gestational problems, infectious diseases, and viral persistence. Of note, both herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) can impair HLA-G expression, interfering with HLA-G-associated immunoregulation. On the other hand, the impacts of HLA-G alleles on susceptibility to Herpesviridae infection is a neglected issue. Therefore, this study evaluated HLA-G allele frequencies and their associations with placental Herpesviridae infection in women from southern Brazil. Placenta samples were collected soon after delivery, and detection of viral DNA of HSV-1, HSV-2 and human cytomegalovirus (HCMV) was performed by polymerase chain reaction (PCR). A fragment of HLA-G (exons 2-4) was amplified by PCR, sequenced, and analyzed to allele determination. One hundred and seventy women had their alleles determined. Overall, 25 HLA-G alleles were found, distributed into 56 different genotypes. The most frequent alleles were G* 01:01:01 and G* 01:01:02, found in 37.9 % and 16.5 % of samples, respectively. Among the 170 women, 89 (52.4 %) tested positive for Herpesviridae DNA in the placenta, 55 (32.3 %) tested negative, 3 (1.8 %) were negative for HSV-1 and HSV-2 (with absent HCMV data), and 23 (13.5 %) were undetermined. The G* 01:01:01 allele was significantly associated with an increased risk of placental HSV-1 infection (p = 0.0151; OR=1.837; IC=1.108-3.045). This study describes new information concerning placental HLA-G alleles in women from southern Brazil and helps explain how genetic background can modify susceptibility to placental infections.
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Affiliation(s)
- Michele Tornatore
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | | | - Brunna M Alves
- Post-Graduate Program in Oncovirology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, RJ, Brazil
| | | | - Fabiana Finger-Jardim
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Emiliana Claro Avila
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Andressa Fernandes Pivato
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Rubens Caurio Lobato
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - José Artur Bogo Chies
- Laboratory of Immunobiology and Immunogenetics, Post-Graduate Program in Genetics and Molecular Biology (PPGBM), Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Joel Henrique Ellwanger
- Laboratory of Immunobiology and Immunogenetics, Post-Graduate Program in Genetics and Molecular Biology (PPGBM), Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Esmeralda A Soares
- Post-Graduate Program in Oncovirology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, RJ, Brazil
| | - Karen Sánchez-Luquez
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Carla Vitola Gonçalves
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Ana Maria Barral de Martínez
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Marcelo A Soares
- Post-Graduate Program in Oncovirology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, RJ, Brazil; Department of Genetics, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Vanusa Pousada da Hora
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil.
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Sparvoli JMH, Sparvoli AC, Pereira AA, Paula ALMD, Garcia L, Gonçalves CV. Effects of hepatitis C virus genotypes and viral load on glucose and lipid metabolism after sustained virological response with direct-acting antivirals. Rev Assoc Med Bras (1992) 2023; 69:e20221163. [PMID: 37222317 PMCID: PMC10204843 DOI: 10.1590/1806-9282.20221163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/23/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The objective of this study, carried out at the university hospital of the Federal University of Rio Grande, was to assess whether the treatment of chronic hepatitis C with direct-acting antivirals and the sustained virological response will affect the metabolic influences of the hepatitis C virus and whether these effects will vary according to genotypes and virus load. METHODS This is an intervention pre-post study, carried out from March 2018 to December 2019, evaluating 273 hepatitis C virus patients treated with direct-acting antivirals. Inclusion criteria included being monoinfected with hepatitis C virus and achieving sustained virological response . Exclusion criteria included the presence of decompensated cirrhosis or co-infected with hepatitis B virus or human immunodeficiency virus. Genotypes, genotype 1 subtypes, and hepatitis C virus viral load were analyzed. Glucose metabolism was evaluated by the Homeostasis Model Assessment-insulin resistance indices: Homeostasis Model Assessment-β, TyG, and HbA1c, measured at the beginning of treatment and in sustained virological response. Statistical analysis with a T test by paired comparison of the means of the variables in the pretreatment and in the sustained virological response. RESULTS Homeostasis Model Assessment-insulin resistance analysis: there were no significant differences between pretreatment and sustained virological response. Homeostasis Model Assessment-β analysis: significant increase in genotype 1 patients (p<0.028). TyG index analysis: significant increase in genotype 1b (p<0.017), genotype 3 (p<0.024), and genotype non-1 with low viral load (p<0.039). HbA1c analysis: significant decrease in genotype 3 (p<0.001) and genotype non-1 patients with low viral load (p<0.005). CONCLUSION We detected significant metabolic influences after sustained virological response: impairment in lipid profile and improvements in the glucose metabolism. We found significant differences in genotype dependence, genotype 1 subtypes, and viral load.
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Affiliation(s)
| | | | | | | | - Laís Garcia
- Universidade Federal do Rio Grande - Rio Grande (RS), Brazil
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Rodrigues Monteiro A, Schadock I, Carneiro da Rosa Aranalde L, Peres Martinez D, Rodrigues Fernandes N, Caurio Lobato R, Silveira Vianna J, Castilho Barros C, Bastos Ramis I, Aguiar Dos Anjos Gatti F, Andrés Mendoza Sassi R, Vitola Gonçalves C, Pousada da Hora V. Prevalence of Overweight and Associated Factors in a Male Prison Population in the Extreme South of Brazil: A Cross-Sectional Study. Metab Syndr Relat Disord 2023; 21:63-69. [PMID: 36409532 DOI: 10.1089/met.2021.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: This cross-sectional study serves as a first Brazilian inventory about overweight as a marker for metabolic health and risk factor to develop noncommunicable chronic diseases in prison populations. The prevalence of overweight, and its associated factors in prisoners of the Fifth Regional State Penitentiary of Rio Grande do Sul (5th DPR) in the extreme South of Brazil were investigated using a precoded questionnaire with sociodemographic, behavioral, and health questions, applied to proportional stratified random sampled prisoners. Methods: Five hundred eighty male prisoners (70%) in the closed regime agreed to answer the questionnaire and allowed anthropomorphic body measurement, carried out by trained scientists. We used bivariate Pearson's chi-squared test and adjusted multinomial logistic regression for analyses. Results: Considering that the studied incarcerated population is young (mean age 33 years) it is concerning that already 43.6% of them are overweight, report regular sweets and sugary soft drink consumption (77.7%, and 81.4%, respectively), 60.2% are smokers, and 19.4% are at elevated risk to develop cardiovascular diseases. Further, 13.8% of the respondents reported a diagnosis of hypertension, 4.9% hypercholesterolemia, and 2.7% diabetes mellitus type 2. Among those who reported not smoking, excess weight was almost four times higher (prevalence ratio: 3.79; 95% confidence interval: 2.61-5.50). Conclusions: Our study suggests that the prison environment promotes modifiable risk factors for chronic diseases. These data deserve attention and intervention, aiming to prevent and reduce the current levels of excess weight.
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Affiliation(s)
| | - Ines Schadock
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | | | | | | | - Rubens Caurio Lobato
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Julia Silveira Vianna
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | | | - Ivy Bastos Ramis
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
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Sparvoli JMH, Sparvoli AC, Dumith SDC, Pereira AA, Paula ALMD, Garcia L, Belarmino V, Hora VPD, Martínez AMBD, Gonçalves CV. Impact of hepatitis C virus eradication with direct-acting antivirals on glycidic metabolism. Archives of Endocrinology and Metabolism 2022; 67:314-322. [PMID: 36468927 DOI: 10.20945/2359-3997000000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective To compare the glucose metabolism of patients with chronic hepatitis C virus infection treated with direct-acting antivirals (DAAs) in pretreatment and sustained viral response (SVR) periods. Materials and methods This was an intervention pre-post study of 273 patients with chronic hepatitis C virus infection treated with DAAs from March 2018 to December 2019. Glycidic metabolism was evaluated through homeostasis model assessment (HOMA) - insulin resistance (IR) and HOMA-β indices and assessments of insulinemia and HbA1c levels. These parameters were analyzed with a T test by paired comparison of the means of the variables and Wilcoxon's test paired for the median; in the variables with an abnormal distribution, the Z score was generated for the mean in both the pretreatment and SVR periods. Statistical significance was considered at p ≤ 0.05. Results Among 273 participants, 125 (45.8%) had prediabetes, and 50 (18.3%) had diabetes. In SVR, there was a significant increase in platelets, albumin, alkaline phosphatase, cholesterol and triglycerides and a significant decrease in aspartate aminotransferase, alanine aminotransferase, gamma GT and bilirubin. The HOMA-IR and HOMA-β indices increased in SVR from 1.95 to 2.29 (p = 0.087) and 71.20 to 82.60 (p = 0.001), respectively. Insulinemia increased from 7.60 μU/mL to 8.90 μU/mL (p = 0.011). HbA1c decreased from 5.6 to 5.4 (p < 0.001). Among patients with prediabetes and those with diabetes, the reduction in HbA1c values was significant (p = 0.006 and p = 0.026, respectively). Conclusion SVR significantly impacts and leads to improvement in glucose metabolism in patients with chronic liver disease induced by hepatitis C virus.
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Oliveira PSD, Gonçalves CV, Watte G, Costa JSDD. Vaccination coverage against human papillomavirus (HPV) and associated factors in female academics from a university in southwestern Goiás, Brazil. Rev Saude Publica 2021; 55:65. [PMID: 34706041 PMCID: PMC8522710 DOI: 10.11606/s1518-8787.2021055003144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/30/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To check the coverage of the HPV vaccine in women enrolled in health courses at a university in southwest Goiás, Brazil, and the factors associated with vaccination. METHODS This is a cross-sectional study, including female university students of health courses, aged 18 years or more. A standardized and self-applying questionnaire was used. Participants who received two or more doses of the vaccine were considered immunized. Multiple analysis was performed using multinomial logistic regression. RESULT We observed that, of the 1510 participants, 473 (31.3%) had two or more doses of HPV vaccine, 167 (11.0%) one dose and 870 (57.6%) were unvaccinated. Participants under 21 years of age and in socioeconomic stratum A were 2 times more likely to have received two or more doses of the vaccine (Prevalence Ratio = 1.95; 95%CI 1.40-2.70 and Prevalence Ratio = 2.09; 95%CI 1.39-3.13, respectively). CONCLUSIONS The research revealed extensive possibility for interventions with the aim of achieving greater vaccination coverage among female university students. Even women with more knowledge and high economic stratum showed low vaccination coverage, suggesting that results of higher vaccine coverage can be obtained with vaccination carried out in a school environment.
