Search

A common germline polymorphism of p53 gene produces an Arginine to Proline change at aminoacid position 72. The resulting codon 72 variants have been reported associated with tumor susceptibility since they reduce p53 ability to activate apoptosis. Codon 72 polymorphism may play a role in subside vulnerability to different carcinogens and might account for ethnic variations in cancer frequency. Using an allele-specific polymerase chain reaction (PCR), we tested peripheral blood samples from 98 patients with thyroid cancer, including 21 follicular (FC) and 77 papillary carcinomas (PC), 44 patients with benign nodules, including 14 follicular adenomas and 30 goiters and 153 healthy individuals from the same geographical region. Data on lifetime occupational history, smoking history, general health conditions, previous diseases and other anamnestic data were obtained through interviews. Patients with FC (Pro/Pro=19.0%, Arg/Arg=42.9%, Arg/Pro=38%) and with PC (Pro/Pro=10.3%, Arg/Arg=36.36%, Arg/Pro=53.24%) showed a significant overrepresentation of codon 72 variants compared to the control population (Pro/Pro=1.9%, Arg/Arg=33.3%, Arg/Pro=64.7%) (P=0.0015). The Pro/Pro genotype, after adjusting for gender, age, tobacco and drugs, was associated with a markedly higher risk of FC (OR=9.714; CI: 2.334–40.436) and of PC (OR=5.299; CI: 2.334–40.436). These results provide evidence that p53 polymorphism is implicated in thyroid carcinogenesis and that individuals harboring the Pro/Pro genotype have an increased risk of developing thyroid cancer. [Copyright &y& Elsevier]

Screening tools are of utmost necessity in order to identify individuals at risk for thyroid nodule cancer. The polymorphic inheritance of human drug-metabolizing enzymes, such as those encoded by the Glutathione-S-Transferase (GST) system, plays an important role in the development of most human cancers. GSTP1 enzyme is the most important detoxification enzyme in human head and neck tissues. An aminoacid substitution (1105V) in the GSTP1 gene result in two genotypes, GSTP1AB and GSTP1BB. Those produce a variant enzyme with lower activity and less capability of effective detoxification of carcinogens than the wild type GSTP1AA. In order to look for the influence of GSTP1 enzymes inheritance pattern on thyroid cancer risk we used a PCR-SSCP-sequencing approach to compare the genotypes of 98 malignant nodules, including 77 papillary carcinomas (PC) and 21 follicular carcinomas (FC), to 44 benign nodules and to 157 healthy control individuals. Individuals with history of previous thyroid disease, exposure to radiation and antecedents of malignancy were excluded. Patients with PC and FC showed a significant over-representation of the variants of GSTP1 allele compared to the control population (p<0.0001). The risk for thyroid cancer in individuals with the variant GSTP1 enzymes, after adjusting for gender, age, tobacco and drugs use, increased 7,092 (CI: 2,307-21,802) and 9,625 (CI: 2.484-37.291) times for PC and FC, respectively. We suggest that GST genotype may be associated with an increased susceptibility to thyroid cancer. GSTP1 profiling from peripheral blood may be a simple and useful tool in the screening for thyroid nodule malignancy. Glutathione-S-Transferase system; GSTP; Thyroid cancer; Screening. [Copyright &y& Elsevier]

We detected Mayaro virus (MAYV) in 3.4% (28/822) of febrile patients tested during 2018-2021 from Roraima State, Brazil. We also isolated MAYV strains and confirmed that these cases were caused by genotype D. Improved surveillance is needed to better determine the burden of MAYV in the Amazon Region. [ABSTRACT FROM AUTHOR]

