Search

Objective: This study aimed to determine the effects of a multicomponent exercise intervention during the first year post‐bariatric surgery (BS) on body composition, weight loss (WL), energy expenditure, and nutrient intake. Methods: A total of 84 patients were included in this study and were randomly assigned to either an exercise group (n = 41) or a control group (n = 20). The exercise group participated in a multicomponent exercise program that began 1‐month post‐BS, whereas the control group received only standard medical care post‐BS. Body composition was assessed by dual‐energy x‐ray absorptiometry, and physical activity energy expenditure was assessed by accelerometers. Nutritional intake was assessed through a 4‐day food diary. Results: A total of 6‐months post‐BS, exercise was found to be effective in mitigating the loss of lower‐limb and appendicular lean mass (LM), as well as favoring trunk fat mass (FM) loss. Moreover, it further decreased percent FM and promoted additional excess WL. After 12 months, exercise not only reduced waist circumference but also helped to lessen the loss of total, trunk, and appendicular LM. Conclusions: Exercise further induced trunk fat mass, percent FM, excess WL, and waist circumference reductions. Moreover, exercise attenuated the loss of total and regional LM. [ABSTRACT FROM AUTHOR]

Currently, there is no way to assess mechanical loading variables such as peak ground reaction forces (pGRF) and peak loading rate (pLR) in clinical settings. The purpose of this study was to develop accelerometry-based equations to predict both pGRF and pLR during walking and running. One hundred and thirty one subjects (79 females; 76.9 ± 19.6 kg) walked and ran at different speeds (2–14 km·h−1) on a force plate–instrumented treadmill while wearing accelerometers at their ankle, lower back and hip. Regression equations were developed to predict pGRF and pLR from accelerometry data. Leave-one-out cross-validation was used to calculate prediction accuracy and Bland–Altman plots. Our pGRF prediction equation was compared with a reference equation previously published. Body mass and peak acceleration were included for pGRF prediction and body mass and peak acceleration rate for pLR prediction. All pGRF equation coefficients of determination were above 0.96, and a good agreement between actual and predicted pGRF was observed, with a mean absolute percent error (MAPE) below 7.3%. Accuracy indices from our equations were better than previously developed equations. All pLR prediction equations presented a lower accuracy compared to those developed to predict pGRF. Walking and running pGRF can be predicted with high accuracy by accelerometry-based equations, representing an easy way to determine mechanical loading in free-living conditions. The pLR prediction equations yielded a somewhat lower prediction accuracy compared with the pGRF equations. Peak ground reaction forces can be accurately predicted through raw accelerometry data. These predictions are valid for a broad range of body masses and for ankle, lower back and hip accelerometer placements. Peak loading rate prediction presented lower accuracy compared with peak ground reaction force prediction. These findings result in a simple method to predict mechanical loading in clinical practice, which is relevant in some areas of sports medicine such as bone health and injury prevention. [ABSTRACT FROM AUTHOR]

The vaginal microbiome has emerged as potentially influencing the natural history of Human Papillomavirus (HPV) infections and their clinical impact. We aimed to characterize the vaginal microbiome in samples from 807 high‐risk HPVs (Hr‐HPV) positive women with a mean age of 41.45 ± 10.79 years who participated in the Regional Cervical Cancer Screening Program from the Northern Region of Portugal. Microbiome analysis was performed with commercial kits for the detection of 21 microorganisms. The most frequent microorganisms were Ureaplasma parvum (52.5%), Gardnerella vaginalis (GV) (34.5%), Atopobium vaginae (AV) (32.6%), Lacto (30.7%), and Mycoplasma hominis (MH) (23.5%). The distribution according to age reveals that MH, Mega1, GV, BVab2, AV, and Mob were more prevalent in women older than 41 years of age (p < 0.050), while Lacto is significantly decreased in this group (23.5% vs. 39.4%, p < 0.001; RR = 0.47). The risk analysis showed that Hr‐HPV‐16/‐18 and Hr‐HPV‐9val genotypes are associated with an increased risk of developing cervical abnormalities, while Lacto (p < 0.001; odd ratio [OR] = 0.33), GV (p = 0.0111; OR = 0.41), AV (p = 0.033; OR = 0.53) and Mob (p = 0.022; OR = 0.29) are associated with protection. Similar results were found for the risk of development atypical squamous cells cannot exclude HSIL/high‐grade squamous intraepithelial lesion. Overall, the multivariate analysis confirmed that lactobacillus and bacteria associated with bacterial vaginosis (GV, AV, and Mob) are associated with protection against the development of cervical abnormalities. This study provides important data to be included in the future management of risk stratification for Hr‐HPV‐positive women. [ABSTRACT FROM AUTHOR]