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Affiliation(s)
| | | | - Guilherme Watte
- Universidade Católica do Rio Grande do Sul. Programa de Pós-Graduação em Medicina e Ciências da Saúde da Pontifícia, Porto Alegre, RS, Brasil
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Sánchez-Luquez K, Schadock IC, Gonçalves CV, Tornatore M, Finger-Jardim F, Avila EC, Soares MA, de Martínez AMB, Ellwanger JH, Chies JAB, da Hora VP. Impact of TLR7 and TLR9 polymorphisms on susceptibility to placental infections and pregnancy complications. J Reprod Immunol 2021; 146:103342. [PMID: 34102513 DOI: 10.1016/j.jri.2021.103342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/10/2021] [Accepted: 05/31/2021] [Indexed: 12/26/2022]
Abstract
This study evaluated the impact of the TLR7 Gln11Leu (rs179008) and TLR9 -1237 T/C (rs5743836) single nucleotide polymorphisms (SNPs) on susceptibility to placental infections and pregnancy complications in 455 Brazilian women. Demographic, socioeconomic, gynecological, and clinical characteristics of the women were collected. Placental tissues were sampled from pregnant women and human and viral DNA was extracted. Human alphaherpesvirus 1 (Herpes simplex virus type 1, HSV-1), Human alphaherpesvirus 2 (Herpes simplex virus type 2, HSV-2) and Human betaherpesvirus 5 (Human cytomegalovirus, HCMV) were detected by nested PCR. TLR9 and TLR7 SNPs were genotyped by PCR amplification of bi-directional specific alleles (Bi-PASA) and restriction fragment length polymorphism (RFLP), respectively. Infections at the time of birth were detected in 45.71 % of women. The presence of the TT genotype (recessive model) of the TLR7 SNP was associated with increased susceptibility to HSV-1 infection (O.R. = 2.23, p = 0.05). The presence of the C allele of the TLR9 SNP, in heterozygosis or homozygosis (dominant model), decreased the infection risk by HCMV (O.R. = 0.31, p-mod<0.05). The TT genotype (recessive model) of the TLR7 SNP was significantly associated (p < 0.05) with increased occurrence of pre-treated hypertension. The codominant model of the TLR9 SNP was significantly associated (p < 0.05) with reduced risk of hospitalization during pregnancy. In combination, the AA/CT (TLR7-TLR9) genotypes significantly decreased the risk of placental infection by HSV-1 and/or HSV-2 (O.R. = 0.47, p = 0.02), the susceptibility to all infectious agents considered in combination (O.R. = 0.4, p = 0.00), and the need of hospitalization (O.R. = 0.48, p = 0.02). In conclusion, TLR7 and TLR9 SNPs are potential modulating factors for the risk of placental infections and pregnancy complications.
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Affiliation(s)
- Karen Sánchez-Luquez
- Laboratory of Molecular Biology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil.
| | - Ines Claudia Schadock
- Laboratory of Molecular Biology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Carla Vitola Gonçalves
- Center for Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Michele Tornatore
- Laboratory of Molecular Biology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Fabiana Finger-Jardim
- Laboratory of Molecular Biology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Emiliana Claro Avila
- Laboratory of Molecular Biology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Marcelo Alves Soares
- Oncovirology Program, National Cancer Institute (INCA), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Maria Barral de Martínez
- Laboratory of Molecular Biology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Joel Henrique Ellwanger
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - José Artur Bogo Chies
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Vanusa Pousada da Hora
- Laboratory of Molecular Biology, School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
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Zanini da Rocha J, Feltraco J, Radin V, Vitola Gonçalves C, Almeida da Silva PE, Von Groll A. Streptococcus agalactiae colonization and screening approach in high-risk pregnant women in southern Brazil. J Infect Dev Ctries 2020; 14:332-340. [PMID: 32379709 DOI: 10.3855/jidc.12025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 02/24/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Considering that Group B Streptococcus (GBS) persists as an important cause of neonatal morbidity and mortality, the objective of this study was to evaluate the frequency of maternal colonization by GBS, comparing the culture by the Granada broth with the GeneXpert real-time PCR diagnostic methods and the impact of chemoprophylaxis in high-risk pregnant women. METHODOLOGY A prospective cohort of 110 pregnant women hospitalized for gestational complications was formed and recruited following interview and collection of rectovaginal swabs. RESULTS The frequency of maternal colonization was 28.2% and statistically associated with Capurro> 37 weeks (p = 0.030) and neonatal infection (p = 0.008). Chemoprophylaxis was offered to 80% of those colonized. Among the pregnant women treated, a fivefold reduction in the rate of prematurity and rate of neonatal infection was observed. The sensitivity was 76.6% and 86.6% in culture and PCR, respectively, with an optimal index of agreement between the methods (K = 0.877). Grenade culture was considered an easy and low-cost method, while GeneXpert presented higher cost and error rate of 10%. However, 23.3% of the pregnant women were diagnosed exclusively by GeneXpert and the results were obtained in two hours. CONCLUSIONS This study showed a significant prevalence of maternal colonization for GBS and that both culture and molecular methods had peculiarities that allow different applicability, with the culture being feasible for antenatal screening and in the hospital for high-risk pregnant women with no sign of imminent delivery and GeneXpert being prioritized for situations of preterm birth.
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Affiliation(s)
- Jeane Zanini da Rocha
- Medical Microbiology Research Center, Faculty of Medicine, Universidade Federal do Rio Grande - FURG, Rio Grande/RS, Brazil.
| | - Jéssica Feltraco
- Medical Microbiology Research Center, Faculty of Medicine, Universidade Federal do Rio Grande - FURG, Rio Grande/RS, Brazil.
| | - Vanessa Radin
- Medical Microbiology Research Center, Faculty of Medicine, Universidade Federal do Rio Grande - FURG, Rio Grande/RS, Brazil.
| | - Carla Vitola Gonçalves
- Medical Microbiology Research Center, Faculty of Medicine, Universidade Federal do Rio Grande - FURG, Rio Grande/RS, Brazil.
| | - Pedro Eduardo Almeida da Silva
- Medical Microbiology Research Center, Faculty of Medicine, Universidade Federal do Rio Grande - FURG, Rio Grande/RS, Brazil.
| | - Andrea Von Groll
- Medical Microbiology Research Center, Faculty of Medicine, Universidade Federal do Rio Grande - FURG, Rio Grande/RS, Brazil.
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Avila EC, Finger-Jardim F, Gonçalves CV, da Hora VP, Soares MA, Martínez AMBD. High Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil. Rev Bras Ginecol Obstet 2020; 42:5-11. [PMID: 32107760 PMCID: PMC10316872 DOI: 10.1055/s-0039-1700794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. METHODS Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencing were used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. RESULTS The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. CONCLUSION The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.
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Affiliation(s)
- Emiliana Claro Avila
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Fabiana Finger-Jardim
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Carla Vitola Gonçalves
- Center for Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Vanusa Pousada da Hora
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Marcelo Alves Soares
- Oncovirology Program, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Rio de Janeiro, Brazil
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Torres AD, Sparvoli JMH, Sparvoli AC, Gonçalves CV. SUSTAINED VIROLOGIC RESPONSE RATE IN CHRONIC HEPATITIS C PATIENTS THROUGH DIRECT-ACTING ANTIVIRALS THERAPY. Arq Gastroenterol 2020; 56:394-398. [PMID: 31800735 DOI: 10.1590/s0004-2803.201900000-79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/14/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND In recent years the management of hepatitis C virus infection and the possibility of its eradication have been researched due to the importance that they represent in the health of the world population. Obtaining data that help to cope with this pathology improves the quality of life of those affected by it. The present study evaluated the effectiveness of direct-acting antiviral therapies provided by the Brazilian Ministry of Health in accordance to the Clinical Protocol and Therapeutic Guidelines of 2015. OBJECTIVE To evaluate the epidemiological profile of patients with chronic hepatitis C and the rate of sustained virologic response using direct-acting antivirals of all individuals that attended the referral service for the treatment of chronic hepatitis C at the Hospital of the Federal University of Rio Grande. METHODS This was an observational, retrospective/prospective study with all patients with chronic hepatitis C who had their treatments available from December 2015 to August 2017 according to the criteria of the Clinical Protocol and Therapeutic Guidelines of 2015. In the first phase, the clinical and demographic variables of all individuals enrolled in a treatment for hepatitis C were selected and collected from the Reference Service database. In the second phase, treatment data were collected. The outcome variable, sustained virologic response, was defined as an undetectable viral load on the blood test three months after the end of treatment. The descriptive and bivariate analyzes were performed with Pearson's chi-square and Fisher's Exact test, adopting a P value ≤0.05 in the SPSS 20 software. RESULTS Of the 252 participants in the study, 228 (90.5%) had a sustained virologic response, 55.2% were male with an average age of 58.6 years (SD±9.1). Genotype 1 was the most prevalent, observed in 54.4% of the participants, and 87.4% of the patients had moderate/advanced hepatic fibrosis. After the statistical analysis, it was observed that the individuals with genotype 3 and moderate/advanced hepatic fibrosis had lower sustained virologic response rate (P=0.05 and P=0.04, respectively). CONCLUSION It was observed that the use of direct-acting antivirals, in comparison to previous therapeutic regimens, increases the sustained virologic response, reaching all patients with mild fibrosis. This study provides information that helps in the hepatitis C treatment by showing that prescribing early treatment for patients without hepatic fibrosis and/or genotype 3 virus could increase therapeutic effectiveness.
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Affiliation(s)
- Andréa Delfino Torres
- Universidade Federal do Rio Grande (FURG), Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde. Rio Grande, RS, Brasil
| | - Jucéli Maria Hendges Sparvoli
- Universidade Federal do Rio Grande (FURG), Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde. Rio Grande, RS, Brasil
| | - Antonio Cardoso Sparvoli
- Universidade Federal do Rio Grande (FURG), Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde. Rio Grande, RS, Brasil
| | - Carla Vitola Gonçalves
- Universidade Federal do Rio Grande (FURG), Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde. Rio Grande, RS, Brasil
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Simões MDO, Dumith SC, Gonçalves CV. Adults and the elderly who received nutritional counseling in a city of southern Brazil: a population-based study. Rev Bras Epidemiol 2019; 22:e190060. [PMID: 31826115 DOI: 10.1590/1980-549720190060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/27/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nutrition counseling has played a critical role in the prevention and treatment of various diseases. OBJECTIVE To evaluate how adults and elderly people, who are residents in an urban area of Southern Brazil, received nutritional counseling. METHODS This was a cross-sectional population based study. Data was collected through a questionnaire applied at home. The outcome was the prevalence of nutritional counseling received in the past year that came from different means, including means of communication. Sociodemographic variables, doctor visits in the past year, nutritional state and other healthcare variables were analyzed. RESULTS The sample included 1,296 individuals (rate of answer of 90.7%). The results indicate that the majority of the people interviewed were females (56.6%), with their age ranging from 18 to 59 years-old (75.3%). The prevalence of people receiving nutritional counseling was 19.9% (95%CI 17.3 -22.5). It was higher among women than men (p = 0.01). The sex-adjusted analyses showed a statistically significant (p < 0.05) association in men for the variables: schooling ≥ 12 years; medical consultation in the last year; low weight; obesity; diabetes and hypertension. Among the women, the following variables were associated with the outcome: health insurance; medical consultation in the last year; obesity and diabetes. CONCLUSIONS The low prevalence of nutritional counseling and its association with diseases exposes the need for it to be implemented not only for treatment purposes but also as preventive health actions.