• Over 75% of adult individuals had antidengue antibodies in the city of Manaus. • Dengue virus-positive individuals do not cross-neutralize zika virus efficiently. • Varying degree of cross-reactivity against emerging and endemic Flaviviruses. Several Flaviviruses can co-circulate. Pre-existing immunity to one virus can modulate the response to a heterologous virus; however, the serological cross-reaction between these emerging viruses in dengue virus (DENV)-endemic regions are poorly understood. A cross-sectional study was performed among the residents of Manaus city in the state of Amazonas, Brazil. The serological response was assessed by hemagglutination inhibition assay (HIA), enzyme-linked immunosorbent assay, and neutralization assay. A total of 74.52% of the participants were immunoglobulin G-positive (310/416), as estimated by lateral flow tests. Overall, 93.7% of the participants were seropositive (419/447) for at least one DENV serotype, and the DENV seropositivity ranged between 84.8% and 91.0%, as determined by HIA. About 93% had antiyellow fever virus 17D-reactive antibodies, whereas 80.5% reacted to wild-type yellow fever virus. Zika virus (ZIKV) had the lowest seropositivity percentage (52.6%) compared with other Flaviviruses. Individuals who were DENV-positive with high antibody titers by HIA or envelope protein domain III enzyme-linked immunosorbent assay reacted strongly with ZIKV, whereas individuals with low anti-DENV antibody titers reacted poorly toward ZIKV. Live virus neutralization assay with ZIKV confirmed that dengue serogroup and ZIKV-spondweni serogroup are far apart; hence, individuals who are DENV-positive do not cross-neutralize ZIKV efficiently. Taken together, we observed a high prevalence of DENV in the Manaus-Amazon region and a varying degree of cross-reactivity against emerging and endemic Flaviviruses. Epidemiological and exposure conditions in Manaus make its population susceptible to emerging and endemic arboviruses. [ABSTRACT FROM AUTHOR]

Currently, there are no evidence-based treatment options for long COVID-19, and it is known that SARS-CoV-2 can persist in part of the infected patients, especially those with immunosuppression. Since there is a robust secretion of SARS-CoV-2-specific highly-neutralizing IgA antibodies in breast milk, and because this immunoglobulin plays an essential role against respiratory virus infection in mucosa cells, being, in addition, more potent in neutralizing SARS-CoV-2 than IgG, here we report the clinical course of an NFκB-deficient patient chronically infected with the SARS-CoV-2 Gamma variant, who, after a non-full effective treatment with plasma infusion, received breast milk from a vaccinated mother by oral route as treatment for COVID-19. After such treatment, the symptoms improved, and the patient was systematically tested negative for SARS-CoV-2. Thus, we hypothesize that IgA and IgG secreted antibodies present in breast milk could be useful to treat persistent SARS-CoV-2 infection in immunodeficient patients. [ABSTRACT FROM AUTHOR]

Previous studies have indicated that antibody responses can be robustly induced after the vaccination in individuals previously infected by SARS-CoV-2. To evaluate anti-SARS-CoV-2 humoral responses in vaccinated individuals with or without a previous history of COVID-19, we compared levels of anti-SARS-CoV-2 antibodies in the sera from 21 vaccinees, including COVID-19-recovered or -naïve individuals in different times, before and after immunization with an inactivated COVID-19 vaccine. Anti-SARS-CoV-2-specific antibodies elicited after COVID-19 and/or immunization with an inactivated vaccine were measured by ELISA and Plaque Reduction Neutralizing assays. Antibody kinetics were consistently different between the two vaccine doses for naïve individuals, contrasting with the SARS-CoV-2-recovered subjects in which we observed no additional increase in antibody levels following the second dose. Sera from SARS-CoV2-naïve individuals had no detectable neutralizing activity against lineage B.1 SARS-CoV-2 or Gamma variant five months after the second vaccine dose. Contrarily, SARS-CoV-2-recovered subjects retained considerable neutralizing activity against both viruses. We conclude that a single inactivated SARS-CoV-2 vaccine dose may be sufficient to induce protective antibody responses in individuals with previous history of SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Background: Steatocystoma simplex is an uncommon skin lesion with a histological pattern that is identical to that of steatocystoma multiplex. We are reporting this case of steatocystoma simplex for its uncommon location in the penile foreskin, and its occurrence in a Wapishana man.Case Presentation: A 56-year-old man of Wapishana ethnicity presented with complaints of referred penile discomfort and pain during sexual intercourse for 5 years. A physical examination revealed a mobile, compressible subcutaneous non-tender mass of 4 cm diameter located on the left-side of his penile foreskin. There were no signs of inflammation, no grip on the penile shaft, and no urethral discharge or enlargement of lymph nodes. We found no evidence of other cysts on cutaneous examination. We performed classical excision of the lesion under local anesthesia and confirmed the diagnosis of steatocystoma with the pathological report. As there were no complications, we discharged him the same day.Conclusion: Steatocystoma can be considered a differential diagnosis for cystic lesions on and around the penis. [ABSTRACT FROM AUTHOR]

