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Women living in rural areas of Amazonas - the riverine - have difficulty accessing adequate health care, aggravating their vulnerability in the face of various pathological processes, such as cervical cancer and sexually transmitted infections. Strategies that expand coverage of screening and early diagnosis are welcome. To evaluate the prevalence of Human Papillomavirus (HPV) and Chlamydia trachomatis (CT) in riverside women from Coari City, Amazonas, in samples obtained by self-collection and to verify the acceptance of this method among the participants. Fifty eight riverside communities were visited, with a “house-to-house” approach. The samples were obtained with a COARI® brush (Kolplast®) and the diagnosis of pathogens was made by Polymerase Chain Reaction. Four hundred and nineteen sexually active women aged between 18 and 70 years old (34.4 ± 12.1) participated in the study. The prevalence of CT in this population sample was 1.1% and that of HPV was 15.7%. We observed a low prevalence of CT and a high prevalence of HPV among participating women, in addition to a good acceptance of self-collection among them.

Objetivo: Identificar quais são as evidências científicas disponíveis na literatura acerca do conhecimento e percepção sobre o HPV na população universitária no Brasil. Métodos: trata-se de uma Revisão Integrativa de Literatura, o qual seguiu a estratégia PICO, os trabalhos analisados foram obtidos em bancos de dados eletrônicos LILACS, MEDLINE, BDENF, CINAHL E SciELO, com a utilização do método PRISMA. Foram considerados artigos gratuitos, originais com texto completo, considerando o período de 2012 a 2022 nos idiomas inglês, espanhol e português. Resultados: os cruzamentos nas bases de dados resultaram em 47 itens dos quais, 11 foram selecionados para fazer parte do estudo após a leitura ne íntegra de todos. Os resultados encontrados na presente revisão revelam que, apesar de muitos dos acadêmicos terem demonstrado conhecimento a respeito do que é o HPV, diversas lacunas de conhecimento foram identificadas, como sua relação com o câncer de colo do útero e outros tipos de câncer, seus sintomas, transmissibilidade, fatores de risco para infecção e questões vacinais, como número de doses, público-alvo, riscos e benefícios. Conclusão: faz-se necessário nortear ações educativas e práticas de promoção à saúde no ambiente universitário a respeito do HPV, visto que é o meio em que se formam os profissionais que tem a responsabilidade de transmitir informação à população.

Introduction: The challenges related to the diagnosis of sexually transmitted infections present more complex factors in remote and hard-to-reach areas. The use of self-collection devices that facilitate the obtaining of a biological sample with high quality for sensitive molecular tests have been examined. This study aimed to evaluate the performance and acceptance of the Evalyn® Brush (Rovers® Medical Devices) for detection of T. vaginalis among women living in the riverside communities of Amazonas, Brazil. Methodology: The study included 300 riverside women. They received instructions for self-collection, carried out the task, and then answered a questionnaire on the use of the device. T. vaginalis was detected by Polymerase Chain Reaction, using primers TVK3/TVK7. Results: The mean age of the women was 35.8 years, and most of them presented low schooling, low income, agricultural activity and lived in a marital union. All samples were positive for human genomic DNA (100%) and the prevalence of T. vaginalis infection was 5.6% (n = 17). Of the 300 women, 293 (97.7%) indicated that they liked the use of the device, 287 (95.7%) reported having had no difficulty in handling it, 265 (88.3%) did not feel any type of discomfort and 228 (76%) said they preferred the self-collection to the collection made by the professional, mainly due to privacy and comfort. Conclusions: The Evalyn® Brush proved reliable as a device for the collection of biological samples for molecular analysis and was well-accepted by women. Its use can be indicated in remote and hard to reach places.