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Affiliation(s)
- Milena de Oliveira Simões
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande - Rio Grande (RS), Brasil
| | - Samuel Carvalho Dumith
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande - Rio Grande (RS), Brasil
| | - Carla Vitola Gonçalves
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande - Rio Grande (RS), Brasil
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11
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Teixeira LO, Figueiredo VLMD, Gonçalves CV, Mendoza-Sassi RA. [Psychometric Evaluation of the Brazilian Version of the "Sexually Transmitted Disease Knowledge Questionnaire"]. Cien Saude Colet 2019; 24:3469-3482. [PMID: 31508765 DOI: 10.1590/1413-81232018249.28212017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 02/11/2018] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the psychometric properties of the Brazilian version of the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). A convenience sample of 429 students of a Brazilian public university participated in the study. Exploratory Factor Analysis suggested one factor solution (variance explained = 61.1%, eigenvalue = 7.2), confirmed by the confirmatory analysis (Root Mean Square Error of Approximation = 0.04; Comparative Fit Index = 0.91; Tucker-Lewis Index = 0.90; Standardized Root Mean Square Residual = 0.05). Five items feature charges less than 0.30 and wer eliminated. The instrument demonstrated internal consistency (Composite reliability = 0.97; Cronbach's alpha = 0.83) and temporal stability (Pearson correlation = 0.86; kappa = 0.16) over a brief period. The knowledge significantly varies by age, sex and course of study. In conclusion, this study highlights the satisfactory psychometric proprieties of the Brazilian version of STD-KQ in university students.
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Affiliation(s)
- Lisiane Ortiz Teixeira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande. R. General Osório s/n, Centro 96200-400 Rio Grande RS Brasil.
| | | | - Carla Vitola Gonçalves
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande. R. General Osório s/n, Centro 96200-400 Rio Grande RS Brasil.
| | - Raúl Andrés Mendoza-Sassi
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande. R. General Osório s/n, Centro 96200-400 Rio Grande RS Brasil.
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12
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Gonçalves CDS, Cesar JA, Marmitt LP, Gonçalves CV. Frequency and associated factors with failure to perform the puerperal consultation in a cohort study. Rev Bras Saude Mater Infant 2019. [DOI: 10.1590/1806-93042019000100004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to identify the frequency and factors associated with the non-realization of puerperal consultations in women resident of a medium-sized municipality in Brazil. Methods: a prospective cohort study based on data collected in two time points, the first 48h and after the 42nd day post-childbirth. In order to analyze data, proportions were compared using the chi-square test, and the adjusted analysis was performed using Poisson regression, according to a predetermined hierarchical model. Significance level was set at 5%. Results: of the 572 women included in the study, 24.8% did not perform puerperal consul-tations. The factors associated with the non-realization of puerperal consultations were: lower income (1 st tercile PR= 2.01; CI95%= 1.21-3.33 – 2 nd tercile PR= 1.94; CI95%=1.17-3.20) and schooling (≤ 8 years PR= 2.00; CI95%= 1.24-3.24), comorbidities during preg-nancy (PR= 1.45; CI95%= 1.01-2.09), realization of antenatal care in the public service (PR= 1.74; CI95%= 1.18-2.58) and non-use of contraceptive methods (PR= 3.10; CI95%=1.86-5.16). Conclusions: puerperal revision does not seem to be valued in the antenatal care, mainly in the public health system. An important inequality was identified in the provision of this service, since women more prone to recurring pregnancy and with lower income and schooling were the ones that least returned to the puerperal consultation.
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13
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Teixeira LO, Belarmino V, Gonçalves CV, Mendoza-Sassi RA. [Temporal trend and spatial distribution of congenital syphilis in the state of Rio Grande do Sul between 2001 and 2012]. Cien Saude Colet 2018; 23:2587-2597. [PMID: 30137128 DOI: 10.1590/1413-81232018238.25422016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/17/2016] [Indexed: 11/22/2022] Open
Abstract
The scope of the study was to evaluate the temporal trend and spatial distribution of congenital syphilis (CS) in the state of Rio Grande do Sul. All cases reported by the SINASC/DATASUS between 2001 and 2012 were included. The number of live births was obtained from DATASUS. Incidence rates of CS were grouped according to micro-regions of IBGE and analyzed for the entire period and for triennia. The spatial correlation was analyzed by the global Moran index (I) and the local index. 3,613 cases were reported. Between 2007 and 2012 89 neonates (3.6%) died. Rates varied from to 1.03 in 2001 to 5.1 cases per 1000 live births in 2012, with an annual increase of 0.84 cases per 1000 live births (p < 0.01) and 93.88% of explained variance. The micro-regions were spatially independent (I = 0.06; p = 0.25), with Porto Alegre having the highest incidence (4.19 cases / 1000 live births) and Jaguarão the lowest (0.23 cases / 1000 live births). Micro-regions with significant local spatial dependence were observed. The increase in cases of CS highlights poor prenatal quality care. Identification of the micro-regions with the highest incidence is essential to focus public policy on this health problem.
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Affiliation(s)
- Lisiane Ortiz Teixeira
- Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Centro. 96203-900 Rio Grande RS Brasil.
| | - Vanusa Belarmino
- Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Centro. 96203-900 Rio Grande RS Brasil.
| | - Carla Vitola Gonçalves
- Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Centro. 96203-900 Rio Grande RS Brasil.
| | - Raúl Andrés Mendoza-Sassi
- Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Centro. 96203-900 Rio Grande RS Brasil.
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Da Mota LD, Finger-Jardim F, Silva CM, Germano FN, Nader MM, Gonçalves CV, Da Hora VP, Silveira J, Basso RP, Soares MA, Martínez AMB. High prevalence and autochtonous transmission of human pegivirus (HPgV-1) in blood donors in the extreme southern of Brazil. J Med Virol 2018; 91:31-37. [PMID: 30133818 DOI: 10.1002/jmv.25291] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/29/2018] [Indexed: 01/04/2023]
Abstract
Recent studies have suggested that human pegivirus 1 (HPgV-1) may have some pathogenic potential. In the southernmost region of Brazil, studies on HPgV-1 are scarce, and circulating genotypes have not yet been identified. The current study aimed to evaluate the prevalence of HPgV-1 among blood donors from the southernmost region of Brazil and identify the genotypes involved with associated factors. A cross-sectional study was conducted with 281 blood donors, who had their plasma subjected to RNA extraction, complementary DNA synthesis, HPgV-1 detection by nested polymerase chain reaction, and subsequent genotyping. The observed prevalence of HPgV-1-RNA was 21.7%. The only variable that was significantly associated with virus infection was the relationship status of the donor. Single or no fixed partner blood donors were twice as likely to have HPgV-1 (95% CI, 1.12 to 4.56; P = 0.02). Genotype 2-subtypes 2b (69%) and 2a (29%)-was the most prevalent. In the absence of risk factors for parenteral transmission, it is likely that sexual transmission was the route of infection in the individuals studied. Further work will be needed to determine whether this virus is inert in the population, or if there are potential deleterious effects in infected individuals.
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Affiliation(s)
- Luísa D Da Mota
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Fabiana Finger-Jardim
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Cláudio M Silva
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Fabiana N Germano
- Laboratory of Biomedical Research, Institute of Health of Nova Friburgo, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Maiba M Nader
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Carla Vitola Gonçalves
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Vanusa P Da Hora
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Jussara Silveira
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Rossana P Basso
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Marcelo A Soares
- Oncovirology Program, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil
| | - Ana M B Martínez
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
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Pereira JL, Volcão LM, Klafke GB, Vieira RS, Gonçalves CV, Ramis IB, da Silva PEA, von Groll A. Antimicrobial Resistance and Molecular Characterization of Extended-Spectrum β-Lactamases of Escherichia coli and Klebsiella spp. Isolates from Urinary Tract Infections in Southern Brazil. Microb Drug Resist 2018; 25:173-181. [PMID: 30133334 DOI: 10.1089/mdr.2018.0046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The objective of this study was to evaluate the frequency of different extended-spectrum β-lactamases (ESBL) as well as to associate these ESBL with antimicrobial (ATM) resistance in Escherichia coli and Klebsiella spp. isolates from outpatients and inpatients with urinary tract infections. The study included 435 consecutive nonduplicate clinical isolates, including 362 E. coli isolates, 62 Klebsiella pneumoniae isolates, and 11 K. oxytoca isolates. Isolates were obtained from patients who were treated in a University Hospital between August 2012 and July 2013. Three multiplex PCR were performed to identify the ESBL groups. A total of 48 (11%) ESBL-producing isolates were found. The risk for the ESBL presence was significantly higher in males (26.4%) than females (8%), from hospital-acquired infections (29.1%) than community-acquired infections (7.0%) and in Klebsiella spp. (27.4%) than in E. coli (7.7%). ESBL-producing isolates presented a significantly higher percentage of resistance in 21 of the 23 ATMs analyzed. The CTX-M-1 group was the most predominant ESBL identified. The blaCTX-M-1-group gene was found in 56% of the total ESBL producers from community and in 42.4% from hospital origins; it was followed in frequency by the blaCTX-M-8/25-group, also found in both environments. Klebsiella spp. presented the largest variety of β-lactamase enzyme combinations and a higher level of resistance to cefotaxime. These findings contribute to better knowledge of the epidemiology of ESBL enzymes and are alarming for the reduced therapeutic options available for the risk groups identified in the studied populations.
