Tumor de testículo: análise de 31 casos.

Trabalho de Conclusão de Curso - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Clínica Cirúrgica, Curso de Medicina, Florianópolis, 198

Poliomielite.

Trabalho de Conclusão de Curso - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Pediatria, Curso de Medicina, Florianópolis, 198

Pesquisa da prevalencia do papilomavírus humano (HPV) em amostra de tecido endometrial normal e com carcinoma pela técnica de PCR.

Orientador : Newton Sérgio de CarvalhoDissertaçao (mestrado) - Universidade Federal do Paraná, Setor de Ciencias da SaúdeResumo: A ação do Papilomavírus humano (HPV) na oncogênese das lesões do trato genital inferior está bem definida. Alguns estudos tem demonstrado a presença do vírus no trato genital superior, particularmente no ovário e cavidade endometrial, sem no entanto, analisar qual a relação da presença do HPV e seu efeito nestes locais. O objetivo deste estudo foi estudar a possível associação da presença do Papilomavírus humano e a carcinogênese endometrial. Para isso, foram avaliadas mulheres com carcinoma endometrial, comparando com as mulheres com endométrio normal e a sua correlação com a idade, tabagismo, diferenciação escamosa e grau de diferenciação tumoral, tipo virai mais frequente e trofismo endometrial nas mulheres sem carcinoma. Trata-se de um estudo observacional do tipo caso-controle onde foram avaliadas 100 mulheres (50 com endométrio normal e 50 com carcinoma endometrial) quanto a presença do DNA HPV em amostra tecidual conservada em blocos de parafina, pelo método de PCR. O risco relativo estimado da presença do HPV foi o mesmo nas mulheres com e sem carcinoma endometrial. A presença do HPV não esteve correlacionada com a idade das mulheres, tabagismo, trofismo endometrial, diferenciação escamosa e grau de diferenciação tumoral. O HPV 16 e 18 (5 dos casos com tipo 16 e 4 com o tipo 18) foram os vírus mais frequentemente encontrados. Concluímos que o HPV está presente no tecido endometrial de mulheres com carcinoma endometrial na mesma proporção que nas com tecido endometrial normal, não demonstrando a possível associação deste vírus no desenvolvimento do carcinoma endometrial. Palavras-chave: Papilomavírus humano; HPV; Oncogênese; Carcinoma endometrial.Abstract: The role of the human Papillomavirus (HPV) on the oncogenesis of the lesions of lower genital tract is very strong. Some studies have had detected the HPV in the upper genital tract, mainly ovary and endometrial cavity. Although, the relation of this viral infection and his effects in this sites is unknown yet. The aim of this study was to determine the relation among HPV and endometrial carcinogenesis. Then, we studied women with and without endometrial carcinoma. Factors as age, tabagism, squamous differentiation and tumoral grade of tumours, trophism of normal endometrial and HPV types detected in endometrial tissues was avaliable too. This is an observational case control study with 100 women (50 with endometrial carcinoma and 50 with normal endometrial tissue) who was analyzed by HPV DNA in the samples of endometrial tissue in paraffinized blocks, using PCR technique. The estimate relative risk of presence of the HPV in the endometrial carcinoma and the normal endometrial tissue was the same. The presence of HPV wasn't associated with age, tabagism, endometrial trophism , squamous differentiation and tumoral grade. The HPV type more frequently detected was 16 and 18 (five cases with HPV 16 and four cases with HPV 18). The conclusion of this study was that the HPV was detected in endometrial tissue of women with endometrial cancer in the same proportion of the women with normal endometrium. The association of HPV DNA and endometrial carcinogenesis wasn't observed. Key-words: human Papillomavirus; HPV; Carcinogenesis; Endometrial carcinoma

Genital Human Papillomavirus Infection in women from Florianópolis - Santa Catarina, Brazil