Cervical cancer prevention is based on primary prevention with vaccines against Human Papillomavirus (HPV) and secondary prevention by screening with High‐Risk‐HPV (Hr‐HPV) detection. Since 2017, cervical cancer screening in women aged 25−60 years has been performed in Portugal using Hr‐HPV detection, followed by cytology in Hr‐HPV‐positive cases. Herein we report the prevalence of Hr‐HPV genotypes and cytological abnormalities among 462 401 women (mean age: 43.73 ± 10.79; median age: 45; range: 24−66 years) that participated in the Regional Cervical Cancer Screening Program of the Northern Region of Portugal, performed between August 2016 and December 2021. Overall, we describe a prevalence rate of 12.50% for Hr‐HPV varying from 20.76% at age 25% to 8.32% at age 64. The five most common Hr‐HPV genotypes identified were HPV‐68 (16.09%), HPV‐31 (15.30%), HPV‐51 (12.96%), HPV‐16 (11.06%), and HPV‐39 (11.01%). The prevalence of Hr‐HPV included in the nonavalent vaccine (HPV‐9valent) was 55.00% ranging from 47.78% to 59.18% across different age groups. Considering positive Hr‐HPV cases, 65.68% had a Negative for Intraepithelial Lesion or Malignancy (NILM) cytology, 20.83% atypical squamous cells of undetermined significance (ASC‐US), 8.85% Low‐Grade Squamous Intraepithelial Lesion (LSIL), 1.65% High‐Grade Squamous Intraepithelial Lesion (HSIL), 2.85% ASC‐H, 0.09% Atypical Glandular Cells, 0.02% Adenocarcinomas, and 0.02% Squamous Cell Carcinoma (SCC). Our analysis revealed that HPV‐9val genotypes were responsible for 52.13% NILM, 59.21% ASC‐US, 55.06% LSIL, 90.14% HSIL, 83.50% ASC‐H, and 100.00% SCC. Furthermore, multiple Hr‐HPV infections (risk ratio [RR] = 1.46; 95% confidence interval [CI] 1.34−1.58), HPV‐16/18 (RR = 5.16; 95% CI 4.75−5.93), or HPV‐9val genotypes (RR = 5.23; 95% CI 4.68−5.85) were associated with a significant risk of developing > HSIL (p < 0.001). To date, this is the largest study on Hr‐HPV genotyping in cervical cancer screening that includes data from a complete cycle of the screening program. Our findings suggest a high prevalence of HPV‐9valent genotypes and a significant association with an increased risk of developing > HSIL. This constitutes important data for health authorities, which may help define the future of vaccination and cervical cancer screening strategies. [ABSTRACT FROM AUTHOR]