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Affiliation(s)
- Juliano Lacava Pereira
- 1 Faculdade de Medicina, Medical Microbiology Research Center (NUPEMM), Universidade Federal do Rio Grande-FURG , Rio Grande, Brazil
| | - Lisiane Martins Volcão
- 1 Faculdade de Medicina, Medical Microbiology Research Center (NUPEMM), Universidade Federal do Rio Grande-FURG , Rio Grande, Brazil
| | - Gabriel Baracy Klafke
- 2 Faculdade de Medicina, Universidade Federal do Rio Grande-FURG , Rio Grande, Brazil
| | - Roseli Stone Vieira
- 3 Hospital Universitário Dr. Miguel Riet Correa , Universidade Federal do Rio Grande-FURG, Rio Grande, Brazil
| | | | - Ivy Bastos Ramis
- 1 Faculdade de Medicina, Medical Microbiology Research Center (NUPEMM), Universidade Federal do Rio Grande-FURG , Rio Grande, Brazil
| | - Pedro Eduardo Almeida da Silva
- 1 Faculdade de Medicina, Medical Microbiology Research Center (NUPEMM), Universidade Federal do Rio Grande-FURG , Rio Grande, Brazil
| | - Andrea von Groll
- 1 Faculdade de Medicina, Medical Microbiology Research Center (NUPEMM), Universidade Federal do Rio Grande-FURG , Rio Grande, Brazil
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Zogbi L, Gonçalves CV, Tejada VF, Martins D, Karam F, Machado Dos Santos S, Caldeira RR, Senhorin GZ, Lauz S. Treatment of bilateral ovarian dysgerminoma with 11-year follow-up: A case report. Ann Med Surg (Lond) 2018; 33:50-52. [PMID: 30186597 PMCID: PMC6122391 DOI: 10.1016/j.amsu.2018.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/04/2018] [Accepted: 08/13/2018] [Indexed: 01/30/2023] Open
Abstract
Introduction Malignant ovarian germ cell tumors (MOGCTs) are rare malignancies with an incidence of about 0.5/100,000. They account for less than 5% of all ovarian tumors, of which 32.8% are dysgerminomas, the female analogue of seminomas. These tumors occur in all age groups, with peak incidence below the age of 20 years in women. Aim To describe the case of a bilateral ovarian dysgerminoma treatment with 11-year follow-up. Methods Case report with details regarding clinical history, surgical treatment, chemotherapy and follow up. We include a brief literature review. Results The patient underwent radical surgery for an advanced dysgerminoma, 20 cm in length, that compromised the contralateral ovary and sigmoid. Neoplastic cells were found in ascitic fluid. Subsequently, she underwent adjuvant chemotherapy according to a standard protocol. She has survived disease-free for more than 11 years. Conclusions Dysgerminoma is a malignant neoplasm that, similar to other cancers, is easier to treat when diagnosed early. However, cures may be obtained even in advanced cases.
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Affiliation(s)
- Luciano Zogbi
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Carla Vitola Gonçalves
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Victor Felipe Tejada
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Daiane Martins
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Fabine Karam
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Sílvia Machado Dos Santos
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Roberta Raseira Caldeira
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Gisele Zanetti Senhorin
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
| | - Susi Lauz
- Faculdade de Medicina (FAMED) - Universidade Federal do Rio Grande (FURG), Rio Grande city, Rio Grande do Sul State, Brazil
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Gonçalves CV, Camargo VP, Cagol JM, Miranda B, Mendoza-Sassi RA. Women's knowledge of methods for secondary prevention of breast cancer. Cien Saude Colet 2018; 22:4073-4082. [PMID: 29267724 DOI: 10.1590/1413-812320172212.09372016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 04/17/2016] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate women's knowledge of methods for screening breast cancer. The study was done on a population of women aged 18 or over in the city of Rio Grande between April and November 2011. Interviewers used questionnaires on all of the women at selected households. Models were developed for every type of screening (self-examination of breasts, mammography, and clinical exams) that were analyzed through the use of Poisson regression. Out of the 1596 women interviewed, 1355 reported self-examination, 456, mammography, and only 191, clinical examination of the breast, performed by a health professional, as important for the prevention of breast cancer. White women with 11 years or more worth of schooling had a greater probability of having mammography exams and clinical examinations as methods for screening. We noted, linked to the aforementioned, that there was a linear tendency whereby there was a greater probability for those with high incomes to undergo one of the above interventions. The study noted that there was a need for more detailed information aimed at the population on prevention methods in order to avoid late diagnosis. We noted that non-white women with little education and on low incomes showed less knowledge of clinical examination methods and mammographies.
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Affiliation(s)
- Carla Vitola Gonçalves
- Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Visconde de Paranaguá 102, Centro. 96020-550 Rio Grande RS Brasil.
| | - Valéri Pereira Camargo
- Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Visconde de Paranaguá 102, Centro. 96020-550 Rio Grande RS Brasil.
| | - Jussara Marli Cagol
- Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Visconde de Paranaguá 102, Centro. 96020-550 Rio Grande RS Brasil.
| | - Bruna Miranda
- Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Visconde de Paranaguá 102, Centro. 96020-550 Rio Grande RS Brasil.
| | - Raul Andres Mendoza-Sassi
- Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Visconde de Paranaguá 102, Centro. 96020-550 Rio Grande RS Brasil.
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Vianna JS, Ramis IB, Ramos DF, Gastal OL, Silva RAD, Gonçalves CV, Silva PEAD. The interplay between mutations in cagA, 23S rRNA, gyrA and drug resistance in Helicobacter pylori. Rev Inst Med Trop Sao Paulo 2018; 60:e25. [PMID: 29972462 PMCID: PMC6029892 DOI: 10.1590/s1678-9946201860025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/09/2018] [Indexed: 02/07/2023] Open
Abstract
In this study, we evaluated the mutations of Helicobacter pylori associated with resistance to clarithromycin and levofloxacin. Furthermore, based on the proposed interaction between antimicrobial resistance and pathogenicity, we correlated the mutation profiles of the strains with the presence of the pathogenicity gene cagA. We analyzed 80 gastric biopsy specimens from H. pylori-infected patients for point mutations in the 23S rRNA gene region and in the gyrA gene, which are related to clarithromycin and levofloxacin resistance, respectively, and investigated the presence of the cagA gene in these strains. We observed that in the assayed biopsies, 8.7% (7/80) had mutations in the 23S rRNA gene region at positions 2143 and 2142, while 22.5% (18/80) had mutations in gyrA at codons 87 and 91. Moreover, absence of the CagA-EPIYA pathogenicity factor was observed in 68% (17/25) of resistant samples. The knowledge of the local profile of antimicrobial resistance and the complex interplay involving resistance and pathogenicity can contribute to an appropriate clinical approach.
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Affiliation(s)
- Júlia Silveira Vianna
- Programa de Pós-Graduação em Biotecnologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ivy Bastos Ramis
- Núcleo de Pesquisas em Microbiologia Médica, Universidade Federal de Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Daniela Fernandes Ramos
- Núcleo de Pesquisas em Microbiologia Médica, Universidade Federal de Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Otávio Leite Gastal
- Setor de Endoscopia Digestiva, Hospital Universitário São Francisco de Paula, Pelotas, Rio Grande do Sul, Brazil
| | - Renato Azevedo da Silva
- Setor de Endoscopia Digestiva, Hospital Universitário São Francisco de Paula, Pelotas, Rio Grande do Sul, Brazil
| | - Carla Vitola Gonçalves
- Núcleo de Pesquisas em Microbiologia Médica, Universidade Federal de Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
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Finger-Jardim F, Avila EC, da Hora VP, Santos PCD, Gonçalves CV, Mor G, de Martinez AMB, Soares MA. Herpes simplex virus type 2 IgG antibodies in sera of umbilical cord as a proxy for placental infection in asymptomatic pregnant women. Am J Reprod Immunol 2018; 79:e12824. [PMID: 29427299 DOI: 10.1111/aji.12824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/17/2018] [Indexed: 12/15/2022] Open
Abstract
PROBLEM Herpes simplex virus type 2 (HSV-2) infection is one of the most prevalent diseases worldwide and is mainly sexually transmitted. When infecting pregnant women, HSV-2 is able to infect the placenta, can reach the fetus, and may affect the fetal development. We sought to determine the prevalence of HSV-2 infection and reactivation in asymptomatic pregnant women, the correlation between IgG in the maternal circulation and cord blood, and the correlation between circulating IgG, placental, and newborn infection (blood cord). METHOD OF STUDY Serum samples and placental tissues from pregnant women and umbilical cord blood samples from their newborns were collected. Anti-HSV-2 antibodies were identified by ELISA, and HSV-2 DNA was detected by nested PCR. RESULTS The seropositivity of IgG in pregnant women was 29.7% and IgM was detected in 1 woman (0.5%). In the umbilical cord of newborns, 33.1% were IgG-positive and IgM was detected in 2 samples (1.5%). A positive correlation between HSV-2 IgG titers in serum from pregnant women and cord blood samples was found (r = .36, P = .001). A difference between the positive and negative placental groups (maternal side) was found in titers of IgG in sera of umbilical cord, which were significantly higher in the positive placental group (P = .004). CONCLUSION We describe for the first time that newborns from mothers with HSV-2 placental infection have higher IgG titers in sera of umbilical cord, suggesting IgGs antibodies can be indicative of placental viral infection in asymptomatic women.
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Affiliation(s)
- Fabiana Finger-Jardim
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Emiliana Claro Avila
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Vanusa Pousada da Hora
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Paula Costa Dos Santos
- Parasitology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Carla Vitola Gonçalves
- Center for Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Gil Mor
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | | | - Marcelo Alves Soares
- Oncovirology Program, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil
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Zanchi M, Mendoza-Sassi RA, Silva MRD, Almeida SGD, Teixeira LO, Gonçalves CV. Pregnancy recurrence in adolescents in Southern Brazil. Rev Assoc Med Bras (1992) 2017; 63:628-635. [PMID: 28977089 DOI: 10.1590/1806-9282.63.07.628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/03/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine the pregnancy recurrence among adolescents and young people in a city located in the extreme south of Brazil and to identify associated factors. METHOD One hundred and twelve (112) women participated, having delivered their children in 2010, while adolescents. The sample was stratified in two stages, being the first a census of the whole population of the city and the second a convenience sample. For statistical analysis, Pearson Chi-square test was used, with a significance level of 5%. RESULTS The recurrence rate was 53.6%, with an average of 28.6 months. At the time of delivery, in 2010, recurrence was significantly associated with level of education (p=0.044) as well as not being in school (p=0.036). In 2014, the factors associated were level of education (p<0.001), transcript of grades (p=0.030) and income (p=0.030). CONCLUSION Recurrence of teenage pregnancy represents a lack of importance given to formal education, a fact that mitigates the opportunities and hinders insertion in the labor market, creating a cycle of social inequality. Multidisciplinary efforts involving schools, health services and the youth in educational activities are thus vital, aiming at critical thinking to transform reality.