Introduction: Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in women. About 80% of sexually active women will have contact with this virus at some age in their lives. Most infections will be transient, but when the infection becomes persistent, associated with high oncogenic risk HPV, there may be progression to cancer, especially cervical cancer. The best way to prevent HPV infection is through the use of vaccines. Objective: To assess which are the most prevalent types of HPV in the city of Florianópolis, Brazil and if the majority of the diagnosed types are contained in the HPV vaccines currently available on the market and in the public health sector. Methods: More than 14,727 HPV tests were evaluated for the diagnosis of genital HPV infection in women from Florianópolis. The prevalence of infection was evaluated according to age of the women. HPV detection was performed using molecular biology tests, such as hybrid capture (for diagnosis of the HPV group, high or low oncogenic risk) and PCR (viral genotyping) techniques. Results: The diagnosis of HPV infection was made for women between one and 102 years of age. The highest positivity of the exams was observed in women aged 20–25 years (51% of the exams). The most prevalent age group was 31–35 years old (23.5%), and the lowest was for women aged 70 and above (0.6%). High oncogenic risk HPV was detected in 94.1% of positive samples and was the most frequent in all age groups. Mixed infection (high- and low-risk HPV) was more prevalent in the 66–70 age group (25.6%). The most frequent genotypes were non-16/18 high oncogenic risk HPV (77% of positive cases). HPV 16 was found in 17.1% of positive cases, and HPV 18 in 6.5%. Conclusion: The most prevalent types of HPV in Florianópolis in the last 6 years are non-16/18 high oncogenic risk HPV types, viral types not covered by the current HPV vaccine available in the public health sector in Brazil

Accuracy of visual inspection, cytology and colposcopy in the diagnosis of high-grade cervical intraepithelial neoplasia

Introduction: Cervical cancer is still one of the leading causes of cancer and mortality in women, especially in low- and middle-income countries. Normally, the prevention of its occurrence is done through efficient screening and treatment programs for high-grade epithelial lesions, which are pre-malignant lesions. Cheaper diagnostic techniques ensure greater access to women, which can prevent a large number of cancer cases worldwide. Objective: The aim of the study was to evaluate the accuracy of visual inspection either with acetic acid or with Lugol’s iodine, cervical cytology and colposcopy in the diagnosis of cervical intraepithelial neoplasia 2 and 3. Methods: This is a study of diagnostic accuracy. We evaluated 115 women with high-grade squamous intraepithelial lesion confirmed by biopsy, 54 with cervical intraepithelial neoplasia 2 and 61 with cervical intraepithelial neoplasia 3, from January 2016 to December 2018 at the Lower Genital Tract Pathology and Colposcopy Service of the Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. A comparative analysis of the visual inspection, Pap smear and colposcopy diagnostic methods was performed. Results: The average age was 33.1 years (standard deviation=9.83) for cervical intraepithelial neoplasia 2 cases and 35.2 years (standard deviation=7.97) for cervical intraepithelial neoplasia 3. In the cervical intraepithelial neoplasia 2 group, visual inspection tests were positive for high-grade squamous intraepithelial lesion in 98.1% of the cases with acetic acid and 94.4% with Lugol’s iodine. Colposcopy identified a probable high-grade squamous intraepithelial lesion in 94.4% of the cases, while cytology only in 42.6%. In the cervical intraepithelial neoplasia 3 group, the visual inspection tests were positive for high-grade squamous intraepithelial lesion in 91.8% of the cases with acetic acid and 95.1% with Lugol’s iodine. Colposcopy identified a probable high-grade squamous intraepithelial lesion in 93.5% of the cases, while cytology in 65.6%. Conclusion: Visual inspection with acetic acid and Lugol’s iodine, and colposcopy test were more accurate for the diagnosis of cervical intraepithelial neoplasia 2 and 3 than through cytopathology

Infecção genital pelo papilomavírus humano (HPV) em mulheres de Santa Catarina/Brasil

Introdução: A infecção por Papilomavírus Humano é a infecção sexualmente transmissível mais frequente na mulher. Cerca de 80% das mulheres sexualmente ativas entrarão em contato com esse vírus em algum momento. A maioria das infecções será transitória, mas quando ela é persistente, associada aos Papilomavírus Humano de alto risco oncogênico, poderá progredir para câncer, principalmente de colo de útero. A melhor forma de se prevenir da contaminação pelo vírus é por meio de vacina, disponível no sistema público do Brasil desde 2014. Objetivos: Avaliar os tipos de Papilomavírus Humano mais prevalentes no estado de Santa Catarina e suas mesorregiões, e se a maioria dos tipos diagnosticados estão contidos nas vacinas contra o Papilomavírus Humano atualmente disponíveis no mercado. Métodos: Foram avaliados 20 mil exames para diagnóstico da infecção genital pelo Papilomavírus Humano em mulheres de todo o estado. A prevalência da infecção foi comparada de acordo com a idade e a procedência dos exames. A detecção do Papilomavírus Humano deu-se pelos exames de biologia molecular pelas técnicas de captura híbrida (para diagnóstico do grupo de Papilomavírus Humano, alto ou baixo riscos oncogênicos) e de PCR (genotipagem viral). Resultados: Foram avaliados exames para diagnóstico da infecção de mulheres entre um e 102 anos de idade. A faixa etária de maior positividade, como era de ser esperado, foi dos 20 aos 25 anos (45.6%) e a menor depois dos 70 anos (7.1%). A maior positividade dos exames foi observada na região Serrana do estado (58.9% dos exames). O Papilomavírus Humano de alto risco oncogênico foi detectado em 93% dos casos positivos e foi o mais frequente em todas as faixas etárias. A infecção mista (Papilomavírus Humano de alto e baixo riscos) foi mais prevalente na faixa etária dos 66 aos 70 anos (29.3%) e na região Sul Catarinense (26.4%). Os genótipos mais frequentes no estado foram os Papilomavírus Humano de alto risco oncogênico não 16/18 (76.9% dos casos positivos). O Papilomavírus Humano 16 foi encontrado em 17.1% dos casos positivos e o Papilomavírus Humano 18 em 6.6%. Conclusão: Os tipos de Papilomavírus Humano mais prevalentes no estado de Santa Catarina, nos últimos seis anos, são os Papilomavírus Humano de alto risco oncogênico não 16/18, tipos virais não cobertos pelas atuais vacinas contra o Papilomavírus Humano disponíveis no Brasil

