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Abstract Cervical cancer is a leading cause of death among women. The endocervical adenocarcinoma (ECA) represents an aggressive and metastatic type of cancer with no effective treatment options currently available. We evaluated the antitumoral and anti-migratory effects of hypericin (HYP) encapsulated on Pluronic F127 (F127/HYP) photodynamic therapy (PDT) against a human cell line derived from invasive cervical adenocarcinoma (HeLa) compared to a human epithelial cell line (HaCaT). The phototoxicity and cytotoxicity of F127/HYP were evaluated by the following assays: colorimetric assay, MTT, cellular morphological changes by microscopy and long-term cytotoxicity by clonogenic assay. In addition, we performed fluorescence microscopy to analyze cell uptake and subcellular distribution of F127/HYP, cell death pathway and reactive oxygen species (ROS) production. The PDT mechanism was determined with sodium azide and D-mannitol and cell migration by wound-healing assay. The treatment with F127/HYP promoted a phototoxic result in the HeLa cells in a dose-dependent and selective form. Internalization of F127/HYP was observed mainly in the mitochondria, causing cell death by necrosis and ROS production especially by the type II PDT mechanism. Furthermore, F127/HYP reduced the long-term proliferation and migration capacity of HeLa cells. Overall, our results indicate a potentially application of F127/HYP micelles as a novel approach for PDT with HYP delivery to more specifically treat ECA. women ECA (ECA available antimigratory anti migratory (HYP F F12 F127HYP FHYP (F127/HYP (PDT (HeLa HaCaT. HaCaT . (HaCaT) assays assay MTT longterm long term addition (ROS Dmannitol D mannitol woundhealing wound healing dosedependent dose dependent form mitochondria Furthermore Overall F1 (HaCaT

https://doi.org/10.1590/s2175-97902023e22459

High molecular prevalence of HPV and other sexually transmitted infections in a population of asymptomatic women who work or study at a Brazilian university
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Suehiro, Tamy Taianne

; Gimenes, Fabrícia

; Souza, Raquel Pantarotto

; Taura, Sergio Ken Iti

; Cestari, Rita Cristina Cardoso

; Irie, Mary Mayumi Taguti

; Boer, Cinthia Gandolfi

; Consolaro, Marcia Edilaine Lopes

; Silva, Vânia Ramos Sela da

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e1

Abstract: En | Text: En | PDF: En

ABSTRACT Sexually transmitted infections (STIs) represent a global health problem with variable prevalence depending on the geographical region and the type of population. Human papillomavirus (HPV) encompasses widespread virus types related to cervical carcinogenesis. The present study investigated the molecular prevalence of HPV and seven other important STIs in asymptomatic women working or studying at a Brazilian university. A secondary aim was to assess cytological abnormalities associated with HPV and other STIs coinfections. We recruited 210 women from a Brazilian university. HPV was detected using a single-round polymerase chain reaction (sPCR) followed by a viral genotyping by restriction fragment length polymorphism (RFLP-PCR). The presence of seven STIs: Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV)-1 and HSV-2 was detected by multiplex PCR (M-PCR). Furthermore, cytological findings and epidemiological characteristics were evaluated.The mean age of the participants was 27.1 years old. HPV prevalence was 33.8%, and HPV16 was the most frequently detected papillomavirus genotype. Moreover, multiple HPV infections were common (42.2%). We detected at least one STI agent in 11.4% of the tested women, most frequently C. trachomatis (6.7%). Among HPV-positive women, 14.1% were coinfected with other STI agents. Cytological abnormalities were observed in 9.5% of smears, and HPV-DNA, high-risk HPV (HR-HPV), HPV16 and HPV multiple infections were associated with abnormal cytological findings. There was a high prevalence of HPV, and C. trachomatis was the most prevalent STI agent, with low rates of cytological abnormalities. These findings highlight the need of timely STI diagnosis in young asymptomatic women and of a public policy design for STI prevention.