Helicobacter pylori infects half of the world population, being associated with several gastric disorders, such as chronic gastritis and gastric carcinoma. The Helicobacter genus also includes other gastric helicobacters, such as H. heilmannii¸ H. ailurogastricus, H. suis, H. felis, H. bizzozeronii, and H. salomonis. These gastric helicobacters colonize both the human and animal stomach. The prevalence of gastric non‐Helicobacter pylori Helicobacter (NHPH) species in humans has been described as low, and the in vitro binding to the human gastric mucosa was never assessed. Herein, human gastric tissue sections were used for the evaluation of the tissue glycophenotype and for the binding of gastric NHPH strains belonging to different species. Histopathological evaluation showed that 37.5% of the patients enrolled in our cohort presented chronic gastritis, while the presence of neutrophil or eosinophilic activity (chronic active gastritis) was observed in 62.5% of the patients. The secretor phenotype was observed in 68.8% of the individuals, based on the expression of Lewis B antigen and binding of the UleX lectin. The in vitro binding assay showed that all the NHPH strains evaluated were able to bind, albeit in low frequency, to the human gastric mucosa. The H. heilmannii, H. bizzozeronii, and H. salomonis strains displayed the highest binding ability both to the gastric superficial epithelium and to the deep glands. Interestingly, we observed binding of NHPH to the gastric mucosa of individuals with severe chronic inflammation and intestinal metaplasia, suggesting that NHPH binding may not be restricted to the healthy gastric mucosa or slight chronic gastritis. Furthermore, the in vitro binding of NHPH strains was observed both in secretor and non‐secretor individuals in a similar frequency. In conclusion, this study is the first report of the in vitro binding ability of gastric NHPH species to the human gastric mucosa. The results suggest that other glycans, besides the Lewis antigens, could be involved in the bacterial adhesion mechanism; however, the molecular intervenients remain unknown. [ABSTRACT FROM AUTHOR]

Cervical cancer remains a health concern. Effective screening programs are critical to reduce the incidence and mortality. High‐risk HPV (hr‐HPV) testing as primary screening tool discloses high sensitivity but suboptimal specificity. Adequate triage tests to reduce unnecessary colposcopy referrals and overdiagnosis/overtreatment are crucial. Hence, we aimed to validate a panel of DNA methylation‐based markers as triage test for women hr‐HPV+ in the population‐based Regional Cervical Cancer Screening Program of Northern Portugal. Firstly, CADM1, MAL, FAM19A4 and hsa‐miR124‐2 promoter methylation levels were assessed by multiplex QMSP in a testing set of 402 FFPE tissue samples (159 normal samples and 243 cervical lesions, including 39 low‐grade intraepithelial squamous lesions [LSIL], 59 high‐grade intraepithelial squamous lesions [HSIL] and 145 cancerous lesions). Then, preliminary validation was performed in 125 hr‐HPV+ cervical scrapes (including 59 normal samples, 30 LSIL, 34 HSIL and 2 cancerous lesions). Higher MALme, FAM19A4me and hsa‐miR124‐2me methylation levels were disclosed in histological HSIL or worse (HSIL+) in testing set. Individually, markers depicted over 86% specificity for HSIL+ detection. In validation set, all these genes significantly differed between histological HSIL+ and low‐grade squamous intraepithelial lesions or less. In combination, these markers reached 74% specificity and 61% sensitivity for identification of histological HSIL+. We concluded that host gene methylation might constitute a useful referral triage tool of hr‐HPV+ women enrolled in the Cervical Cancer Screening Program of Northern Portugal. What's new? For cervical cancer screening, high‐risk HPV (hr‐HPV) testing is highly sensitive, but for those who test positive, a more specific test is needed to reduce unnecessary colposcopy. Here, the authors validated a panel of DNA methylation‐based markers to screen hr‐HPV+ women. They measured promoter methylation of four genes, CADM1, MAL, FAM19A4, and hsa‐miR124‐2, in cervical samples including normal tissue, low‐ and high‐grade squamous intraepithelial lesions (LSIL and HSIL) and cancerous lesions. The markers showed 74% specificity for HSIL or cancer, indicating that DNA methylation could be a useful triage tool for hr‐HPV+ women. [ABSTRACT FROM AUTHOR]