A decreased radioiodine uptake is frequently detected in differentiated thyroid carcinomas (DTC) and is associated with high recurrence rate and reduced survival. We investigated the correlation between NIS mRNA expression levels in the primary tumor and patient outcome using a quantitative real-time RT-PCR method. NIS expression was decreased in 17 DTC (21.04±39.66 pg Eq) compared to four autoimune thyroid disease (180.51±92.63 pg Eq) and 14 normal tissues (75.71±66.98 pg Eq) (p<0.0001). The 17 thyroid differentiated carcinoma patients were submitted to surgery complemented by radioiodine ablation and had at least 24 months of follow-up, under levothyroxine continued suppressive therapy. According to their outcome, we could characterize a group of papillary carcinoma patients with aggressive carcinomas, whose NIS mRNA levels were markedly lower than a group with non-aggressive carcinomas (0.62±0.79 versus 54.87±53.79; p<0.005). We suggest that the quantification of NIS mRNA relative levels in the primary tumor may predict poor outcome. [Copyright &y& Elsevier]

Introdução: A doença causada pelo coronavírus de 2019 (COVID-19) é um problema global complexo, apresentando uma ampla gama de manifestações clínicas, desde casos assintomáticos até formas graves com risco de morte. Evidências epidemiológicas sugerem que as crianças tendem a apresentar formas mais leves da doença e uma menor taxa de mortalidade após a infecção pelo SARS-CoV-2, com exceção de uma síndrome inflamatória multissistêmica (MISC) associada a comorbidades em uma parcela relativamente pequena de crianças. Objetivo: Investigar as diferenças de resposta imune celular e humoral entre crianças e adultos com COVID-19, com o intuito de identificar fatores que possam contribuir para essa variação na sintomatologia. Método: Realizamos uma caracterização minuciosa do plasma e das células mononucleares de sangue periférico (PBMCs) em pacientes adultos e pediátricos com COVID-19, coletados em três momentos diferentes: durante a fase aguda da doença e após três e seis meses. Usando citometria de fluxo com múltiplos parâmetros, identificamos 78 subtipos diferentes de células imunes e analisamos um conjunto de dados extenso, totalizando 38.670 pontos, incluindo anticorpos IgA e IgG anti-SARS-CoV-2 e a frequência de células T efetoras específicas. Resultados: Nossos resultados revelaram diferenças significativas na cinética e no perfil de respostas de memória entre crianças e adultos. Vimos que, durante a fase aguda da infecção, as crianças e os adultos exibiram semelhanças e diferenças em suas respostas imunes, que pudemos distinguir por meio da Análise de Componentes Principais (PCA) e de clusterização hierárquica. Crianças também possuem altos títulos virais e produzem uma resposta imune forte, mas diferente para SARS-CoV-2 quando comparado com adultos. No momento de diagnóstico, crianças apresentaram altas frequências de células T CD8+ que produzem TNF em resposta a peptídeos da proteína N, enquanto a resposta de adultos com doença leve ou moderada foi baixa. Essa resposta foi reduzida em todos os adultos, que apresentam mais células T específicas para a proteína S. O estudo sequencial mostra que as crianças apresentam um aumento de títulos de IgG e IgA para N, mas não para a proteína S. A análise imparcial de tSNE demonstrou que em crianças, a resposta anti-N de células T CD8+TNF+ evoluiu para células T CD8+ de memória efetora e terminalmente diferenciada (EMRA), em apenas 3 meses, dominando a população de memória T, 6 meses após a infecção inicial. Essa resposta se correlaciona com anticorpos anti-N, mas não com anti-S. Todos os grupos analisados produziram anticorpos neutralizantes para a variante original, no entanto, foi vista uma perda de potencial de neutralização contra variantes de preocupação (VOCs). Conclusão: Nossos resultados sugerem que a proteção da doença e a reinfecção por VOCs pode ser funcionalmente diferente. Eles mostram a importância de se vacinar crianças, que permanecem sob risco apesar de já terem sido previamente infectadas. [ABSTRACT FROM AUTHOR]