https://doi.org/10.1590/s1678-9946202163001 1097 downloads

COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves

; Ximenez, João Paulo Bianchi

; Seiva, Fábio Rodrigues Ferreira

; Panis, Carolina

; Bezerra, Rafael dos Santos

; Ferrasa, Adriano

; Cecchini, Alessandra Lourenço

; Medeiros, Alexandra Ivo de

; Almeida, Ana Marisa Fusco

; Ramão, Anelisa

; Boldt, Angelica Beate Winter

; Moya, Carla Fredrichsen

; Chin, Chung Man

; Paula, Daniel de

; Rech, Daniel

; Gradia, Daniela Fiori

; Malheiros, Danielle

; Venturini, Danielle

; Tavares, Eliandro Reis

; Carraro, Emerson

; Ribeiro, Enilze Maria de Souza Fonseca

; Pereira, Evani Marques

; Tuon, Felipe Francisco

; Follador, Franciele Aní Caovilla

; Fernandes, Glaura Scantamburlo Alves

; Volpato, Hélito

; Cólus, Ilce Mara de Syllos

; Oliveira, Jaqueline Carvalho de

; Rodrigues, Jean Henrique da Silva

; Santos, Jean Leandro dos

; Visentainer, Jeane Eliete Laguila

; Brandi, Juliana Cristina

; Serpeloni, Juliana Mara

; Bonini, Juliana Sartori

; Oliveira, Karen Brajão de

; Fiorentin, Karine

; Lucio, Léia Carolina

; Faccin-Galhardi, Ligia Carla

; Ferreto, Lirane Elize Defante

; Lioni, Lucy Megumi Yamauchi

; Consolaro, Marcia Edilaine Lopes

; Vicari, Marcelo Ricardo

; Arbex, Marcos Abdo

; Pileggi, Marcos

; Watanabe, Maria Angelica Ehara

; Costa, Maria Antônia Ramos

; Giannini, Maria José S. Mendes

; Amarante, Marla Karine

; Khalil, Najeh Maissar

; Lima Neto, Quirino Alves de

; Herai, Roberto H.

; Guembarovski, Roberta Losi

; Shinsato, Rogério N.

; Mainardes, Rubiana Mara

; Giuliatti, Silvana

; Yamada-Ogatta, Sueli Fumie

; Gerber, Viviane Knuppel de Quadros

; Pavanelli, Wander Rogério

; Silva, Weber Claudio da

; Petzl-Erler, Maria Luiza

; Valente, Valeria

; Soares, Christiane Pienna

; Cavalli, Luciane Regina

; Silva Jr, Wilson Araujo

Genetics and Molecular Biology

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2021, Volume 44 N. 1 elocation e20200452

Abstract: En | Text: En | PDF: En

Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

https://doi.org/10.1590/1678-4685-gmb-2020-0452

Zika virus infection in the genital tract of non-pregnant females: a systematic review
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Morelli, Fabrício

; Souza, Raquel Pantarotto

; Cruz, Taís Elisângela da

; Damke, Gabrielle Marconi Zago Ferreira

; Damke, Edilson

; Suehiro, Tamy Tuani

; Silva, Vânia Ramos Sela da

; Consolaro, Marcia Edilaine Lopes

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e16

Abstract: En | Text: En | PDF: En

ABSTRACT This review provides a general overview on the positivity and persistence of Zika virus (ZIKV) in female genital tract (FGT) of non-pregnant women and animals, as well as in cell cultures, and its influence on FGT health. We performed a systematic review based on the PRISMA statement to identify studies focused on “Zika virus” and “non-pregnant female” in PubMed, Embase, Scopus Scholar and Web of Knowledge databases of full-text papers and abstracts published in English, with no restrictions regarding the initial date of publication, up to August 2019. Our search terms yielded 625 records, that were 108 after removal of duplicates, leaving 517 items for title and abstract reviews. Of these, 475 did not meet the inclusion criteria, leaving 42 records for full-text review and resulting in the exclusion of 6 additional records. The remaining 36 met our inclusion criteria. Variations were observed regarding the presence and persistence of ZIKV in lower and upper genital samples. However, the FGT was the place in which ZIKV RNA has been detected, sometimes for relatively long periods, even after the clearance from blood and urine. In addition to the vagina and cervix, the endometrium, uterus and ovary (oocytes and follicles) could also be involved in persistent ZIKV infections. Further prospective studies are needed to assess the effect of ZIKV on FGT health.