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Affiliation(s)
- Mariza Zanchi
- PhD Student, Health Science Graduate Program, Faculdade de Medicina da Universidade Federal do Rio Grande (Famed-FURG), Rio Grande, RS, Brazil
| | | | | | | | - Lisiane Ortiz Teixeira
- PhD Student, Health Science Graduate Program, Faculdade de Medicina da Universidade Federal do Rio Grande (Famed-FURG), Rio Grande, RS, Brazil
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Brandolt TM, Klafke GB, Gonçalves CV, Bitencourt LR, Martinez AMBD, Mendes JF, Meireles MCA, Xavier MO. Prevalence of Candida spp. in cervical-vaginal samples and the in vitro susceptibility of isolates. Braz J Microbiol 2016; 48:145-150. [PMID: 27756539 PMCID: PMC5220630 DOI: 10.1016/j.bjm.2016.09.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 05/30/2016] [Indexed: 01/06/2023] Open
Abstract
Vulvovaginal candidiasis (VVC) is an infection of the genital mucosa caused by different species of the genus Candida. Considering the lack of data on this topic in the south of Brazil, this study aimed to assess the prevalence of Candida spp. in the cervical-vaginal mucosa of patients treated at a university hospital in southern Rio Grande do Sul, as well as the etiology and the susceptibility of the isolates against fluconazole, itraconazole, miconazole and nystatin. Samples were collected at the gynecology clinic of the Federal Hospital of the University of Rio Grande, and the isolates were identified using phenotypic and biochemical tests. The susceptibility analysis was performed according to the CLSI M27-A2 protocol. Of the 263 patients included, Candida spp. was isolated in 27%, corresponding to a prevalence of approximately 15% for both VVC and colonization. More than 60% of the isolates were identified as Candida albicans; C. non-albicans was isolated at a rate of 8.6% in symptomatic patients and 14.3% in asymptomatic patients. The prevalence of resistance against fluconazole and itraconazole was 42% and 48%, respectively; the minimal inhibitory concentration of miconazole ranged from 0.031 to 8μg/mL, and that of nystatin ranged from 2 to >16μg/mL. The high rate of resistance to triazoles observed in our study suggests the necessity of the association of laboratory exams to clinical diagnosis to minimize the practice of empirical treatments that can contribute to the development of resistance in the isolates.
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Affiliation(s)
- Tchana Martinez Brandolt
- Universidade Federal do Rio Grande, Laboratório de Micologia, Rio Grande, RS, Brazil; Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brazil
| | - Gabriel Baracy Klafke
- Universidade Federal do Rio Grande, Laboratório de Micologia, Rio Grande, RS, Brazil
| | - Carla Vitola Gonçalves
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brazil
| | | | | | | | | | - Melissa Orzechowski Xavier
- Universidade Federal do Rio Grande, Laboratório de Micologia, Rio Grande, RS, Brazil; Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brazil.
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Valença MS, Scaini JLR, Abileira FS, Gonçalves CV, von Groll A, Silva PEA. Prevalence of tuberculosis in prisons: risk factors and molecular epidemiology. Int J Tuberc Lung Dis 2016; 19:1182-7. [PMID: 26459530 DOI: 10.5588/ijtld.15.0126] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Tuberculosis (TB) in prisons is a challenge for the public health system. Active and passive case screening are important tools for TB case detection. OBJECTIVE To characterise TB in a southern Brazil prison in terms of epidemiological variables, diagnostic approaches and clinical isolate genotypes. DESIGN Inmates of a southern Brazilian prison were assessed using active and passive TB case screening. Sputum microscopy, culture, drug susceptibility testing and genotyping were performed. Data were analysed using descriptive statistics and multivariable logistic regression. RESULTS TB prevalence was 4712 per 100 000 inmates, and was associated with low educational level, time incarcerated, productive cough, previous TB history, smoking and human immunodeficiency virus (HIV) infection. Overall, 27.8% of TB cases were detected by culture only; the prevalence of drug-resistant strains was 7.8%; 58.3% of clinical isolates had an identical genotypic profile. CONCLUSION The study showed extensive circulation of Mycobacterium tuberculosis strains in a highly endemic prison. It is recommended that priority be given to the evaluation of prison inmates with longer jail times, those who are HIV-positive, those with symptoms and those with a previous history of tuberculosis. We observed that active case finding induced passive case detection.
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Affiliation(s)
- M S Valença
- Escola de Enfermagem, Universidade Federal do Rio Grande, Rio Grande, Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Pelotas, Brazil
| | - J L R Scaini
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - F S Abileira
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - C V Gonçalves
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - A von Groll
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - P E A Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
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Wachholz VA, Costa MG, Kerber NPDC, Gonçalves CV, Ramos DV, Sena FG. Relação entre a qualidade da assistência pré-natal e a prematuridade: Uma revisão integrativa. ACTA ACUST UNITED AC 2016. [DOI: 10.18378/rebes.v6i2.3542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A prematuridade é um dos grandes problemas de saúde pública, por contribuir fortemente para a elevada taxa de morbimortalidade infantil. Possíveis fatores de risco que colaboram para sua ocorrência têm sido investigados, dentre eles a assistência pré-natal, pois a mesma é elencada em virtude de, por meio dela, ser possível prevenir, diagnosticar e tratar eventos indesejáveis que possam resultar em danos para mãe e o recém-nascido. Objetivou-se identificar a produção cientifica sobre a associação entre a prematuridade e a qualidade da assistência pré-natal. Revisão integrativa com coleta de dados realizada de março a junho de 2014 utilizando o descritor trabalho de parto prematuro nas bases de dados Scientific Eletronic Library Online e Literatura Internacional em Ciências da Saúde. Os artigos foram organizados conforme o assunto abordado, sendo criadas três categorias: fatores de risco para o parto prematuro, prevenção ao parto prematuro e assistência pré-natal e parto prematuro. Embora tenham sido encontrados poucos estudos relacionando o parto prematuro e a realização do pré-natal, cabe ressaltar a importância da realização de uma assistência pré-natal adequada, de acordo com o que o Ministério da Saúde preconiza por meio de uma rotina mínima. Ela é importante para detectar e tratar precocemente determinadas complicações que levam, entre outros desfechos indesejáveis, ao parto prematuro. Relationship between the quality of service pre -natal and a prematurity: An integrative reviewAbstract: Prematurity is a one of the major problem of public health, for contributing to the high rate of infant morbidity and mortality. Possible risk factors that collaborate to their occurrence have been investigated, including prenatal assistance, because through it, be possible to prevent, diagnose and treat adverse events that may result in damage to mother and the newborn. The objective identify the scientific production on the association between prematurity and the quality of prenatal care. Integrative review with data collection carried out from March to June 2014 using the descriptor preterm labor in databases Scientific Electronic Library Online and International Literature on Health Sciences. The articles were organized according to the subject matter, being created three categories: risk factors for preterm birth, preterm labor prevention and prenatal care and preterm birth. Although they have been found few studies relating the premature birth and the completion of prenatal care, it is important to stress the importance of a proper prenatal care, according to the Ministry of Health recommends using a minimum routine. It is important to detect and treat early certain complications that lead, among other undesirable outcomes, to premature birth.
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Volcão LM, Lacava JP, Ramis IB, Ramos DF, Damati GS, Gonçalves CV, Da Silva PEA, Groll AV. Factors associated with ciprofloxacin and levofloxacin resistance in gram-negative bacilli isolated from urinary tract infections. Rev Epidemiol Control Infect 2016. [DOI: 10.17058/reci.v6i1.6574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives: Fluoroquinolones are one of the most frequently prescribed antimicrobial classes for the treatment of urinary tract infections (UTIs) of both hospital and community origin. This study aims to determine the frequency and the factors associated with resistance to ciprofloxacin and levofloxacin in gram-negative bacilli isolated from patients with UTIs treated in a hospital in southern Brazil. Methods: We performed a transversal and analytical study based on cases of urinary tract infection caused by gram-negative bacteria (GNB) in patients at the Hospital Universitário Dr. Miguel Riet Correa Jr. in Rio Grande/RS from August 2012 to July 2013. Independent variables such as the age and sex of patients, source of infection of the UTI and the characteristics of the bacterial strains were analyzed. Results: Of the 562 GNB analyzed, the total frequencies of ciprofloxacin and levofloxacin resistance were, respectively, 25.5% and 23.3% in strains of community origin and 62.6% and 59% in strains of hospital origin. The risk factors associated with ciprofloxacin and levofloxacin resistance were sex (male), infections acquired in the hospital, longer hospitalization times, and the presence of extended spectrum β-lactamases (ESBLs) in the bacterial strains. Conclusions: We observed a strong association between GNB resistance, the time spent in the hospital and the presence of ESBLs. To control antibiotic resistance and to reduce the cost of health care, a strong hospital policy of vigilance is required regarding the use of and resistance to antibiotics.
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da Rosa MC, Lobato RC, Gonçalves CV, Silva NMOD, Barral MFM, Martinez AMBD, da Hora VP. Evaluation of factors associated with vertical HIV‐1 transmission. Jornal de Pediatria (Versão em Português) 2015. [DOI: 10.1016/j.jpedp.2015.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Rosa MCD, Lobato RC, Gonçalves CV, Silva NMOD, Barral MFM, Martinez AMBD, Hora VPD. Evaluation of factors associated with vertical HIV-1 transmission. J Pediatr (Rio J) 2015; 91:523-8. [PMID: 26126701 DOI: 10.1016/j.jped.2014.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/19/2014] [Accepted: 12/22/2014] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To compare the prevalence and factors associated with vertical transmission of human immunodeficiency virus 1 (HIV-1) among pregnant women treated in the periods of 1998-2004 and 2005-2011 in a reference service for the care of HIV-infected patients in southern Brazil. METHODS This was a descriptive and analytical study that used the databases of laboratories from the CD4 and STDs/AIDS Viral Load National Laboratory Network of the Brazilian Ministry of Health. HIV-1-infected pregnant women were selected after an active search for clinical information and obstetric and neonatal data from their medical records between the years of 1998 and 2011. RESULTS 102 pregnant women were analyzed between 1998 and 2004 and 251 in the period between 2005 and 2011, totaling 353 children born to pregnant women with HIV-1. It was observed that the vertical transmission rate was 11.8% between 1998 and 2004 and 3.2% between 2005 and 2011 (p<0.001). The increased use of antiretroviral drugs (p=0.02), the decrease in viral load (p<0.001), and time of membrane rupture lower than 4h (p<0.001) were associated with the decrease of vertical transmission factors when comparing the two periods. CONCLUSION It was observed a decrease in the rate of vertical transmission in recent years. According to the studied variables, is suggested that the risk factors for vertical transmission of HIV-1 were absence of antiretroviral therapy, high viral load in the pregnant women, and membrane rupture time >4h.