Pesquisa da prevalencia do papilomavírus humano (HPV) em amostra de tecido endometrial normal e com carcinoma pela técnica de PCR.

Orientador : Newton Sérgio de CarvalhoDissertaçao (mestrado) - Universidade Federal do Paraná, Setor de Ciencias da SaúdeResumo: A ação do Papilomavírus humano (HPV) na oncogênese das lesões do trato genital inferior está bem definida. Alguns estudos tem demonstrado a presença do vírus no trato genital superior, particularmente no ovário e cavidade endometrial, sem no entanto, analisar qual a relação da presença do HPV e seu efeito nestes locais. O objetivo deste estudo foi estudar a possível associação da presença do Papilomavírus humano e a carcinogênese endometrial. Para isso, foram avaliadas mulheres com carcinoma endometrial, comparando com as mulheres com endométrio normal e a sua correlação com a idade, tabagismo, diferenciação escamosa e grau de diferenciação tumoral, tipo virai mais frequente e trofismo endometrial nas mulheres sem carcinoma. Trata-se de um estudo observacional do tipo caso-controle onde foram avaliadas 100 mulheres (50 com endométrio normal e 50 com carcinoma endometrial) quanto a presença do DNA HPV em amostra tecidual conservada em blocos de parafina, pelo método de PCR. O risco relativo estimado da presença do HPV foi o mesmo nas mulheres com e sem carcinoma endometrial. A presença do HPV não esteve correlacionada com a idade das mulheres, tabagismo, trofismo endometrial, diferenciação escamosa e grau de diferenciação tumoral. O HPV 16 e 18 (5 dos casos com tipo 16 e 4 com o tipo 18) foram os vírus mais frequentemente encontrados. Concluímos que o HPV está presente no tecido endometrial de mulheres com carcinoma endometrial na mesma proporção que nas com tecido endometrial normal, não demonstrando a possível associação deste vírus no desenvolvimento do carcinoma endometrial. Palavras-chave: Papilomavírus humano; HPV; Oncogênese; Carcinoma endometrial.Abstract: The role of the human Papillomavirus (HPV) on the oncogenesis of the lesions of lower genital tract is very strong. Some studies have had detected the HPV in the upper genital tract, mainly ovary and endometrial cavity. Although, the relation of this viral infection and his effects in this sites is unknown yet. The aim of this study was to determine the relation among HPV and endometrial carcinogenesis. Then, we studied women with and without endometrial carcinoma. Factors as age, tabagism, squamous differentiation and tumoral grade of tumours, trophism of normal endometrial and HPV types detected in endometrial tissues was avaliable too. This is an observational case control study with 100 women (50 with endometrial carcinoma and 50 with normal endometrial tissue) who was analyzed by HPV DNA in the samples of endometrial tissue in paraffinized blocks, using PCR technique. The estimate relative risk of presence of the HPV in the endometrial carcinoma and the normal endometrial tissue was the same. The presence of HPV wasn't associated with age, tabagism, endometrial trophism , squamous differentiation and tumoral grade. The HPV type more frequently detected was 16 and 18 (five cases with HPV 16 and four cases with HPV 18). The conclusion of this study was that the HPV was detected in endometrial tissue of women with endometrial cancer in the same proportion of the women with normal endometrium. The association of HPV DNA and endometrial carcinogenesis wasn't observed. Key-words: human Papillomavirus; HPV; Carcinogenesis; Endometrial carcinoma