https://doi.org/10.1590/s1678-9946202062016 1134 downloads

Association of human papillomavirus and Chlamydia trachomatis with intraepithelial alterations in cervix samples
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Wohlmeister, Denise

; Vianna, Débora Renz Barreto

; Helfer, Virgínia Etges

; Gimenes, Fabrícia

; Consolaro, Marcia Edilaine Lopes

; Barcellos, Regina Bones

; Rossetti, Maria Lucia

; Calil, Luciane Noal

; Buffon, Andréia

; Pilger, Diogo André

Memórias do Instituto Oswaldo Cruz

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feb 2016, Volume 111 N. 2 Pages 106 - 113

Abstract: En | Text: En | PDF: En

The influence of different infectious agents and their association with human papillomavirus (HPV) in cervical carcinogenesis have not been completely elucidated. This study describes the association between cytological changes in cervical epithelium and the detection of the most relevant aetiological agents of sexually transmitted diseases. Samples collected from 169 patients were evaluated by conventional cytology followed by molecular analysis to detect HPV DNA, Chlamydia trachomatis, herpes simplex virus 1 and 2,Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, andTreponema pallidum, besides genotyping for most common high-risk HPV. An association between cytological lesions and different behavioural habits such as smoking and sedentariness was observed. Intraepithelial lesions were also associated with HPV and C. trachomatis detection. An association was also found between both simple and multiple genotype infection and cytological changes. The investigation of HPV and C. trachomatisproved its importance and may be considered in the future for including in screening programs, since these factors are linked to the early diagnosis of patients with precursor lesions of cervical cancer.

https://doi.org/10.1590/0074-02760150330 3275 downloads

EFFECT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY ON VAGINAL Candida spp. ISOLATION IN HIV-INFECTED COMPARED TO HIV-UNINFECTED WOMEN
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ALCZUK, Silvia de Souza Dantas

; BONFIM-MENDONÇA, Patrícia de Souza

; ROCHA-BRISCHILIARI, Sheila Cristina

; SHINOBU-MESQUITA, Cristiane Suemi

; MARTINS, Helen Priscilla Rodrigues

; GIMENES, Fabrícia

; ABREU, André Luelsdorf Pimenta de

; CARVALHO, Maria Dalva de Barros

; PELLOSO, Sandra Marisa

; SVIDZINSKI, Terezinha Inez Estivalet

; CONSOLARO, Marcia Edilaine Lopes

Revista do Instituto de Medicina Tropical de São Paulo

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apr 2015, Volume 57 N. 2 Pages 169 - 174

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Candidíase vulvovaginal (CVV) em mulheres infectadas pelo HIV contribuiu substancialmente para a diminuição da sua qualidade de vida. O objetivo deste estudo foi avaliar o efeito do uso de terapia anti-retroviral altamente ativa (HAART) no isolamento de Candida spp. vaginais em mulheres HIV positivas comparado às não infectadas por HIV. Este estudo transversal incluiu 178 mulheres infectadas pelo HIV (grupo HIV) e 200 mulheres não infectadas (grupo controle) acompanhadas no Serviço de Assistência Especializada (SAE) para as doenças sexualmente transmissíveis (DST)/AIDS da cidade de Maringá/Brasil, de 1 abril a 30 de outubro de 2011. As leveduras foram isoladas e identificadas por métodos fenotípicos e moleculares. A susceptibilidade in vitro aos antifúngicos fluconazol, itraconazol, nistatina e anfotericina B foi avaliada pelo método de referência de microdiluição. Nós encontramos maior frequência de isolamento vaginal total de Candida spp. no grupo HIV do que no grupo controle. Entretanto, foi observada frequência similar de colonização e CVV entre os dois grupos. Apesar de C. albicans ser a mais frequente e sensível a azólicos e polienos em mulheres infectadas pelo HIV e não infectadas, foi detectada emergente resistência de C. glabrata a AMB nas mulheres infectadas pelo HIV. Embora tenha sido observada maior frequência de isolamento vaginal de Candida spp. nas mulheres infectadas pelo HIV do que nas não infectadas, colonização e CVV apresentaram frequência similar em ambos os grupos, o que indica que HAART parece proteger contra colonização vaginal e CVV.

