CÂNCER DE MAMA NA GESTAÇÃO: UM RELATO DE CASO

JUSTIFICATIVA: O câncer de mama na gestação é definido quando o diagnóstico é feito durante a gravidez ou em até doze meses após o parto. É responsável por 0,2-3,8% de todos os cânceres de mama, porém é a neoplasia de maior prevalência na gestação. As alterações fisiológicas da gravidez fazem com que o diagnóstico seja tardio e assim, em estágios mais avançados. Por isso, é necessário o diagnóstico precoce. OBJETIVOS: Descrever caso de câncer de mama diagnosticado no puerpério imediato. MÉTODOS: Análise de prontuário médico e revisão bibliográfica. RESULTADOS: L. F. A, 34 anos, primigesta. Admitida com idade gestacional de 40 semanas e queixa de bolsa rota. Realizada cesárea devido à bradicardia fetal persistente. Um dia após o parto, evoluiu com confusão mental, rebaixamento de consciência e dor abdominal intensa. Ao exame apresentava mama esquerda com massa ocupando quadrantes laterais, endurecida e mal delimitada. Axila esquerda com linfonodo suspeito. Laboratório demonstrou hipercalcemia e LDH aumentados. Tomografia de abdômen e pelve com presença de lesões hipodensas hepáticas e múltiplas lesões líticas ósseas compatíveis com neoplasias secundárias. Realizada biópsia de mama esquerda e punção de linfonodo axilar, respectivamente, demonstrando carcinoma ductal invasor e linfonodo sugestivo de malignidade. Paciente apresentou declínio do quadro clínico, evoluindo a óbito no décimo dia de puerpério. CONCLUSÃO: O câncer de mama na gestação apresenta-se como um desafio clínico. Assinala-se a importância do exame minucioso das mamas no ciclo gravídico puerperal, fazendo parte da propedêutica, possibilitando-se assim o diagnóstico o mais precoce possível. PALAVRAS-CHAVE: câncer; mama; gestação

Evaluation of Cardiometabolic Parameters among Obese Women Using Oral Contraceptives

BackgroundCombined oral contraceptive (COC) use has been associated with an unfavorable impact on carbohydrate and lipid metabolism in diverse populations of normal weight and obese women. The present study aimed to evaluate the cardiometabolic and inflammatory profiles of women in northeastern Brazil with respect to COC use and obesity.MethodsWe performed a cross-sectional study to verify cardiovascular parameters, including blood pressure (BP), fasting serum glucose, lipid, and inflammatory profile, in a population of women aged 15–45 years, considering obesity and COC use. Our sample consisted of 591 women, 481 women who were COC users, and 110 age-matched women who were COC non-users, classified as obese and non-obese according to BMI.ResultsCOC use and obesity were associated with increased systolic (p ≤ 0.001) and diastolic BP (p = 0.001), blood glucose (p ≤ 0.001), total cholesterol (p = 0.008), low-density lipoprotein cholesterol (p ≤ 0.001), very low-density lipoprotein cholesterol (p ≤ 0.001), triglycerides (p ≤ 0.001), ferritin (p = 0.006), C-reactive protein (CRP) (p ≤ 0.001), and nitric oxide metabolites (p ≤ 0.001), as well as decreased high-density lipoprotein cholesterol (HDL-c) (p ≤ 0.001) in comparison to controls. CRP and HDL-c levels in obese COC users were determined to be outside reference range values. The odds of having lower levels of HDL-c and elevated CRP increased among obese COC users. COC use was independently associated with low levels of HDL-c, especially second-generation progestins (p < 0.001; OR = 8.976; 95% CI 2.786–28.914).ConclusionObesity and COC use were associated with alterations in lipid and inflammatory cardiometabolic parameters, particularly increased CRP levels and decreased HDL-c, which are considered markers of cardiovascular disease (CVD) risk. Given the need to prevent unintended pregnancy among obese women, together with weight loss counseling, it is important to evaluate the most effective and safest contraceptive methods to avoid the potential risk of developing CVD

Avaliação dos efeitos de Streptococcus mutans sobre formação de biofilme e morfogênese de Candida albicans in vitro e estudo experimental em Galleria mellonella