Chlamydia trachomatis (CT) infection is often silent and can lead to long-term reproductive complications in women. In this study, we determined the prevalence of CT infection and possible associations between the presence of the infection and clinical-epidemiological variables in pregnant women attended at the Basic Health Units of the Coari city, Amazonas, Brazil. From July 2016 to March 2017, 164 pregnant women undergoing prenatal care were recruited. One hundred of these women were tested for CT infection using two types of samples: cervico-vaginal and urine. The diagnosis was confirmed by PCR with primers specific for the omp1 gene of CT chromosomal DNA. Of the 100 pregnant women, 18 (18%) had CT infection, 8 (8%) of which were positive in both samples, 7 (7%) only in the urine sample and 3 (3%) only in cervical-vaginal sample. There was moderate agreement (Kappa=0.55) and no statistically significant difference between sample types (p = 0.400). The mean age of infected women was 21.1 years (SD = 4.6). Of the clinical-epidemiological variables analyzed, “more than 2 partners in the last 12 months” (p = 0.022) and gynecological complaint of “pain after intercourse” (p = 0.020) were associated with CT infection. This study showed a high prevalence (18%) of CT infection among pregnant women in Coari / Amazonas. Urine sampales were as good as cervical-vaginal ones for the screening of CT infection during the prenatal period.

INTRODUCTION: Chlamydia trachomatis is a small gram-negative bacterium sexually transmitted, which progresses asymptomatically in the majority of infected people, causing long-term damage mainly in the female reproductive system. The polymerase chain reaction (PCR) has been the diagnostic method most widely used in recent epidemiological studies by presenting superior sensitivity than the other sensitivity tests. For a good performance of PCR, the choice of enzymes is very important because they have different characteristics that influence their performance. OBJECTIVE: To analyze and compare the detection of C. trachomatis using three commercial enzymes Taq DNA polymerases in 280 cervical samples. METHODS: The enzymes used were: Taq DNA Polymerase Recombinant (Invitrogen, USA), Platinum ® Taq DNA Polymerase (Invitrogen, USA) and Platinum ® Taq DNA Polymerase High Fidelity (Invitrogen, USA). RESULTS: 280 cervical samples from women living in Coari City, Amazonas State, Brazil were analyzed, whose average age was 36.3 years old, the majority had low educational level, their first sexual intercourse was around 15.7 (SD = 0.7) with an average number of 3.7 children. 42.5% had clinical complaints during the visit, with a predominance of vaginal discharge, itching, pelvic pain and painful urination. Of the 280 samples, four (1.4%) were positive using the recombinant Taq DNA polymerase, seven (2.5%) using the enzyme Platinum ® Taq DNA Polymerase and 11 (3.9%) specimens were positive using Platinum ® Taq DNA Polymerase High Fidelity. Statistical analysis showed no difference between groups (p = 0.186). CONCLUSION: Enzyme Taq DNA polymerases with different properties show differences in performance in the detection of C. trachomatis.

Introduction: The human papillomavirus (HPV) is the main risk factor related to cervical cancer, the third most frequent type of cancer in Brazilian women. Early identification of high-risk HPV types in the normal cervix, or cervix with premalignant lesions may help prevent the progression of these lesions to cancer. Objective: This study aimed to detect and genotype HPV in women with low-grade intraepithelial lesion (LSIL) and atypical squamous cells of undetermined significance (ASC-US). Methods: Patients were selected from files of the cytology laboratory of Fundação Alfredo da Mata (FUAM), between January 2009 and July 2011, for cytological reassessment and HPV molecular detection with genotyping. Results: Out of the100 eligible patients, 70% (70/100) participated in the study; initially, 34 of them had ASC-US and 36 had LSIL. After cytological reassessment, eight (11.4%) patients showed normal cytology; 33 (47.2%), inflammatory lesions; 22 (31.4%), ASCUS; six (8.6%), LSIL; and one (1.4%), high-grade squamous intraepithelial lesions (HSIL). HPV was detected in 28.6% (20/70) of the samples. Out of the 20 HPV-positive patients, one had normal cytology, six showed inflammatory cytology, 10 showed ASCUS, two had LSIL and one, HSIL. After genotyping, the HPV types identified were: 6, 16, 58, 61, 70, 83, 84 and 85. The most prevalent HPV type was the 58. Conclusion: The presence of high-risk HPV in women with old cervical lesions, whether they have evolved or not, indicates the need to improve patient monitoring and surveillance. RESUMO Introdução: O papilomavírus humano (HPV) é o principal fator de risco relacionado com câncer cervical. A identificação precoce de tipos de HPV de alto risco em cérvice normal ou com lesões precursoras pode auxiliar a prevenir que essas lesões progridam para neoplasias malignas. Objetivos: Este estudo teve como objetivo detectar e genotipar o HPV em mulheres com resultado citológico de lesão intraepitelial escamosa de baixo grau (LSIL) e células escamosas atípicas de significado indeterminado (ASC-US). Métodos: Mulheres diagnosticadas com LSIL e ASC-US foram selecionadas a partir do arquivo de exames do Laboratório de Citologia da Fundação Alfredo da Matta (FUAM), em Manaus (AM), no período de janeiro de 2009 a julho de 2011, para reavaliação citológica, detecção molecular e genotipagem do HPV. A detecção molecular foi realizada pela técnica de nested reação em cadeia da polimerase (PCR); a genotipagem, por sequenciamento automático do ácido desoxirribonucleico (DNA). Resultados: Das 100 pacientes selecionadas, 70% (70/100) participaram do estudo, sendo que inicialmente 34 delas tinham resultado citológico de ASC-US e 36 de LSIL. Após reavaliação citológica, oito (11,4%) apresentaram citologia normal; 33 (47,2%), citologia inflamatória; 22 (31,4%), ASC-US; seis (8,6%), LSIL e uma (1,4%), lesão intraepitelial de alto grau (HSIL). O HPV foi detectado em 28,6% (20/70) das amostras examinadas. Das 20 pacientes HPV positivas, uma apresentou citologia normal; seis apresentaram citologia inflamatória; 10 exibiram ASC-US; duas, LSIL e uma, HSIL. Foram identificados os tipos de HPV 6, 16, 58, 61, 70, 83, 84 e 85, sendo o HPV 58 o mais prevalente. Conclusão: A presença de HPV de alto risco em mulheres com lesões cervicais antigas, tendo elas evoluído ou não, mostra a necessidade de maior acompanhamento e vigilância dessas pacientes.