Vulvovaginal candidiasis (VVC) in HIV-infected women contributed to the impairment of their quality of life. The aim of this study was to evaluate the effect of highly active antiretroviral therapy (HAART) use on the vaginal Candida spp. isolation in HIV-infected compared to HIV-uninfected women. This cross-sectional study included 178 HIV-infected (HIV group) and 200 HIV-uninfected women (control) that were studied at the Specialized Assistance Service (SAE) for sexually transmitted diseases (STD)/AIDS of the city of Maringá, Brazil, from April 1 to October 30, 2011. The yeasts were isolated and identified by phenotypic and molecular methods. The in vitro antifungal susceptibility to fluconazole, itraconazole, nystatin and amphotericin B was tested by the reference microdilution method. Higher frequencies of total vaginal Candida spp. isolation were found in the HIV-infected group than in the control group. However, both groups showed a similar frequency of colonization and VVC. Although C. albicans was the most frequent and sensitive to azolics and polyenes in both HIV-infected and uninfected women, the emerging resistance of C. glabrata to amphotericin B in the HIV-infected women was observed. Although higher frequency of vaginal Candida spp. isolation had been observed in the HIV-infected than in HIV-uninfected women, colonization and VVC showed similar frequency in both groups, indicating that HAART appears to protect against vaginal colonization and VVC.

https://doi.org/10.1590/S0036-46652015000200012 2355 downloads

Prevalence of Candida albicans and non-albicans isolates from vaginal secretions: comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women
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Gunther, Luciene Setsuko Akimoto

; Martins, Helen Priscila Rodrigues

; Gimenes, Fabrícia

; Abreu, André Luelsdorf Pimenta de

; Consolaro, Marcia Edilaine Lopes

; Svidzinski, Terezinha Inez Estivalet

Sao Paulo Medical Journal

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2014, Volume 132 N. 2 Pages 116 - 120

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

CONTEXTO E OBJETIVO: Candidíase vulvovaginal (CVV) é causada pelo crescimento anormal de fungos do tipo leveduras na mucosa do trato genital feminino. Pacientes com diabetes mellitus (DM) são mais susceptíveis a infecções fúngicas, incluindo por espécies de Candida. O presente estudo investigou a frequência de isolamento total de Candida spp. vaginal, e diferentes quadros clínicos (CVV e CVV recorrente- CVVR) em mulheres com DM tipo 2 comparadas às não diabéticas. A razão de cura do tratamento com fluconazol também foi avaliada. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado no sistema público de saúde de Maringá, Paraná, Brazil. MÉTODO: O estudo envolveu 717 mulheres de 17-74 anos de idade e, destas, 48 (6,7%) tinham DM 2 (média de 53,7 anos), independentemente de sinais e sintomas de CVV. As leveduras foram isoladas e identificadas por métodos fenotípicos clássicos. RESULTADOS: No grupo de não diabéticas (controle), leveduras vaginais totais foram isoladas em 79 (11,8%) mulheres, e no grupo de diabéticas, em 9 (18,8%) (P = 0,000). O grupo de diabéticas mostrou mais mulheres sintomáticas (CVV + CVVR = 66,66%) do que colonizadas (33.33%), e significativamente mais colonização, CVV e CVVR, que as controle. A razão média de cura com fluconazol foi de 75.0% no grupo diabéticas e 86.7% no controle (P = 0.51). CONCLUSÃO: Nós encontramos que DM 2 em mulheres brasileiras associou-se com colonização vaginal por leveduras, CVV e CVVR, razão similar de isolamento de C. albicans e espécies não albicans. Boa taxa de cura foi obtida com fluconazol em ambos os grupos.