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Ramis IB, Vianna JS, Halicki PCB, Lara C, Tadiotto TF, da Silva Maciel JB, Gonçalves CV, von Groll A, Dellagostin OA, da Silva PEA. Relationship of interleukin-1B gene promoter region polymorphism with Helicobacter pylori infection and gastritis. J Infect Dev Ctries 2015; 9:1108-16. [PMID: 26517486 DOI: 10.3855/jidc.6123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 03/10/2015] [Accepted: 04/01/2015] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Helicobacter pylori infection is associated with gastritis, peptic ulcer disease and gastric carcinoma. The severity of damage is determined by the interplay between environmental/behavioral factors, bacterial pathogenicity genes and host genetic polymorphisms that can influence the secretion levels of inflammatory cytokines. Accordingly, this study aimed to identify polymorphisms in the IL-1B and IL-1RN genes and their associations with H. pylori infection, cagA gene of H. pylori, and gastroduodenal diseases. METHODOLOGY Gastric biopsy samples from 151 patients infected with H. pylori and 76 uninfected individuals were analyzed. H. pylori infection was diagnosed by histology and PCR. Polymorphisms at positions -511, -31 and +3954 of the IL-1B gene were detected by PCR-RFLP, and an analysis of the VNTR polymorphism of the IL-1RN gene was performed by PCR. RESULTS It was observed that the presence of the T/T genotype at position -511 and the C/C genotype at position -31 were associated with H. pylori infection and with an increased risk of gastritis in H. pylori-positive patients. Additionally, strains from patients H. pylori-positive carrying the cagA gene was significantly related with the T/T genotype at position -511 of IL-1B. No association of polymorphisms at position +3954 of IL-1B and in the IL-1RN with H. pylori infection and with risk of severe gastric diseases was found. CONCLUSIONS We demonstrated that polymorphisms in the promoter region of the IL-1B gene (at positions -511 and -31) are associated with an enhanced risk of H. pylori infection as well as gastritis in H. pylori-positive patients.
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Affiliation(s)
- Ivy Bastos Ramis
- Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brasil.
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Santos PC, Lehmann LM, Lorenzi C, Hirsch C, Telmo PL, Mattos GT, Cadore PS, Klafke GB, Berne MEA, Gonçalves CV, Scaini CJ. The Seropositivity of Toxocara spp. Antibodies in Pregnant Women Attented at the University Hospital in Southern Brazil and the Factors Associated with Infection. PLoS One 2015; 10:e0131058. [PMID: 26146833 PMCID: PMC4492739 DOI: 10.1371/journal.pone.0131058] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/28/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human toxocariasis is a parasitic zoonosis with a worldwide distribution but is underdiagnosed with an underestimated impact on human health. The ingestion of embryonated eggs of Toxocara spp. present on the hands or in contaminated food or water is the main mode of infection. The only record of Toxocara congenital infection in humans occurred in a premature infant. Helminth infections during pregnancy may be associated with reproductive disorders. Studies investigating the occurrence of toxocariasis in pregnancy are scarce, as is research on the possible implications of these parasites in reproductive health. The aim of this study was to determine the seroprevalence of antibodies to Toxocara spp. in pregnant women and to identify risk factors associated with its infection. METHODOLOGY/PRINCIPAL FINDINGS The cross-sectional study of the seropositivity of specific antibodies for Toxocara spp. was performed on 280 pregnant women. Serum samples were examined with enzyme-linked immunoassay. Epidemiological data were obtained through a questionnaire containing information about obstetric history, general life style choices, and the social and economic status of the women. The prevalence of Toxocara spp. IgG in pregnant women was 6.4%. Some of the risk factors associated with the infection were owning dogs (p = 0.003), living in the city centre (p = 0.028), living at the city beach (p = 0.003), and having a family income at or below minimum wage (p < 0.001). There was no association between reproductive disorders and Toxocara seropositivity. CONCLUSIONS/SIGNIFICANCE The seroprevalence of 6.4% for Toxocara spp. in pregnant women shows that there was exposure to the parasite. The study demonstrates the need for attention for the completion of clinical diagnosis parameters, as well as the expansion of highly specific serological studies in different regions to understand the impact of toxocariasis in pregnancy.
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Affiliation(s)
- Paula Costa Santos
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Lis Maurente Lehmann
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Carolina Lorenzi
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Carolina Hirsch
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Paula Lima Telmo
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Gabriela Torres Mattos
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Priscila Silva Cadore
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Gabriel Baracy Klafke
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Maria Elisabeth Aires Berne
- Laboratory of Parasitology, Institute of Biology, Department of Microbiology and Parasitology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Carla Vitola Gonçalves
- Obstetric Center, University Hospital of Rio Grande–Rio Grande, Rio Grande do Sul, Brazil
| | - Carlos James Scaini
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
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Teixeira LO, Amaral SC, Finger-Jardim F, Hora VPD, Gonçalves CV, Soares MA, Martinez AMBD. Frequência do Papilomavírus Humano na placenta, no colostro e no sangue do cordão umbilical. Rev Bras Ginecol Obstet 2015; 37:203-7. [DOI: 10.1590/so100-720320150005293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/24/2015] [Indexed: 11/22/2022] Open
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Garcês AX, de Martinez AMB, Gonçalves CV, Germano FN, Barral MFM, Vieira VC. [Prevalence of Chlamydia trachomatis and risk factors associated with infection detected in endocervical sample]. Rev Bras Ginecol Obstet 2014; 35:379-83. [PMID: 24126358 DOI: 10.1590/s0100-72032013000800008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 08/01/2013] [Indexed: 11/22/2022] Open
Abstract
PURPOSE It was to determine the prevalence of Chlamydia trachomatis and the risk factors associated with infection in endocervical specimens from women seen in outpatient Obstetrics and Gynecology. METHODS Samples of endocervical secretion of 200 women treated at the University Hospital of the Federal University of Rio Grande were analyzed for the presence of C. trachomatis by polymerase chain reaction (PCR) using primers that amplify CT05/CT06 281 base pairs of the main outer membrane protein of C. trachomatis. All participants completed a pre-coded and self-report questionnaire. Data were analyzed with the SPSS 17.0 software; for multivariate analysis it was used Poisson regression. RESULTS Of the 200 women who were included in the study, the prevalence of infection with C. trachomatis was 11% (22 patients) and these 55 (27.5%) were positive for HPV. Risk factors associated with infection by C. trachomatis were: 8 years or less of schooling (p<0.001), family income below the poverty level (p=0.005), first intercourse at age 15 or less (p=0.04) and being a carrier of the virus HIV (p<0.001). After multivariate analysis, only the variables of schooling or less than eight years (PR 6.0; 95%CI 1.26 - 29.0; p=0.02) and presence of HIV (RP 14.1; 95%CI 3.4 - 57.5; p<0.001) remained statistically significant. CONCLUSIONS The prevalence of C. trachomatis in endocervical specimens by PCR was 11%. The factors associated with a higher infection by C. trachomatis were lower education and being HIV positive.
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Caldeira TDM, Gonçalves CV, Oliveira GRD, Fonseca TVD, Gonçalves R, Amaral CTD, Hora VPD, Martinez AMBD. Prevalence of herpes simplex virus type 2 and risk factors associated with this infection in women in southern Brazil. Rev Inst Med Trop Sao Paulo 2014; 55:315-21. [PMID: 24037285 PMCID: PMC4105068 DOI: 10.1590/s0036-46652013000500004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 02/05/2013] [Indexed: 01/09/2023] Open
Abstract
SUMMARY The herpes simplex virus type 2 (HVS-2) is the most prevalent infection worldwide. It is a cofactor in the acquisition of human immunodeficiency virus (HIV) and the persistence of human papillomavirus (HPV). This study evaluated the prevalence of HSV-2, using the polymerase chain reaction (PCR), and associated factors in patients treated at the Federal University of Rio Grande (FURG) and Basic Health Units (BHU) in Rio Grande, Brazil. The observed prevalence of HSV-2 was 15.6%. Among the 302 women studied, 158 had received assistance in BHU and 144 were treated at FURG. The prevalence of HSV-2 in these groups was 10.8% and 20.8%, respectively, RR 1.9 and p = 0.012. Knowledge about the Pap smear, and the presence of lesions showed no association with HSV-2 infection. Multivariate analysis showed that the variable that most influenced the risk of HSV-2 infection was the presence of HIV infection, with a relative risk of 1.9 and p = 0.04. Discussion: Genital ulcers are an important entry point for HIV, and condom use is an important strategy to reduce transmission of HIV and HSV-2.
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Finger-Jardim F, Teixeira LO, de Oliveira GR, Barral MFM, da Hora VP, Gonçalves CV, Soares MA, de Martinez AMB. Herpes simplex virus: prevalence in placental tissue and incidence in neonatal cord blood samples. J Med Virol 2013; 86:519-24. [PMID: 24375504 DOI: 10.1002/jmv.23817] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2013] [Indexed: 11/12/2022]
Abstract
Herpes simplex virus (HSV) infection is one of the most prevalent infectious diseases worldwide, with HSV-2 being primarily associated with genital infections. HSV-2 is believed to account for the majority of cases of neonatal herpes, which may cause diverse of complications in infected newborns. The present study sought to estimate the prevalence of HSV-2 in placental tissue samples and the incidence of HSV-2 in the umbilical cord blood of newborn infants. Placental tissue samples from 201 women (maternal-side and fetal-side = 402 specimens) and 184 neonatal cord blood samples, all collected at the obstetric ward of a University hospital were studied. HSV-2 was detected by means of nested PCR. The prevalence of HSV-2 in placental samples was 9.0% (n = 18), and the incidence of neonatal HSV-2 infection was 1.1% (n = 2). All HSV-2-positive patients were asymptomatic at the time of delivery and none reported genital herpes. Women with a time between rupture of membranes and delivery of ≥360 min had an approximately fourfold risk of HSV-2 infection in the placental tissue (95% CI 0.93-5.66, P = 0.01). These results suggest that HSV-2 is present in the placenta of asymptomatic women and that a risk of transmission to the neonate exists. New strategies must be implemented for the management of asymptomatic patients who are capable of transmitting the virus to the newborn.