Objective To evaluate both the performance and acceptability of a method coupling self-sampling with detection of cervical malignancy via elevated HPV 16 and 18 E6 oncoproteins (OncoE6™ Cervical Test) in remote areas in Brazil. Methods Women living in rural villages in proximity to Coari city, Amazonas, Brazil were invited to participate in a cervical cancer screening study. 412 subjects were enrolled; there were no refusals. In addition to E6 protein detection, DNA was extracted from the brushes and evaluated for HPV genotypes by PCR (PGMY09/11), followed by typing by the Papillocheck™ if positive. Subjects who were found to be positive for OncoE6 or HPV-DNA were referred for colposcopy. Results For 110 subjects (27%) this was the first cervical cancer exam. Overall the HPV-DNA prevalence was 19.1% (n = 79); 1.4% (n = 6) were positive by the OncoE6 Test. Fifty-six women attended the invitation for colposcopy where nine had an abnormal cervix and were subsequently biopsied. Histopathological analysis revealed 2 CIN3, 2 carcinomas and 5 CIN1. OncoE6 called two out of the three HPV 16 or 18 associated CIN3+ lesions. Conclusions The findings suggest that self-administered sample collection in combination with OncoE6 Test is feasible in this population. This could enable expanded screening coverage while ensuring a high specificity which is imperative given the remote geographic location, since women bearing abnormal test results would necessitate travel and logistical burden to access colposcopy and treatment.