Background: Common variable immunodeficiency is the most prevalent symptomatic primary immunodeficiency in adults. Affected patients fail to mount an appropriate humoral response against community acquired infectious diseases and recent reports have provided data supporting the increased susceptibility of these patients to severe SARS-CoV-2 infections. In this context, the infusion of COVID-19 convalescent plasma could represent an effective therapeutic strategy. Case presentation: 25-year old woman diagnosed with common variable immunodeficiency in 2013, developed severe COVID-19 that rapidly progressed to pneumonia presenting with multiple bilateral lung opacities that were both central and peripheral and presented as ground-glass and consolidation types involving all lobes, bilaterally. As blood oxygen saturation decayed and lung abnormalities were not responsive to large spectrum antibiotics and corticosteroids, patient was placed on mechanical ventilation and compassionate-use of approved COVID-19 convalescent donor plasma was introduced. The patient presented a rapid response to the approach and mechanical ventilation could be interrupted 24 h after first dose of COVID-19 convalescent donor plasma. As a whole, the patient received four doses of 200 mL convalescent plasma during a period of 6 days. There was rapid improvement of clinical status, with interruption of supplemental oxygen therapy after 6 days and reduction of lung abnormalities as evidence by sequential computed tomography scans. Conclusions: This is a single patient report that adds to other few reports on common variable immunodeficiency and agammaglobulinemia, suggesting that COVID-19 convalescent donor plasma could be a valuable therapeutic approach to treat patients affected by dysgammaglobulinemias and presenting severe COVID-19. [ABSTRACT FROM AUTHOR]

We report a case of bacterial endocarditis resulting from genital piercing in a male patient with known prior valvular heart disease. Body piercings have emerged as a fashion trend among teenagers and young adults. Concurrently, the number of complications related to body piercing has risen, alerting doctors and wearers to safety concerns. The potential risks of regional complications in male genital piercings (e.g. irritation, paraphimosis, priapism, rupture of of the urethra, urethral stenosis, infections, and obstruction of urinary flow) are underestimated by the wearer. Bacterial endocarditis with genital piercing is a severe severe complication arising after the implantation of these accessories. Recognizing symptoms early and providing medical treatment is crucial to minimize morbidity and mortality of bacterial. [ABSTRACT FROM AUTHOR]

The development of infectious genital sores in children is rarely observed. We report a case of chigoe flea infection on the penis of a child living in an urban area. Healthcare professionals should be warned about the prevention of possible clinical complications. [ABSTRACT FROM AUTHOR]

The HIV-1 epidemic in Brazil has spread towards the Northern country region, but little is known about HIV-1 subtypes and prevalence of HIV strains with resistance mutations to antiretrovirals in some of the Northern states. HIV-1 protease (PR) and reverse transcriptase (RT) sequences were obtained from 73 treatment-naive and -experienced subjects followed between 2013 and 2014 at a public health reference unit from Roraima, the northernmost Brazilian state. The most prevalent HIV-1 clade observed in the study population was the subtype B (91%), followed by subtype C (9%). Among 12 HIV-1 strains from treatment-naïve patients, only one had a transmitted drug resistance mutation for NNRTI. Among 59 treatment-experienced patients, 12 (20%) harbored HIV-1 strains with acquired drug resistance mutations (ADRM) that reduce the susceptibility to two classes of antiretroviral drugs (NRTI and NNRTI or NRTI and PI), and five (8%) harbored HIV-1 strains with ADRM that reduced susceptibility to only one class of antiretroviral drugs (NNRTI or PI). No patients harboring HIV strains with reduced susceptibility to all three classes of antiretroviral drugs were detected. A substantial fraction of treatment-experienced patients with (63%) and without (70%) ADRM had undetectable plasma viral loads (<40 copies/ml) at the time of sampling. Among treatment-experienced with plasma viral loads above 2,000 copies/ml, 44% displayed no ADRM. This data showed that the HIV-1 epidemic in Roraima displayed a much lower level of genetic diversity and a lower prevalence of ADRM than that described in other Brazilian states. [ABSTRACT FROM AUTHOR]

