Abstract INTRODUCTION This study characterized the clinico-epidemiological profile of American cutaneous leishmaniasis (ACL) cases in Barbalha, Ceará State, Brazil. METHODS Medical records of 363 patients visiting Federal University of Cariri between 2009 and 2014 were analyzed. RESULTS ACL was more prevalent in men with low education level from rural zones. The main presentation was a single ulcer, mainly in the lower limbs, and 49.8% also presented lymphadenomegaly. The annual incidence ranged from 2.83 to 22.60 per 10,000 inhabitants. CONCLUSIONS: The rates observed in this study indicate the importance of additional research to contribute to the control of this endemic disease.

O papilomavírus humano (HPV) é um agente epiteliotrópico cujos genótipos de alto risco têm uma ligação já bem estabelecida com o desenvolvimento de cânceres cervicais. Embora a relação do HPV com o carcinoma de células escamosas oral (CCEO) venha sendo estudada desde o início da década de 1980, seu papel na carcinogênese oral e os prováveis mecanismos moleculares subjacentes ainda não estão completamente elucidados. Realizou-se uma revisão sistemática dos trabalhos existentes na literatura científica internacional até o momento da elaboração deste manuscrito concernente à associação do HPV com o CCEO, esquadrinhando as características das amostras, das prevalências verificadas, das técnicas utilizadas e os achados relevantes dos estudos. Os resultados demonstram que o HPV está associado a cerca de um quarto dos CCEO. Outro aspecto interessante refere-se ao padrão distinto das infecções nesses tumores orais, incluindo a participação de genótipos incomuns em lesões malignas cervicais, tais como HPV-38, 44, 53 e 70. Igualmente interessante é a possibilidade de atuação carcinogênica sem a ocorrência de integração viral, constatada pela elevada expressão de ácido ribonucleico mensageiro (RNAm) de E6 e E7, de genótipos de alto risco, em casos cujo vírus encontrava-se em estado epissomal. Essas evidências reforçam a tese do envolvimento do HPV na gênese dos CCEO, ao mesmo tempo em que alertam para a possibilidade de comportamentos virais inesperados que, por vezes, não são percebidos ou compreendidos devido à limitação tecnológica da época e à carência de estudos com abordagem apropriada.

The human papillomavirus (HPV) is an epitheliotropic agent whose high-risk genotypes have a well-established link with the development of cervical cancer. Although the relation of HPV to the oral squamous cell carcinoma (OSCC) has been studied since the beginning of the 1980s, its role in the oral carcinogenesis and the probable underlying molecular mechanisms are still not fully elucidated. We performed a systematic review of the worldwide scientific literature, published until the preparation of the present paper, concerning the association of HPV with OSCC, scrutinizing the samples, prevalence levels, the techniques utilized and relevant findings of the studies. The results showed that HPV is associated with approximately one quarter of OSCCs. Another interesting feature is the distinct pattern of infection in these oral tumors, including the participation of genotypes that are uncommon in cervical malignant lesions, such as HPV-38, 44, 53 and 70. Equally interesting is the possibility of carcinogenic action without the occurrence of viral integration, verified by the high expression of messenger ribonucleic acid (mRNA) of E6 and E7 from high-risk genotypes in cases whose virus remain in the episomal form. These findings support the assumption of HPV involvement in the genesis of OSCC, whereas warn about the possibility of unexpected viral behaviors that sometimes are not perceived or understood due to the technological limitations of the time and to the shortage of studies with the adequate approaches.