Introdução: O carcinoma de células escamosas oral (OSCC) representa a neoplasia maligna mais freqüente em boca, e, entre os agentes etiológicos implicados, o papilomavírus humano (HPV) tem sido extensivamente estudado nos últimos anos. Objetivo: Analisar comparativamente os índices de proliferação celular em OSCCs HPV-negativos e HPV-positivos. Material e método: A amostra consistiu em 11 casos de OSCCs HPV-positivos (10 infectados por HPV-18 e um por HPV-16 e 18) e 13 HPVnegativos, previamente analisados quanto à presença ou ausência, bem quanto à tipagem viral por proteína C reativa (PCR) (primers GP5+/GP6+) e hibridização dot blot, respectivamente. No método imunoistoquímico utilizou-se a técnica da estreptoavidina-biotina, com anticorpo para a proteína nuclear Ki-67. Resultados: O teste estatístico não-paramétrico de Mann-Whitney revelou que não houve diferença estatisticamente significativa entre os grupos HPV-positivo e HPV-negativo (p = 0,72). Discussão: Os estudos semelhantes a estes são poucos e não são concordantes em demonstrar maior atividade proliferativa tumoral nos casos HPV-positivos em relação aos HPV-negativos, seja através da análise da expressão de proteínas relacionadas ao ciclo celular, seja na análise direta da fração proliferativa tumoral. Conclusão: Não houve diferença no índice de proliferação celular entre os grupos de OSCCs HPV-positivo e HPV-negativos. Background: Oral Squamous Cell Carcinoma (OSCC) is the most common malignant tumor in the mouth, and the human papillomavirus (HPV) has been hardly studied as a possible etiologic agent. Objectives: The aim of this study was to compare the rates of cell proliferation in HPV-positive and HPV-negative OSCC, using the immunohistochemical antibody Ki-67. Material and method: The sample consisted of 11 cases HPV-positive OSCC (10 cases infected with HPV-18 and 1 case infected with HPV-16 and 18) and 13 cases HPV-negative OSCCs, previously analyzed regarding the presence or absence of HPV, as well as the viral type, using PCR (primers GP5+/GP6+) and dot blot hybridization, respectively. Immunohistochemical study was performed by streptoavidin-biotin technique with antibody against nuclear protein Ki-67. Results: The mean of positivity index of the HPV-positive OSCC (17.7%) was greater than HPV-negative OSCC (14.2%), however the statistic analysis showed that standard deviation in both groups was very high, almost equal the mean (14% and 9.5%, respectively). The Mann-Whitney non-parametric statistic test disclosed that there wasn’t a significantly statistical difference between the groups. Discussion: Similar studies to these are few and they are not concordant in demonstrating a bigger tumoral proliferative activity in those cases infected by HPV in relation to those not infected, either through the analysis of the protein expression related to the cellular cycle as in the direct analysis of the tumoral proliferative fraction. Conclusion: There were not differences in the rates of cell proliferation between the HPV-positive and HPV-negative grups.

O fibroma de células gigantes, a hiperplasia fibrosa e o fibroma constituem algumas das mais freqüentes lesões fibrosas orais, compartilhando características clínicas e histopatológicas. Este estudo teve o objetivo de investigar a imunorreatividade das células gigantes estreladas mono, bi ou multinucleadas, características do fibroma de células gigantes e, ocasionalmente presentes na hiperplasia fibrosa e no fibroma, a anticorpos anti-vimentina e anti-actina de músculo (HHF-35), visando detectar características fenotípicas destas células. Os resultados demonstraram que na maioria dos casos houve imunorreatividade para a vimentina, sugerindo um fenótipo fibroblástico para estas células. The giant cell fibroma, fibrous hyperplasia and fibroma are the most frequent fibrous oral lesions, sharing clinical and histopathological features. The purpose of this study was to investigate the immunoreactivity of the large stellate-shaped mononuclear and multinucleated cells, reported as the most characteristic histological feature of the giant cell fibroma but present occasionally in fibrous hyperplasia and fibroma, for the antibodies vimentin and HHF-35 in order to detect phenotypical characteristic of these cells. The results showed in the most of cases positive staining for vimentin, suggesting a fibroblast phenotype for these cells.

Summary This study describes the prevalence of infection by Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis in a female population in Amazonas, Brazil. We collected cervical samples from 361 women examined at 10 primary care health services in the city of Coari, Amazonas, Brazil. The women were interviewed about socio-economic data, clinical history and sexual behaviour. Pelvic examinations were performed and cervical specimens were collected for detection of pathogens by PCR. The prevalence of infection was: 12.7% for Trichomonas vaginalis, 6.4% for Chlamydia trachomatis and 1.4% for Neisseria gonorrhoeae. There were no statistically significant associations between infections by any of the pathogens nor by any pathogen alone with any clinical variable, socio-demographic data or sexual behaviour. This study draws attention to the need for surveillance and possible need for screening for Chlamydia trachomatis, which often progresses asymptomatically. For the significant prevalence found, attention should also be given to asymptomatic infection by Trichomonas vaginalis, since this pathogen has recently been implicated as a risk factor for HIV infection.