Interactions between fungi and bacteria are present in nature and has great medical and environmental importance. The development of adequate models in vitro and in vivo to characterize these interactions are essential for understanding the pathogenesis of diseases and discovery of new therapeutic strategies. The aim of this study was to evaluate the microbial interactions between Streptococcus mutans and Candida albicans in vitro and in an experimental model of Galleria mellonella. In the in vitro study, the effects of S. mutans on biofilm formation and on the filamentation ability by C. albicans were evaluated. On both tests, we evaluated the direct effects of S. mutans cells and indirect effects of the supernatant culture of S. mutans on C. albicans. Furthermore, the effects of the S. mutans were tested on C. albicans at different stages of growth of the bacterial culture (4, 6, 18 and 24 h). In vivo study, were inoculated S. mutans together with C. albicans in larvae of G. mellonella for induction of experimental infection. The effects of S. mutans on experimental candidiasis in G. mellonella was evaluated by analysis of the survival curve, the study of the culture of hemolymph for quantification of C. albicans and by histological evaluation the formation of hyphae of C. albicans in the host tissues. The results of in vitro tests and number of CFU/mL in G. mellonella were submitted to ANOVA and Tukey's test. The data obtained in the survival of G. mellonella were analyzed using the log- rank test. In all tests, were adopted significance level 5%. In vitro results showed that cells of S. mutans favored biofilm formation by C. albicans, however when C. albicans was put in contact with the only supernatant of a culture of S. mutans, there was a reduction in biofilm formation and inhibition of the morphological transition of C. albicans. In the in vivo study, it was found that the injection of ....As interações entre fungos e bactérias estão presentes na natureza e tem grande importância médica e ambiental. O desenvolvimento adequado de modelos in vitro e in vivo para caracterizar essas interações é essencial para o entendimento da patogênese das doenças e descoberta de novas estratégias terapêuticas. O objetivo desse estudo foi avaliar as interações microbianas entre Streptococcus mutans e Candida albicans em modelos de biofilmes formados in vitro e em modelo experimental de Galleria mellonella. No estudo in vitro, foram avaliados os efeitos de S. mutans sobre a formação de biofilme por C. albicans e sobre a capacidade de filamentação de C. albicans. Em ambos os testes, foram avaliados os efeitos diretos das células de S. mutans sobre C. albicans e também os efeitos indiretos de S. mutans sobre C. albicans, utilizando apenas o sobrenadante da sua cultura. Além disso, foram testados os efeitos de S. mutans sobre C. albicans em diferentes fases de crescimento da cultura bacteriana (4, 6, 18 e 24 h). Para a realização do estudo in vivo, pela primeira vez na literatura, foram inoculados S. mutans juntamente com C. albicans em lagartas de G. mellonella para indução de infecção experimental. Os efeitos de S. mutans sobre a candidose experimental em G. mellonella foram avaliados pela análise da curva de sobrevivência, pelo estudo da cultura da hemolinfa para quantificação de C. albicans e através da avaliação histológica da presença de hifas de C. albicans nos tecidos do hospedeiro. Os resultados dos testes in vitro e da contagem de UFC/mL em G. mellonella foram submetidos à Análise de Variância e teste de Tukey. Os dados obtidos na curva de sobrevivência de G. mellonella foram analisados pelo método de Log-rank. Em todos os testes, foi considerado nível de significância de 5%. Os resultados in vitro demonstraram que as células de S. mutansfavoreceram a formação de biofilme por C. albicans ...

Different extracts of Zingiber officinale decrease Enterococcus faecalis infection in Galleria mellonella