CONTEXT AND OBJECTIVE: Vulvovaginal candidiasis (VVC) is caused by abnormal growth of yeast-like fungi on the female genital tract mucosa. Patients with diabetes mellitus (DM) are more susceptible to fungal infections, including those caused by species of Candida. The present study investigated the frequency of total isolation of vaginal Candida spp., and its different clinical profiles - colonization, VVC and recurrent VVC (RVVC) - in women with DM type 2, compared with non-diabetic women. The cure rate using fluconazole treatment was also evaluated. DESIGN AND SETTING: Cross-sectional study conducted in the public healthcare system of Maringá, Paraná, Brazil. METHODS: The study involved 717 women aged 17-74 years, of whom 48 (6.7%) had DM type 2 (mean age: 53.7 years), regardless of signs and symptoms of VVC. The yeasts were isolated and identified using classical phenotypic methods. RESULTS: In the non-diabetic group (controls), total vaginal yeast isolation occurred in 79 (11.8%) women, and in the diabetic group in 9 (18.8%) (P = 0.000). The diabetic group showed more symptomatic (VVC + RVVC = 66.66%) than colonized (33.33%) women, and showed significantly more colonization, VVC and RVVC than seen among the controls. The mean cure rate using fluconazole was 75.0% in the diabetic group and 86.7% in the control group (P = 0.51). CONCLUSION: We found that DM type 2 in Brazilian women was associated with yeast colonization, VVC and RVVC, and similar isolation rates for C. albicans and non-albicans species. Good cure rates were obtained using fluconazole in both groups.

https://doi.org/10.1590/1516-3180.2014.1322640 12783 downloads

Lack of association between genotypes and virulence factors in C. albicans strains isolated from vaginal secretion
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Shinobu, Cristiane Suemi

; Ogatta, Sueli Fumie Yamada

; Bizerra, Fenando

; Furlaneto, Luciana

; Peralta, Rosane Marina

; Svidzinski, Terezinha Inez Estivalet

; Consolaro, Marcia Edilaine Lopes

Brazilian Journal of Microbiology

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sep 2007, Volume 38 N. 3 Pages 467 - 471

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A fisiopatogenia da candidíase vulvovaginal (CVV) não está completamente elucidada até o presente momento. O objetivo deste estudo foi avaliar se exite relação entre os diferentes genótipos de Candida albicans, seu principal agente, e a virulência desta levedura em isolados vaginais, e checar se existem marcadores laboratoriais que possam predizer a habilidade de cada isolado para desenvolver CVV independentemente dos sintomas. Foram determinados a produção de exoenzimas protease, fosfolipase and hemolisina, resistência ao peróxido de hidrogêncio, e genótipo. O genótipo A foi predominante (75%), protease, fosfolipase e atividade hemolítica foram alevadamente expressos, e a maioria das leveduras foram sensíveis ao H2O2 em 1 e 2 horas de exposição, sugerindo que estes fatores são importantes na virulênciae de isolados vaginais. Entretanto, não houve nenhuma correlação com os genótipos. Os diferentes isolados expressaram potencial de virulência similares, sugerindo que outros fatores relacionados às leveduras e ao hospedeiro devem participar no desenvolvimento da doença clínica.