Considering that the muscles of the anus perform a critical role in maintaining continence, losses in their structure can negatively affect the physiological control of the intestinal contents. Anorectal electro-stimulation (ARES) has been reported to have a positive effect on the functionality of treated patients, but how ARES affects the structural tissues of the anorectal segment remains unknown. Because the study of how ARES structurally affects human tissues is not possible, this study aimed to clarify these effects in a murine model, which has a similar anorectal segment (structure and physiology) to humans. For the descriptive and comparative study, randomly selected nulliparous adult Wistar rats ( n = 5) were submitted to 30 anorectal sessions of ARES with a biphasic current (700 μs, 50 Hz from 2 to 4 mA). After treatment, the animals were euthanized, and the anorectal segments were dissected and processed for histopathological analysis. Our results showed that ARES increased the widths of the mucosal, submucosal and muscle layers of the rectum, as well as the number of leukocytes in the mucosa. ARES also caused hyperplasia of the smooth muscle of the internal anal sphincter and hypertrophy of the external anal sphincter muscle. In conclusion, our results showed that ARES had not only a positive effect on the structure (morphology) of all tissues associated with the rectum and anus but, more importantly, on the structural gain of the muscles (hyperplasia and hypertrophy), which could point to a functional gain of the anal sphincter, reinforcing the applicability of ARES as a non-invasive treatment for anal incontinence. [ABSTRACT FROM AUTHOR]

The Epstein-Barr Virus (EBV) is associated with the development of several diseases, including infectious mononucleosis (IM), Burkitt's Lymphoma (BL), Nasopharyngeal Carcinoma, and other neoplasias. The publication of EBV genome 1984 led to several studies regarding the identification of different viral strains. Currently, EBV is divided into EBV type 1 (B95-8 strain) and EBV type 2 (AG876 strain), also known as type A and type B, which have been distinguished based upon genetic differences in the Epstein-Barr nuclear antigens (EBNAs) sequence. Several other EBV strains have been described in the past 10 years considering variations on EBV genome, and many have attempted to clarify if these variations are ethnic or geographically correlated, or if they are disease related. Indeed, there is an increasing interest to describe possible specific disease associations, with emphasis on different malignancies. These studies aim to clarify if these variations are ethnic or geographically correlated, or if they are disease related, thus being important to characterize the epidemiologic genetic distribution of EBV strains on our population. Here, we review the current knowledge on the different EBV strains and variants and its association with different diseases. J. Med. Virol. 89:373-387, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Human cytomegalovirus (HCMV) infection is a major cause of morbidity and mortality in allogeneic hematopoietic stem cell transplant recipients. The significant clinical impact of HCMV infection and progression to HCMV disease among allogeneic hematopoietic stem cell transplant recipients has been reduced by prophylactic, preemptive, and curative treatments using ganciclovir, valganciclovir, foscarnet, and cidofovir. Resistance to (val)ganciclovir results from mutations localized in HCMV UL97 gene (encoding the pUL97 phosphotransferase), UL54 gene (encoding the pUL54 DNA polymerase), or both genes, whereas foscarnet and cidofovir resistance results from mutations localized within UL54 gene only. This review is focused on HCMV antiviral drug resistance, including the functions of target genes of antivirals, the mechanisms of antiviral resistance, the different mutations in pUL97 and pUL54 that have been identified in either clinical isolates or laboratory strains, and their impact on HCMV susceptibility to antiviral drugs. It emphasizes the importance of proving that observed genetic changes confer resistance so they can be distinguished from polymorphisms. Because of the emergence of HCMV resistance to currently available drugs, novel drugs are urgently needed for the therapeutic management of HCMV-resistant infections in hematopoietic stem cell transplant patients. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Variations in the genome sequence of Epstein-Barr Virus (EBV) are thought to lead to differential interaction with host cells, immune evasion, and transformation. The discussion regarding EBV strains as having a geographic or disease-association has been increasing and the majority of studies are performed in Asiatic populations. We developed a case-control study with 139 individuals, including 96 subjects with different malignancies and 43 healthy individuals, from the North region of Portugal. We have used PCR protocols for the characterization of EBV strains (type A or B) based on EBNA3C genome variation and for the LMP1 30bp-deletion variants (wt-LMP1 or del-LMP1). Our study showed that type A is the most prevalent in our population (100% of healthy controls, 96.9% of aHSCT patients, 90.8% of HNSCC patients, and 94.9% of NPC patients) and that type B was significantly associated with NPC ( P = 0.019; RR = 8.90). Regarding the LMP1 30bp-deletion, we found a similar distribution of both wt- and del-LMP1 variants in controls and dispare results in cases: del-LMP1 was more frequent in aHSCT and HNSCC patients (64.7% and 63.2%, respectively) and wt-LMP1 in NPC patients (100%). In fact, the study reveals that wt-LPM1 was significantly associated with NPC ( P < 0.001; RR = 18.4). Hence, our study showed that EBV type B and wt-LMP1 variant seem to be associated with NPC in our population, with a clear disease-association for wt-LMP1. These results contribute for the knowledge of EBV genetic diversity among Caucasian populations. J. Med. Virol. 87:1382-1388, 2015. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