The aim of this study was to determine the prevalence of human papillomavirus (HPV) in a women population living within the state of Amazonas, Brazil, and to determine the viral genotypes found. The study included 361 sexually active women over 18 years of age. We performed the Pap test and the molecular diagnosis for HPV DNA using polymerase chain reaction (PCR). The amplicons obtained were sequenced in automatic sequencer for genotyping. The presence of HPV DNA was found in 29.1% (105) of the women. Only 321 women presented satisfactory slides for cytological diagnosis, 97.9% (314) had normal cytology (negative for cancer), and 2.1% (7) had abnormal cytology (4 ASCUS, 1 LSIL, and 2 HSIL). The types more frequently found were HPV 16 (58.1%) and HPV 58 (20.0%). Additionally, we found more 13 types of HPV. Compared with previous studies in Brazil, our data confirmed a high prevalence and genotypic diversity of HPV in Brazilian women.

The giant cell fibroma, fibrous hyperplasia and fibroma are the most frequent fibrous oral lesions, sharing clinical and histopathological features. The purpose of this study was to investigate the immunoreactivity of the large stellate-shaped mononuclear and multinucleated cells, reported as the most characteristic histological feature of the giant cell fibroma but present occasionally in fibrous hyperplasia and fibroma, for the antibodies vimentin and HHF-35 in order to detect phenotypical characteristic of these cells. The results showed in the most of cases positive staining for vimentin, suggesting a fibroblast phenotype for these cells.

The benign peripheral nerve sheath tumours are rare lesions mainly represented by schwannoma and neurofibroma. The present work evaluated the clinical and histopathological features of schwannomas and neurofibromas of the oral cavity diagnosed in a Brazilian population. Among 9.000 cases of oral lesions archived from 1970 to 2008, four schwannomas and 12 neurofibromas were identified, microscopically revised and immunohistochemically certified through a panel including monoclonal antibodies (anti-S100, vimentin, HHF-35 and desmin). From biopsy and histological sections records, clinical and histopathological data were retrieved, reviewed and statistically analysed. Predominantly, schwannomas affected non-white males (3:1), with an age and size averages of 34.7 years and 2.8 cm, respectively. Neurofibromas preferentially occurred on the gingival/alveolar ridge of white females (5:1), with 35.7-year mean age, peak of incidence between 3rd and 5th decade, and size average of 1.7 cm. (12 cases, 75%). The studied tumours exhibited more frequently as a painless, sessile and slow growth very similar to other oral lesions, but their microscopic features differed significantly. Schwannomas and neurofibromas are extremely uncommon in the oral cavity, exhibiting clinical features very similar but specific and peculiar microscopic findings that are useful in the establishment of the diagnosis, which in some particular cases must be confirmed by immunohistochemistry.

Made available in DSpace on 2016-09-23T15:09:10Z (GMT). No. of bitstreams: 1 pib-s00322009[1].pdf: 1160979 bytes, checksum: b5b0fdf04e4422f287aaf3e04fc0083e (MD5) Previous issue date: 2010-07-29 CNPQ Os Papilomavírus Humano (HPV) são vírus epiteliotrópicos que infectam superfícies mucosas e cutâneas de uma a variedade de animais e são espécie específicos para seus respectivos hospedeiros. São vírus DNA dupla fita com cerca de 8 Kb e possuem em seu genótipo uma região Early (E) ou pecoce constituída pelos genes de expressão precoce E1 e E2 e os oncogenes E4, E5, E6 e E7, além de uma região tardia ou Late (L) constituída pelos genes de expressão tardia do capsídeo viral L1 e L2, sendo a região L1 a mais conservada de todos os Papilomavírus. A literatura relata mais de 118 tipos de HPV sendo considerados de alto risco oncogênico e baixo risco oncogênico. A associação entre o câncer cervical e a infecção pelo HPV já é bem estabelecida. A infecção pelos HPVs oncogênicos é um dos fatores de risco para o desenvolvimento do câncer cervical, sendo o HPV tipo 16 o mais frequentemente detectado nestas lesões. Em cavidade oral, os estudos sobre a participação do HPV na gênese do câncer são inconclusivos. Os índices de detecção destes vírus são extremamente variáveis, bem como os principais tipos virais encontrados. Este estudo tem por objetivo avaliar a presença do DNA do HPV, por Reação em Cadeia de Polimerase (PCR) em carcinoma de células escamosas oral, assim como genotipá-los.