Epstein-Barr virus (EBV) has been associated with 10% of gastric carcinomas. The aim of this study was to determine the frequency of EBV in gastric carcinomas in Brazil assessed by in situ hybridization (ISH) and PCR, which would contribute to the characterization of the clinical and pathological aspects of EBV-associated gastric carcinomas. One hundred and ninety-two gastric carcinoma cases were collected at hospitals in two Brazilian states. Seventy-three out of 151 cases were PCR(+), while 11/160 cases were ISH(+). Nine out of eleven ISH(+) cases displayed a diffuse staining pattern and 2 out of 11 a focal pattern. Both techniques showed that the EBV(+) cases were characterized by their association with males, older patients, lower gastric region, intestinal type, advanced stage and poorly to moderately differentiated tumors. The concordance between the two techniques was 55.8% (Cohen's kappa index = 0.034). Four cases were ISH(+)/PCR(-), while 49 cases were PCR(+)/ISH(-). Only two cases showed stained lymphocytes by ISH and one of them was PCR(-). The observed discrepancy between the two techniques could not be explained just by the elevated accuracy of PCR. ISH(+)/PCR(-) carcinomas may be encountered if EBV is not present in the whole tumor tissue or if there are polymorphisms in the sequences of the viral genome amplified. On the other hand, the high frequency of PCR(+) results associated with the absence of ISH staining in lymphocytes and/or tumors cells suggests that the virus may be present in tumor cells or other cell types without expressing EBER1, the target of the ISH technique.

INTRODUÇÃO: O vírus Epstein-Barr (EBV) está associado a cerca de 10% dos adenocarcinomas gástricos, representando mais de 50 mil casos por ano no mundo. Apesar dos estudos realizados em várias partes do mundo, alguns aspectos clinicopatológicos permanecem controversos. OBJETIVOS: O presente estudo teve como objetivo analisar as características clinicopatológicas de casos de adenocarcinomas gástricos procedentes dos estados de São Paulo e Ceará, correlacionando-os com a detecção de EBV. MATERIAIS E MÉTODOS: Foram obtidos 192 casos de adenocarcinomas gástricos de hospitais dos estados de São Paulo e do Ceará, dos quais 160 foram submetidos à técnica de RNA-hibridização in situ para detecção de EBV. RESULTADOS: Dos 160 casos, 11 (6,9%) foram EBV-positivo, exibindo intensa marcação nuclear em células tumorais. Destes, dois casos também apresentaram linfócitos infiltrados marcados. Não encontramos marcação em tecido normal ou pré-neoplásico. São Paulo e Ceará apresentaram as frequências 3/60 (5%) e 8/100 (8%), respectivamente, e maior relação do EBV com indivíduos do sexo masculino, de idade avançada, com tumores do tipo intestinal, de estadiamento elevado e grau pouco a moderadamente diferenciado. Os casos do Ceará exibiram aumento relativo de tumores EBV(+) localizados na cárdia, enquanto os casos de São Paulo demonstraram aumento naqueles localizados no corpo gástrico. CONCLUSÃO: A frequência de tumores EBV(+) do presente estudo situa-se nos valores descritos na literatura mundial. Entre os achados, um deles não encontra paralelo na literatura mundial e refere-se ao elevado percentual de tumores EBV(+) no corpo gástrico observado nos casos de São Paulo.

INTRODUCTION: The Epstein-Barr virus (EBV) has been associated with approximately 10% of gastric adenocarcinomas, which represents more than 50,000 cases/year worldwide. Despite the studies undertaken in several countries, some clinical-pathological aspects remain contentious. OBJECTIVE: The objective of this study was to analyze clinical-pathological features of gastric adenocarcinomas from two Brazilian states, São Paulo and Ceará, by correlating them with EBV detection. MATERIALS AND METHODS: One hundred ninety-two gastric adenocarcinoma cases were selected from hospitals in São Paulo and Ceará, of which 160 were submitted to RNA in situ hybridization for EBV detection. RESULTS: Eleven (6.9%) out of 160 cases were EBV-positive with intense nuclear staining in tumor cells. Among these, two cases also showed stained infiltrating lymphocytes. There was no staining in normal or preneoplastic tissue. São Paulo and Ceará yielded the respective results: 3/60 (5%) and 8/100 (8%). In both states, EBV was more prevalent among elder male patients with little to moderately differentiated intestinal tumors in advanced stage. Ceará cases substantiated a relative increase in EBV(+) tumors located in the cardia, whereas São Paulo cases presented an increase in the gastric corpus. CONCLUSION: The frequency of EBV(+) tumors is similarly described in the literature. Among our findings, the elevated percentage of EBV(+) tumors in the gastric corpus, which was observed in São Paulo cases, is unprecedented in the literature.