ABSTRACT Infection by high-risk types of human papillomavirus (HPV) is considered necessary but not sufficient for the development of cervical cancer. Previous studies suggested that cytomegalovirus (CMV) and Epstein-barr virus (EBV) could be co-factors of HPV-associated carcinogenesis. The aim of this study was to characterize the prevalence of CMV and EBV and evaluate its association with the development cervical lesions in Portugal. The prevalence of CMV and EBV infections was determined by real-time PCR in 89 cervical samples from women with different histological lesions, who attended the Portuguese Institute of Oncology of Porto. This study revealed an overall prevalence of 4.5% for CMV and 10.1% for EBV. Age-stratified analysis revealed that CMV infection was present in individuals <30 and >60 years old, while EBV infection was present in all age groups. CMV was detected in 9.5% of low-grade lesions and in 22.2% of in situ/invasive carcinomas, while EBV infection was found in all different types of lesions. In addition, data revealed that CMV infection was associated with an increased risk of in situ/invasive carcinoma development (OR = 1.28; P = 0.035). The study reveals a low prevalence for both viruses; nevertheless, these results are important for knowledge on the shedding of EBV and CMV in cervical samples. J. Med. Virol. 85:1409-1413, 2013. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The objective of this study was to microscopically evaluate the human periodontal ligament adhered to extracted teeth, after extra-alveolar period of 1 h using, as storage media, pasteurized milk (group I), chicken egg white (group II) and artificial saliva (group III). Forty intact premolars were selected, with indication of tooth extraction for orthodontic reasons. After the extraction of 30 teeth, they were maintained dried on a gauze at room temperature for 10 min, and then immersed in the selected storage media. After the established time, the teeth were washed with saline solution and placed in 10.0% buffered formalin. Ten teeth were extracted and immediately immersed in 10.0% neutral formalin (group IV). Thereafter, they were submitted to histological processing. After fixation and decalcification, the specimens were cut at the cervical, medium and apical thirds, inserted in paraffin and serially sectioned, with 6-μm thickness. They were stained by hematoxylin–eosin and analyzed under light microscopy. According to the results of quantitative analysis, there was no statistically significant difference in the number of cells per mm2 between groups I, II and III. The qualitative analysis showed similar results in relation to the organization of collagen fibers and the number of cells in groups I and II, but group III displayed a higher disorganization of the collagen fibers and also a higher reduction in the number of cells. Based on these results, it was concluded that the quality of periodontal ligament was affected by the storage media, when compared with the control group. There was a statistically significant difference in the number of cells per mm2 between the control group and groups I, II and III. There was no significant statistical difference in the number of cells per mm2 between groups I, II and III. [ABSTRACT FROM AUTHOR]