The physiopathogenesis of vulvovaginal candidiasis (VVC) is still not completely elucidated. The objective of this study was to evaluate if there is a relationship between the different genotypes of Candida albicans, their main agent and the virulence of this yeast in vaginal isolates, and to check if there are laboratorial markers that can predict the ability of each isolate to develop VVC independently of symptoms. The production of exoenzymes protease, phospholipase and haemolysin, resistance to hydrogen peroxide, and the genotype were determined. Genotype A was predominant (75%), protease, phospholipase and haemolytic activity were highly expressed, and the majority of the yeasts were sensitive to H2O2 in 1 and 2 hours of exposure, suggesting that these factors are important in the virulence of vaginal isolates. However they did not have any correlation with the genotypes. The different isolates expressed similar virulence potential, suggesting that other factors relating to the yeasts and the host must participate in the development of the clinical disease.

2227 downloads

Nitrito urinário e infecção do trato urinário por cocos gram-positivos
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Sato, Andréa de Fátima

; Svidzinski, Arthur Estivalet

; Consolaro, Marcia Edilaine Lopes

; Boer, Cinthia Gandolfi

Jornal Brasileiro de Patologia e Medicina Laboratorial

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dec 2005, Volume 41 N. 6 Pages 397 - 404

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

INTRODUÇÃO: A infecção do trato urinário (ITU) é uma das mais comuns na clínica médica. Os testes que utilizam tiras reagentes detectam significativamente mais infecções por bactérias gram-negativas do que por espécies gram-positivas, uma vez que o teste de nitrito não revela a presença de patógenos gram-positivos em muitos casos. OBJETIVOS: Explorar a microbiologia e a freqüência de infecção urinária por cocos em adultos sintomáticos, relacionando-as com o resultado de nitrito urinário, para traçar o perfil epidemiológico desses pacientes. MATERIAL E MÉTODO: Um estudo retrospectivo foi conduzido na Secretaria de Saúde do município de Maringá-PR, no período de abril de 2004 a março de 2005. RESULTADOS: Amostras de urina de 3.426 pacientes foram coletadas e analisadas. Um total de 448 (13,1%) amostras foi positivo para cultura. Em 388 (86,6%) casos houve crescimento de bacilos gram-negativos (BGN) e em 60 (13,4%) casos, cocos gram-positivos (CGP). A análise estatística de co-morbidades revelou diferença significativa na proporção de pacientes com hipertensão (31,3% com nitrito positivo versus 4,5% com nitrito negativo, p < 0,05). Os pacientes com resultado de nitrito positivo relataram febre em proporção maior que os com nitrito negativo (75% versus 43,2%, respectivamente; p < 0,05). Staphylococcus aureus redutores de nitrato mostraram maior resistência à ciprofloxacina (66,7%) quando em comparação com os isolados não-redutores (100% sensíveis). CONCLUSÕES: Este estudo preliminar mostrou que a avaliação de sinais clínicos e sintomas, juntamente com o resultado de nitrito urinário na tira reagente, poderia auxiliar o médico na tomada de decisões importantes.

BACKGROUND: Urinary tract infection (UTI) is among the most common infections in medical center. Urinalysis tests detect significantly more gram-negative infections than those due to gram-positive bacteria because the urinary nitrite test does not detect the presence of gram-positive pathogens in many cases. OBJECTIVES: Explore the microbiology and frequency of UTI by coccus in symptomatic adult patients, comparing them with urinary nitrite results, in order to delineate the epidemiological profile of these patients. MATERIAL AND METHOD: Retrospective analysis was conducted from April 2004 through March 2005 at Health Center, Maringa, Brazil. RESULTS: Urine specimens from 3,426 patients were collected and examined. A total of 448 (13.1%) samples had positive culture results. There were 388 (86.6%) strains of gram-negative rods and 60 (13.4%) of gram-positive cocci. A statistical analysis of patients' comorbidities revealed a significant difference in the proportion of patients with hypertension (31.3% with positive nitrite vs. 4.5% with negative nitrite, p < 0.05). The proportion of patients with positive nitrite who had fever was larger than patients with negative nitrite (75% vs. 43.2% respectively, p < 0.05). Nitrate-reducing Staphylococcus aureus showed high level resistance to ciprofloxacin (66.7%) in comparison with nitrite-negative isolates (100% sensitive). CONCLUSIONS: This preliminary study had shown that evaluation of clinical signs and symptoms, together with urinary nitrite result, could help physician to take important decisions.