Even after two years of the pandemic, a completely effective treatment against SARS-CoV-2 has not yet been established. Considering this fact and the emergence of successive new viral variants, the development of therapies based on natural polyclonal antibodies recovered from convalescent plasma remains relevant. This study presents a comparison between different methods of screening antibodies in samples of 41 individuals previously diagnosed with COVID-19. We found a significant correlation between Abbot Architect anti-SARS-CoV-2 IgG and Abbott Allinity SARS-CoV-2 IgG II Quantitative assay intensity of reactivity and neutralizing antibody (nAb) titers. Thus, we propose an initial antibody screening with IgG anti-N Abbott Architect test, with an index of, for example, > 3.25 or SARS-CoV-2 IgG II Quantitative Abbott Allinity assay > 137.65 AU/mL as good predictors of Nab ≥ 1:80. For the quantitative method, this threshold demonstrated a 100 % sensitivity and 80 % specificity, with 97.3 % accuracy. An interesting observation was the increase in the neutralizing activity of the anti-SARS-CoV-2 antibodies with the longest interval between the end of the symptoms and the collection, demonstrating that the delay in plasma collection does not affect the achievement of adequate nAbs levels. These results demonstrate the possibility of using faster and more widely available commercial serological tests with a good correlation with viral neutralization tests in culture, allowing for optimized large-scale donor selection, which will be of utmost importance for the development of therapies such as hyperimmune immunoglobulin. • Commercial serological tests for anti-SARS-CoV-2 antibodies show good correlation with neutralizing antibodies in culture. • This study demonstrates accurate cut-off points in serological tests for the selection of donors with nAbs > 1:80. • We propose a strategy for the selection of donors that can be useful for the production of therapeutics on a large scale. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Dengue Virus Serotype 4, Roraima State, Brazil," from J. G. Temporão and colleagues which appeared in the 2011 issue of the periodical.

BACKGROUND: The aim of this study was to examine the influence of preexamination intimation and counseling of women with urinary incontinence on physical and psychological discomforts during urodynamic assessment. METHODS: One hundred and fifty-two women with urinary incontinence, who underwent urodynamic assessment, were studied prospectively. A questionnaire survey was used to study their awareness about the nature of the assessment, extent of physical discomfort, mental stress, and the pain level during the assessment and to determine if pre-examination counseling had any effect on the level of pain or distress. RESULTS: Most patients felt that the urodynamic examination was important, but noted lack of detailed information. Although the patients were anxious, most were not in distress. There was no correlation between prior information and the extent of pain or distress. However, older women reported less pain during the procedure compared to the younger women. The results also indicated that the patients were comfortable with familiar doctors, and that most preferred a female doctor. CONCLUSION: Our findings confirm the importance of pre-examination counseling in women before undergoing urodynamic examination to minimize the symptoms of anxiety and shame, which may indirectly result in fewer artefacts and better interpretation of the results. [ABSTRACT FROM AUTHOR]

Introduction Leiomyoma in the urethra is a rare occurrence. These are rare benign mesenchymal tumors that arise from the smooth muscle of the urethra. Such tumors often appear in females during their reproductive age (from menarche to menopause); the mean age of their appearance is approximately 41 years. Case presentation We report here a case of a 52-year-old White woman who presented with complaints of sporadic hematuria, dyspareunia, and feeling of nodulation in her vagina. Conclusions Histopathological studies confirmed the urethral leiomyoma, and the surgery completely resolved the original symptoms. Although the average age of occurrence of such tumors in females is about 41 years, the present case involves an older woman of 52 years. Most importantly, the mass was located in the distal urethra, an uncommon site of presentation of leiomyoma in females. [ABSTRACT FROM AUTHOR]

Purpose . A series of polymorphisms in germ-line DNA have been investigated in an effort to delineate polygenic models of cancer susceptibility and prognosis. As low-penetrance susceptibility genes may combine additively or multiplicatively and contribute to cancer incidence and to the response to chemotherapy, we studied GSTT1, GSTM1, GSTO2, GSTP1 and codon 72 of p53 genotype profiles in ovarian cancer patients. Methods . We compared 69 ovarian cancer patients with 222 control healthy women paired for ethnic and life-style characteristics. Outcome was evaluated in 29 stage III and IV patients submitted to a platinum-based chemotherapy followed-up for 6–29 months (17 ± 9 months). Results . GSTT1, GSTM1, GSTO2 and GSTP1 genes presented a similar genotype distribution, but codon 72 of p53 gene wild-type variant was less frequent in ovarian cancer patients than in controls (χ2; P = 0.0004). Conclusions. We were unable to demonstrate any association between the GST genotypes studied and the risk of ovarian cancer but the inheritance of a heterozygous Arg/Pro genotype of p53 increased the risk of ovarian cancer more than 2.5 times (OR = 2.571; 95% CI = 1.453–4.550). There was no association of the studied genes to any clinical or pathological feature of the patients or to their response to chemotherapy. [ABSTRACT FROM AUTHOR]

Dengue is the most important arboviral disease worldwide. We report the complete genome sequence of a dengue virus serotype 4, genotype II strain isolated in 2010 from a patient with classical dengue fever in Boa Vista, Roraima, Brazil. [ABSTRACT FROM AUTHOR]