Intrusive luxation is one of the most severe types of dental trauma. The occurrence of pulp necrosis in intruded teeth with open apices is 100%. The risk of development of inflammatory or replacement root resorptions is high. Thus, endodontic intervention is required soon after the occurrence of trauma, in an attempt to prevent or delay the appearance of such lesions. On the other hand, the access to the root canal is difficult, as the crown is intruded. A multidisciplinary approach comprising Surgery, Orthodontics and Endodontics is required to allow exposure of the crown, orthodontic extrusion and onset of endodontic therapy. The patient GCSA, aged 15 years, attended the community project ‘Lugar de dente é na boca’ (‘teeth should be in the mouth’) of the Federal University of Goiás, Brazil, 1 week after complete intrusion of the right maxillary central incisor. Radiographic examination revealed that the incisal edge of this tooth was at the level of the crown-root interface of the adjacent teeth. After surgical exposure of the crown, pulp sensitivity was evaluated and was found to be negative. After onset of endodontic therapy, the patient was referred for orthodontic extrusion of the intruded tooth. Successive changes of root canal dressing were performed and the root canal was definitely obturated at 3 years and 6 months after onset of treatment. The present paper reports on a case of severe intrusive luxation, discusses the different treatments recommended for repositioning of traumatically intruded teeth, and questions the ideal period of maintenance of calcium hydroxide dressing in the root canal, in an attempt to prevent the occurrence of root resorption and repair any existing resorption. [ABSTRACT FROM AUTHOR]

Background. Nasopharyngeal cancer (NPC) is multifactorial, and the genetic background may be a crucial etiologic factor. Cyclin D1 (CCND1) is a key regulator of the cell cycle, and its altered activity is associated with the development of cancer. Methods. We analyzed the A870G CCND1 polymorphism by polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP) in 281 individuals, including 94 patients with NPC and 187 healthy individuals. Results. Our results indicate that individuals carrying two G alleles have a 2.17-fold increase in the risk for the development of NPC (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.19–3.98; p = .016). Age-adjusted logistic regression analysis confirmed this association (adjusted odds ratio [aOR], 2.14; 95% CI, 1.14–4.04; p = .018). Multivariate analysis demonstrates an independent association between GG CCND1 genotype (aOR, 2.06), male sex (aOR, 2.66), and age at diagnosis (aOR, 2.02) regarding the development of undifferentiated NPC. The proportion of NPC cases attributable to the GG CCND1 genotype was 14.76%. Conclusions. Our results may be important in the definition of a biologic predictive profile for the development of NPC within our population. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [ABSTRACT FROM AUTHOR]

Objective: 1) Learn the histologicdistribution of nasopharyngeal carcinoma (NPC) in a nonendemic European country. 2) Learn epidemiological data of NPC in a nonendemic European country. 3) Understand the implications of some genetic polymorphisms on NPC development. Method: Using data collected from a retrospective study of 320 NPC patients obtained at the Oporto Portuguese Institute of Oncology during 31 years, a study is made concerning histological characterization, median age, gender profiles, NPC‐EBV relationship, and relevance of concerned genetic polymorphisms on probability of disease and age of onset. Results: A total of 300 out of 320 patients had nonkeratinizing carcinomas (93.75%), with a mean age of 48 years old and twofold male preponderance. Using PCR analysis, EBV‐DNA was found in 91.7% of 36 tumor tissue samples. Regarding genetic polymorphisms, 2 case‐control studies were performed, including 104 patients and 285 control individuals. TP53 codon 72 pro/pro genotype (P =. 012; OR = 2.67; 95% CI 1.21‐5.90) and A870G cyclin D1 GG genotype (P =. 016; OR = 2.09; 95% CI 1.15‐3.79) were associated with increased risk for NPC development. Moreover, cyclin D1 GG genotype was also correlated with earlier disease onset. Conclusion: The high relative proportion of nonkeratinizing carcinomas is a relevant finding in this nonendemic European country, and so is the association of EBV‐DNA with NPC. This study may help to understand the biologic mechanisms of NPC and the correlation of EBV infection with disease in a low‐risk nonendemic region. [ABSTRACT FROM AUTHOR]