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10.

Caracterização de leveduras isoladas da vagina e sua associação com candidíase vulvovaginal em duas cidades do sul do Brasil
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Ferrazza, Magda Helena S. H.

; Maluf, Márcia L. Ferrarezi

; Consolaro, Marcia Edilaine Lopes

; Shinobu, Cristiane Suemi

; Svidzinski, Terezinha Inez Estivalet

; Batista, Márcia Regina

Revista Brasileira de Ginecologia e Obstetrícia

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feb 2005, Volume 27 N. 2 Pages 58 - 63

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVOS: avaliar a distribuição de espécies de leveduras isoladas da vagina em duas localidades do sul do Brasil e comparar o perfil de suscetibilidade in vitro destas leveduras a antifúngicos usados na prática clínica. MÉTODOS: todas as mulheres atendidas entre janeiro e junho de 2004 para exames rotineiros de amostras vaginais, independente de serem sintomáticas ou não, foram incluídas neste estudo. Foram excluídas as que apresentavam imunodeficiências como AIDS ou outras infecções genitais. Amostras de conteúdo vaginal dessas mulheres (Jaraguá do Sul - SC (n=130) e Maringá - PR (n=97)) foram cultivadas. As leveduras isoladas foram identificadas e submetidas ao teste de suscetibilidade aos antifúngicos fluconazol, nistatina e anfotericina B. RESULTADOS: a freqüência de cultura positiva para levedura foi semelhante nas duas localidades, aproximadamente 24%. Candida albicans foi a espécie prevalente, mas sua freqüência diferiu: em SC correspondeu a 77,4% das leveduras e foi a mais freqüente tanto nas mulheres sintomáticas quanto nas assintomáticas. Já no PR foi 50,0%, com predomínio mais evidente nos casos sintomáticos. Observamos altos índices de suscetibilidade ao fluconazol e anfotericina B, porém 51,1% das leveduras apresentaram suscetibilidade dependente da dose (S-DD) para nistatina. C. albicans mostrou maior tendência de resistência à nistatina (52,8% de S-DD) do que as espécies não-albicans (44,4%). CONCLUSÕES: nossos dados mostram diferenças regionais quanto à espécie de levedura em amostras vaginais. Sugerem que a determinação da espécie pode ter implicação clínica, considerando as diferenças quanto à suscetibilidade, principalmente à nistatina, e que poderiam ter importância no manejo da candidíase vulvovaginal.

PURPOSE: to evaluate the distribution of yeast species isolated from the vagina in two cities of the South of Brazil and compare the in vitro susceptibility profile of these yeasts against some antifungals, which are used in clinical routine. METHODS: all women attended from January to June 2004 for vaginal routine examinations, independent of being symptomatic or not were included in the study. Only those who presented immunodeficiency like AIDS or any other genital infection were excluded. Samples of vaginal discharge from the women (Jaraguá do Sul - SC (n=130) and Maringá - PR (n=97)) were cultivated. The yeasts were identified and submitted to the susceptibility test against the antifungals fluconazole, nystatin and amphotericin B. RESULTS: the frequency of positive cultures for yeasts was the same in both cities; C. albicans was the most prevalent species (about 24%), but its frequency was different: in SC it corresponded to 77.4% of the yeasts both in symptomatic and asymptomatic women and in PR it was 50.0% with predominance in symptomatic women. We observed high rates of susceptibility to fluconazole and amphotericin B, but 51.1% of the yeasts presented dose-dependent susceptibility (DDS) to nystatin. C. albicans showed a higher tendency to be nystatin resistant (52.8% DDS) than non-albicans species (44.4%). CONCLUSIONS: our data showed geographic differences among the species of yeasts isolated from the vagina and suggest that this fact has clinical relevance considering the differences in susceptibility, especially regarding nystatin, which could be important for the management of vulvovaginal candidiasis.