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Affiliation(s)
- Fabiana Finger-Jardim
- Laboratory of Molecular Biology, School of Medicine, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
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Zanchi M, Gonçalves CV, Cesar JA, Dumith SDC. [Agreement between data from prenatal care cards and maternal recall in a medium-sized Brazilian city]. CAD SAUDE PUBLICA 2013; 29:1019-1028. [PMID: 23703007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 01/08/2013] [Indexed: 06/02/2023] Open
Abstract
Prenatal care is a key indicator of the quality of health services. The current study aimed to evaluate the correlation between data from prenatal care cards and maternal recall in the city of Rio Grande, Rio Grande do Sul State, Brazil. The cross-sectional study included all mothers from 2010 who had received prenatal care. Interviews were conducted with a pre-coded questionnaire in the maternity hospital. Of the 2,288 mothers interviewed, 1,228 (53.7%) had the prenatal care card with them and thus comprised the group for comparison. The analysis used kappa correlation and confidence interval. The variables six or more prenatal visits, clinical breast and gynecological examination, two blood tests, VDRL, HIV serology, urine test, and tetanus vaccination showed statistically significant differences between annotated and maternal recall data (p ≤ 0.001). Adequacy of prenatal care based on the guidelines of the Program for Humanization of Prenatal Care (PHPN) was 23.9% according to information provided by the patients and 4.4% according to information recorded on the prenatal cards (p ≤ 0.001). The prenatal care card showed underreporting, which limited the quality assessment of prenatal care.
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Affiliation(s)
- Mariza Zanchi
- Universidade Federal do Rio Grande, Rio Grande, Brasil.
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Zanchi M, Gonçalves CV, Cesar JA, Dumith SDC. Concordância entre informações do Cartão da Gestante e do recordatório materno entre puérperas de uma cidade brasileira de médio porte. CAD SAUDE PUBLICA 2013. [DOI: 10.1590/s0102-311x2013000500019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A assistência pré-natal é um indicativo da qualidade dos serviços de saúde. Esse estudo objetivou avaliar a concordância entre os dados do pré-natal da memória materna e do cartão da gestante no Município do Rio Grande, Rio Grande do Sul, Brasil. Estudo transversal incluindo todas puérperas do ano de 2010 que realizaram pré-natal. As entrevistas e a coleta dos dados do cartão ocorreram nas maternidades. Das 2.288 puérperas entrevistadas, 1.228 (53,7%) portavam o cartão da gestante, sendo a comparação realizada nesse grupo. A análise foi feita utilizando-se o teste de concordância kappa e o intervalo de confiança. A realização de seis ou mais consultas de pré-natal, exame das mamas e ginecológico, dois exames de sangue, VDRL, anti-HIV, urina e a vacinação antitetânica demonstraram diferença estatística entre os dados referidos e anotados (p ≤ 0,001). A adequação do pré-natal pelo índice do Programa de Humanização do Pré-Natal (PHPN) nos dados referidos foi de 23,9% e de 4,4% nos dados anotados (p ≤ 0,001). Observamos um sub-registro no cartão da gestante, o qual influenciou negativamente na avaliação da qualidade do pré-natal.
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Tornatore M, Gonçalves CV, Bianchi MS, Germano FN, Garcés AX, Soares MA, Machado ES, de Martinez AMB. Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern Brazil: high rate of intraepithelial cervical lesions. Mem Inst Oswaldo Cruz 2013; 107:205-10. [PMID: 22415259 DOI: 10.1590/s0074-02762012000200009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 10/10/2011] [Indexed: 11/22/2022] Open
Abstract
Human immunodeficiency virus type 1 (HIV-positive) pregnant women require specific prophylactic and therapeutic approaches. The efficacy of established approaches is further challenged by co-infection with other sexually transmitted diseases (STDs). The objective of this study was to determine the prevalence of co-infections in pregnant women infected with different HIV-1 subtypes and to relate these findings, together with additional demographic and clinical parameters, to maternal and infant outcomes. Blood samples from pregnant women were collected and tested for syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV). Human papillomavirus (HPV) diagnosis was evaluated by the presence of alterations in the cervical epithelium detected through a cytopathological exam. Medical charts provided patient data for the mothers and children. Statistical analyses were conducted with STATA 9.0. We found a prevalence of 10.8% for HCV, 2.3% for chronic HBV, 3.1% for syphilis and 40.8% for HPV. Of those co-infected with HPV, 52.9% presented high-grade intraepithelial lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1' and 5' and Capurro scores were similar between co-infected and non-co-infected women. The presence of other STDs did not impact maternal and concept outcomes. More than half of the patients presenting cervical cytology abnormalities suggestive of HPV had high-grade squamous intraepithelial lesions or cervical cancer, evidencing an alarming rate of these lesions.
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Affiliation(s)
- Michele Tornatore
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
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Gonçalves CV, Mendoza-Sassi RA, Cesar JA, de Castro NB, Bortolomedi AP. [Body mass index and gestational weight gain as factors predicting complications and pregnancy outcome]. Rev Bras Ginecol Obstet 2013; 34:304-9. [PMID: 22948502 DOI: 10.1590/s0100-72032012000700003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 06/06/2012] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the impact of body mass index (BMI) at the beginning of pregnancy and weight gain on pregnancy outcome so that this measure can be implemented and valued by prenatal care health services. METHOD Cross-sectional population-based study of all births in the only two hospitals in Rio Grande city (Brazil), in 2007. Among the 2,557 mothers interviewed, it was possible to calculate BMI in only 1,117. The Stata 11 software was used for data analysis. Logist regression was applied to the outomes involving diabetes mellitus, premature labor and cesarean section. Regarding birth weight, data were adjusted by multinomial logistic regression using as base category the group of 2,500 to 4,000 g. The level of significance was set at p-value <0.05 in a two-tailed test. RESULTS There was no increased risk of hypertension or diabetes in patients in the different groups of BMI and weight gain. The risk of preterm delivery was evident in the group with a weight gain ≤ 8 kg (p<0.05). Regarding the route of delivery, it was observed that the higher the BMI in early pregnancy (p=0.001) and the greater the weight gain during pregnancy (p=0.004), the greater the risk of surgical delivery, which reached 11% in the group of obese mothers (p=0.004) and 12% in the group with a weight gain ≥ 17 kg (p=0.001). The weight of the newborns was influenced by BMI and weight gain, and the higher the BMI in early pregnancy and the gestational weight gain, the greater the risk of macrosomia. CONCLUSION The monitoring of BMI and weight gain during pregnancy is a low cost and useful procedure for the establishment of nutritional interventions aimed at reducing maternal and fetal risks.
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Gonçalves CV, Sassi RM, Oliveira Netto I, de Castro NB, Bortolomedi AP. [Cytopathological coverage of the cervix in Basic Health Units of the Family]. Rev Bras Ginecol Obstet 2012; 33:258-63. [PMID: 22189854 DOI: 10.1590/s0100-72032011000900007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 09/20/2011] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the coverage of Pap smear cytology at Basic Family Health Units (BFHU) and to describe the characteristics of non-performance of this test in the last three years. METHODS A cross-sectional study was conducted in Rio Grande (RS), Brazil, in areas covered by the Family Health Teams Family (FHT). The interviews were conducted by students participating in the Health-PET, at women's home. Crude analysis was performed using SPSS software to calculate prevalence ratio, 95% confidence intervals and p value. Multivariate analysis was performed by Poisson regression using Stata 9.0 software, which were included the variables with p value of up to 0.20 in the crude analysis. At the first level, the variables were age, having a partner, and literacy. At the second level, the variables were number of visits and offer of a Pap smear. RESULTS The prevalence of Pap cytology performed 36 months ago or less was 66.3%. In adjusted analysis, women aged 19 years or less (p<0.001), without a partner (p<0.001), illiterate (p= 0.01), who had never consulted at the basic unit (p=0.02) and who had not been offered the examination during the visit (p=0.006), were more likely not to have had a cytopathology exam in the last 36 months. CONCLUSION The local health proved to be ineffective and inequitable. Ineffective because it covers fewer women than indicated by the World Health Organization and uneven because access to this test varied according to some characteristics of the users.
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Gonçalves CV, Duarte G, Costa JSDD, Quintana SM, Marcolin AC. Perdas de oportunidades na prevenção do câncer de colo uterino durante o pré-natal. Ciênc saúde coletiva 2011; 16:2501-10. [DOI: 10.1590/s1413-81232011000500020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Accepted: 10/30/2009] [Indexed: 11/22/2022] Open
Abstract
A gravidez representa uma excelente oportunidade para prevenção do carcinoma cervical, já que o exame ginecológico faz parte da rotina de pré-natal. Foi realizado um estudo transversal, no qual foram entrevistadas 445 puérperas utilizando-se questionários padronizados. A prevalência de CP atualizado era de 38,9% no início da gestação, chegando a 59,1% no puerpério (p>0,001). As puérperas com 19 anos ou menos, não brancas, com escolaridade inferior a onze anos, com renda familiar inferior a um salário mínimo, sexarca aos 15 anos ou menos, início do pré-natal após o primeiro trimestre e com o acompanhamento no Sistema Único de Saúde (SUS) apresentaram menor cobertura do citopatológico. Na análise ajustada, essas variáveis não mostraram significância associada à cobertura do citopatológico. Entretanto, a realização do pré-natal mostrou uma tendência à melhora da cobertura do CP com razão de prevalência de 1,18 (95%CI: 0,98-1,42). O serviço local de saúde mostrou-se pouco efetivo, revelando a necessidade de aumentar a cobertura do citopatológico, motivando e capacitando os profissionais quanto à importância dos procedimentos da rotina pré-natal.