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Importância da aplicação de critérios morfológicos não-clássicos para o diagnóstico citológico de papilomavírus humano
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Jordão, Andréa Valderrama

; Ruggeri, Léo Sérgio

; Chiucheta, Giselle Itália Ruggeri

; Piva, Sérgio

; Consolaro, Marcia Edilaine Lopes

Jornal Brasileiro de Patologia e Medicina Laboratorial

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2003, Volume 39 N. 1 Pages 81 - 89

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Existe atualmente grande preocupação com a melhoria no diagnóstico citológico de HPV através da introdução de critérios não-clássicos para o seu diagnóstico, tendo em vista a elevada freqüência da infecção viral, bem como o seu potencial carcinogênico. O presente trabalho objetivou uma releitura de 65 casos positivos para HPV por captura híbrida (cujos critérios inicialmente utilizados foram apenas os clássicos), e a introdução dos critérios não-clássicos. Os critérios citológicos mais observados foram os não-clássicos, sendo bi ou multinucleação o mais freqüente, com n = 39 (60%), seguido de halo perinuclear, com n = 37 (56,9%) e disceratose leve e núcleo hipercromático, ambos com n = 32 (49,2%). Para NIC I predominou a disceratose, com n = 20 (100%); para inflamação, disceratose leve, com n = 35 (87,5%) e para Ascus e Agus, halo perinuclear, núcleo hipercromático, células gigantes e bi ou multinucleação, todos com n = 4 (100%). Todos os 20 casos de NIC I, dez dos 40 casos de inflamação e todos os casos de Ascus (n = 1) e Agus (n = 3) foram considerados positivos para HPV com a utilização de critérios não-clássicos, passando a 52,3% dos casos positivos pela captura híbrida a apresentarem a infecção viral pela citologia, em detrimento de 23,1% só com os critérios clássicos. Um número razoável de amostras diagnosticadas inicialmente como inflamatórias passaram a apresentar a infecção viral, podendo representar a variedade subclínica do vírus, para a qual o diagnóstico molecular apresentou-se como melhor metodologia. A utilização de critérios não-clássicos de HPV pela citologia parece muito importante para maximizar a eficiência diagnóstica.

There is currently a great concern with regard to improvements in the cytological diagnosis of HPV through the introduction of non-classical criteria in its diagnosis. This is important owing to the high frequency of viral infection and its cancerigenous potential. The aim of the research was a reinterpretation of 65 positive HPV cases by hybrid capture. Classical criteria had been used in the first instance and eventually non-classical ones have been applied. The cytological criteria most frequently reported were non-classical. Bi or multinucleation with n = 39 (60%), perinuclear halo with n = 37 (56.9%), light dyskeratosis and hyperchromatic nucleus, both with n = 32 (49.2%) were the most frequent. Whereas dyskeratosis was predominant with n = 20 (100%) in NIC I and light dyskeratosis with n = 35 (87.5%) in inflammation, in Ascus and Agus perinuclear halo, hyperchromatic nucleus, giant cells and bi or multinucleation, with n = 4 (100%) each, were predominant. The 20 NIC I cases, ten out of the 40 inflammation cases and all Ascus (n = 1) and Agus (n = 3) cases were HPV positive when non-classical criteria were employed. Hybrid capture revealed 52.3% of positive cases with viral infection by cytology to the detriment of 23.1% when classical criteria were used. A considerable number of samples initially diagnosed inflammatory showed viral infection which may represent the virus's subclinical variety. In the latter the molecular diagnosis was the best methodology. The use of HPV non-classical criteria by cytology seems to be important to improve efficiency of diagnosis.

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