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Entiauspe LG, Teixeira LO, Mendoza-Sassi RA, Gonçalves CV, Gonçalves P, Martinez AMBD. Papilomavírus humano: prevalência e genótipos encontrados em mulheres HIV positivas e negativas, em um centro de referência no extremo Sul do Brasil. Rev Soc Bras Med Trop 2010; 43:260-3. [DOI: 10.1590/s0037-86822010000300009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 04/05/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: O objetivo deste estudo foi detectar a presença do papilomavírus humano e verificar a prevalência e distribuição dos genótipos HPV-6, -11, -16 e -18 em mulheres HIV-1 positivas e negativas. MÉTODOS: Analisou-se amostras de secreção cervical de 98 mulheres por reação em cadeia da polimerase nested para presença do HPV e tipo-específica para detecção dos genótipos, sendo estes confirmados por análise dos fragmentos de restrição. Realizou-se os testes do qui-quadrado e Fisher para a análise estatística. RESULTADOS: O DNA-HPV foi observado em 66,3% das amostras analisadas, 76,4% no grupo HIV positivo e 60% no grupo HIV negativo (p=0,1). Uma prevalência maior de infecção viral por genótipos oncogênicos foi observada no grupo de pacientes HIV positivo (65,2%) quando comparado ao grupo HIV negativo (28,6%), (p=0,006), sendo HPV-16 foi o mais frequente nos dois grupos, seguido pelo HPV-18. CONCLUSÕES: Sugere-se que mulheres HIV positivas apresentam maior probabilidade de se infectar por genótipos oncogênicos de HPV, ressaltando a importância de um programa de rastreamento e diagnóstico diferenciado para este grupo.
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Affiliation(s)
| | | | | | - Carla Vitola Gonçalves
- Universidade Federal do Rio Grande; Hospital Universitário Dr. Miguel Corrêa Riêt Júnior
| | - Paulo Gonçalves
- Universidade Federal do Rio Grande; Hospital Universitário Dr. Miguel Corrêa Riêt Júnior
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Tornatore M, Gonçalves CV, Mendoza-Sassi RA, Silveira JM, D'ávila NE, Maas CG, Bianchi MS, Pinheiro EM, Machado ES, Soares MA, Martinez AMB. HIV-1 vertical transmission in Rio Grande, Southern Brazil. Int J STD AIDS 2010; 21:351-5. [DOI: 10.1258/ijsa.2009.009033] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine the rate and risk factors of HIV-1 mother-to-child transmission (MTCT), the timing of transmission and the transmitted subtype in a population where subtypes B and C co-circulate. One hundred and forty-four babies born to HIV-1-infected mothers were studied. Subtype and timing of transmission were determined by a nested polymerase chain reaction of the gp41 gene. Seven children were infected (4.9%): four were infected intrautero and one intrapartum. The higher frequency of intrautero transmission was statistically significant ( P = 0.001). Use of antiretrovirals (ARVs) in the three stages of gestation was a protective risk factor for MTCT (PR = 0.42; CI: 0.21–0.83; P = 0.013). A higher HIV viral load at delivery was the only independent risk factor for MTCT. Early and universal access to ARVs during pregnancy are the most important measures to decrease vertical HIV-1 transmission even in areas where HIV clade distribution differs.
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Affiliation(s)
- M Tornatore
- Universidade Federal do Rio Grande, Rio Grande do Sul
| | - C V Gonçalves
- Universidade Federal do Rio Grande, Rio Grande do Sul
| | | | - J M Silveira
- Universidade Federal do Rio Grande, Rio Grande do Sul
| | - N E D'ávila
- Universidade Federal do Rio Grande, Rio Grande do Sul
| | - C G Maas
- Universidade Federal do Rio Grande, Rio Grande do Sul
| | - M S Bianchi
- Universidade Federal do Rio Grande, Rio Grande do Sul
| | - E M Pinheiro
- Universidade Federal do Rio Grande, Rio Grande do Sul
| | - E S Machado
- Departamento de Genética, Universidade Federal do Rio de Janeiro
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro
| | - M A Soares
- Departamento de Genética, Universidade Federal do Rio de Janeiro
- Divisão de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
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Gonçalves CV, Cesar JA, Mendoza-Sassi RA. Qualidade e eqüidade na assistência à gestante: um estudo de base populacional no Sul do Brasil. CAD SAUDE PUBLICA 2009; 25:2507-16. [DOI: 10.1590/s0102-311x2009001100020] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 07/01/2009] [Indexed: 11/22/2022] Open
Abstract
Estudo de base populacional com objetivo de avaliar a cobertura da assistência pré-natal, de acordo com a renda familiar, em município do Sul do Brasil. As informações foram coletadas por questionário, com as mães nas primeiras 24 horas após o parto. Observa-se que a cobertura pré-natal, o inicio das consultas no primeiro trimestre, a realização de seis consultas ou mais, a execução do exame das mamas e do exame especular, a realização dos exames de laboratório da rotina pré-natal do Programa de Humanização no Pré-natal e Nascimento (PHPN) e a realização da ultra-sonografia, aumentam com a melhoria da renda familiar, sendo mais realizados nas gestantes do quartil de maior renda (p < 0,001). Apesar destes resultados, a prevalência de baixo peso ao nascer não apresentou diferença estatística significante entre os diferentes quartis. O serviço local de saúde mostrou-se pouco efetivo porque apenas 26,8% dos pré-natais foram classificados como adequados, segundo parâmetros do PHPN, e desigual porque as pacientes do menor quartil de renda tiveram o acompanhamento da sua gestação com qualidade inferior à das pacientes do quarto quartil.
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Gonçalves CV, Duarte G, Costa JSDD, Marcolin AC, Bianchi MS, Dias D, Lima LCDVE. Diagnosis and treatment of cervical cancer during pregnancy. SAO PAULO MED J 2009; 127:359-65. [PMID: 20512291 DOI: 10.1590/s1516-31802009000600008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 12/10/2009] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies. The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy. MATERIALS A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management. RESULTS There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy. However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment. CONCLUSION All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable.
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Affiliation(s)
- Carla Vitola Gonçalves
- Mother-Child Department, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.
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Gonçalves CV, Quintana SM, Marcolin AC, Duarte G, da Costa JSD, Karam F, Steigleder M. Microinvasive carcinoma of the uterine cervix in a 14-year-old adolescent: case report and literature review. SAO PAULO MED J 2009; 127:105-7. [PMID: 19597687 PMCID: PMC10964802 DOI: 10.1590/s1516-31802009000200010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 01/05/2009] [Accepted: 03/12/2009] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Cancer of the uterine cervix is rare during adolescence. The reported rates are 0/100,000 adolescents aged 10 to 19 years and 1.7/100,000 women aged 20 to 24 years. However, several studies have shown increasing incidence of preneoplastic lesions at increasingly early ages. CASE REPORT This paper reports a case of microinvasive carcinoma of the uterine cervix in a 14-year-old patient with menarche at 10 years of age and first coitus at 12 years of age. The objective of the present report was to alert gynecologists and pediatricians regarding the need for cervical carcinoma prevention among sexually active adolescents, based on educational programs that explain the purpose of colpocytological examinations and encourage their use, along with condom use and limitation of the number of sexual partners.
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Affiliation(s)
- Carla Vitola Gonçalves
- MD. Adjunct professor, Mother and Child Department, Fundação Universidade Federal do Rio Grande (FURG), Rio Grande do Sul, Brazil.
| | - Silvana Maria Quintana
- MD. Assistant professor, Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Alessandra Cristina Marcolin
- MD. Medical gynecologist and obstetrician, Hospital das Clínicas (HC), Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Geraldo Duarte
- MD, PhD. Titular professor, Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Juvenal Soares Dias da Costa
- MD. Adjunct professor, Department of Social Medicine, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil.
| | - Fabine Karam
- MD. Medical resident in Gynecology and Obstetrics, Fundação Universidade Federal do Rio Grande (FURG), Rio Grande do Sul, Brazil.
| | - Mônia Steigleder
- Medical student, Fundação Universidade Federal do Rio Grande (FURG), Rio Grande do Sul, Brazil.
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Gonçalves CV, Dias-da-Costa JS, Duarte G, Marcolin AC, Garlet G, Sakai AF, Bianchi MS. [Clinical breast examination during prenatal visits: analysis of coverage and associated factors in a city in the State of Rio Grande do Sul, Brazil]. CAD SAUDE PUBLICA 2009; 24:1783-90. [PMID: 18709219 DOI: 10.1590/s0102-311x2008000800007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 02/12/2008] [Indexed: 11/22/2022] Open
Abstract
The Brazilian Ministry of Health recommends that breast examination be performed along with breastfeeding orientation during the first prenatal visit. The aims of the current study were to analyze breast examination during prenatal care and describe the factors associated with insufficient coverage. A cross-sectional study was performed in Rio Grande, Rio Grande do Sul State, Brazil, from May to July 2007. Data for women who had just given birth were recorded on a standardized questionnaire. Of 445 women, 266 (59.8%) had not undergone breast examination during prenatal care. Non-white women and those with a monthly income below the minimum wage (BRL 380.00) or with prenatal care and delivery in the public health system showed the highest probability of not having a breast examination during prenatal care. The results show the low prevalence of breast examination during prenatal care and indicate serious problems related to quality of prenatal care, besides unequal access for poor women.
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Affiliation(s)
- Carla Vitola Gonçalves
- Departamento Materno-Infantil, Fundação Universidade Federal do Rio Grande, Rio Grande, Brasil
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Gonçalves CV, Costa JSDD, Duarte G, Marcolin AC, Lima LCDVE, Garlet G, Bianchi MS, Sakai AF. Avaliação da frequência de realização do exame físico das mamas, da colpocitologia cervical e da ultrassonografia obstétrica durante a assistência pré-natal: uma inversão de valores. Rev Assoc Med Bras (1992) 2009; 55:290-5. [DOI: 10.1590/s0104-42302009000300021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2007] [Accepted: 10/06/2008] [Indexed: 11/22/2022] Open
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Gonçalves CV, Duarte G, Marcolin AC, Quintana SM, Covas DT, Costa JSDD. Avaliação longitudinal da infecção por parvovírus B19 entre grávidas em Ribeirão Preto, SP, Brasil. Rev Bras Ginecol Obstet 2003. [DOI: 10.1590/s0100-72032003000500003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Duarte G, Marcolin AC, Gonçalves CV, Quintana SM, Berezowski AT, Nogueira AA, Cunha SPD. Infecção urinária na gravidez: análise dos métodos para diagnóstico e do tratamento. Rev Bras Ginecol Obstet 2002. [DOI: 10.1590/s0100-72032002000700007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Duarte G, Gonçalves CV, Marcolin AC, Paschoini MC, Quintana SM, Mussi-Pinhata MM. Teste rápido para detecção da infecção pelo HIV-1 em gestantes. Rev Bras Ginecol Obstet 2001. [DOI: 10.1590/s0100-72032001000200008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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