Dried, fresh and glycolic extracts of Zingiber officinale were obtained to evaluate the action against G. mellonella survival assay against Enterococcus faecalis infection. Eighty larvae were divided into: 1) E. faecalis suspension (control); 2) E. faecalis + fresh extract of Z. officinale (FEO); 3) E. faecalis + dried extract of Z. officinale (DEO); 4) E. faecalis + glycolic extract of Z. officinale (GEO); 5) Phosphate buffered saline (PBS). For control group, a 5 μL inoculum of standardized suspension (107 cells/mL) of E. faecalis (ATCC 29212) was injected into the last left proleg of each larva. For the treatment groups, after E. faecalis inoculation, the extracts were also injected, but into the last right proleg. The larvae were stored at 37 °C and the number of dead larvae was recorded daily for 168 h (7 days) to analyze the survival curve. The larvae were considered dead when they did not show any movement after touching. E. faecalis infection led to the death of 85% of the larvae after 168 h. Notwithstanding, in treatment groups with association of extracts, there was an increase in the survival rates of 50% (GEO), 61% (FEO) and 66% (DEO) of the larvae. In all treatment groups, the larvae exhibited a survival increase with statistically significant difference in relation to control group (p=0.0029). There were no statistically significant differences among treatment groups with different extracts (p=0.3859). It may be concluded that the tested extracts showed antimicrobial activity against E. faecalis infection by increasing the survival of Galleria mellonella larvae.Extratos seco, fresco e glicólico de Zingiber officinale foram obtidos para avaliar suas ações por meio de ensaio de sobrevivência em G. mellonella contra infecção por Enterococcus faecalis. Oitenta larvas foram divididas em: 1) Suspensão de E. faecalis (controle); 2) E. faecalis + extrato fresco de Z. officinale (FEO); 3) E. faecalis + extrato seco de Z. officinale (DEO); 4) E. faecalis + extrato glicólico de Z. officinale (GEO); 5) Solução tampão fosfato salina (PBS). Para o grupo de controle, 5 µL de inóculo de suspensão padronizada (107 células/mL) de E. faecalis (ATCC 29212) foi injetado na última proleg esquerda de cada lagarta. Para os grupos com tratamento, após a injeção de E. faecalis, os extratos foram injetados na última proleg direita. Após as injeções, as lagartas foram armazenadas a 37 °C e o número de animais mortos foi registrado diariamente em 168 h (7 dias) para analisar a curva de sobrevivência. As lagartas foram consideradas mortas quando elas não mostraram qualquer movimento após o toque. A infecção por E. faecalis levou à morte de 85% das lagartas após 168 h. Não obstante, nos grupos de tratamento com associação dos extratos, houve um aumento nas taxas de sobrevivência de 50% (GEO), 61% (FEO) e 66% (DEO) das lagartas. Em todos os grupos com tratamento, as lagartas apresentaram um aumento na sobrevivência, com diferença estatisticamente significativa em relação ao grupo controle (p=0,0029). Não houve diferença estatisticamente significativa entre os tratamentos com os diferentes extratos (p=0,3859). Pode concluir-se que os extratos testados mostraram atividade antimicrobiana contra a infecção por E. faecalis, aumentando a sobrevivência das lagartas de G. mellonella.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Correlation of phospholipase and proteinase production of Candida with in vivo pathogenicity in Galleria mellonella

An essential factor to the virulence of the genus Candida is the ability to produce enzymes and this may be crucial in the establishment of fungal infections. AIM:This study investigated in vitro enzymatic activities of Candida species and their virulence in an in vivo Galleria mellonella experimental model. METHODS: Twenty-four clinical strains of Candida spp. isolated from the human oral cavity were evaluated, including the following species: C. albicans, C. dubliniensis, C. glabrata, C. tropicalis, C. krusei, C. parapsilosis, C. norvegensis, C. lusitaniae and C. guilliermondii. All Candida strains were tested in vitro for production of proteinase and phospholipase. The Candida strains were also injected into Galleria mellonella larvae to induce experimental candidiasis, and after 24 hours, the survival rate was assessed. RESULTS: Phospholipase and proteinase activity were observed in 100% of the C. albicans strains. In the non-albicans species, proteinase and phospholipase activity were observed in 25 and 43% of the studied strains, respectively. The most pathogenic Candida species in G. mellonella were C. albicans, C. dubliniensis and C. lusitaniae, whereas C. glabrata was the least virulent species. Furthermore, a positive significant correlation was found between both enzymatic activities with virulence in G. mellonella. CONCLUSIONS: The virulence of Candida strains in G. mellonella is related to the quantity of proteinases and phospholipases production of each strain

Correlation of phospholipase and proteinase production of Candida with in vivo pathogenicity in Galleria mellonella

ntial factor to the virulence of the genus Candida is the ability to produce enzymes and this may be crucial in the establishment of fungal infections. Aim: This study investigated in vitro enzymatic activities of Candida species and their virulence in an in vivo Galleria mellonella experimental model. Methods: Twenty-four clinical strains of Candida spp. isolated from the human oral cavity were evaluated, including the following species: C. albicans, C. dubliniensis, C. glabrata, C. tropicalis, C. krusei, C. parapsilosis, C. norvegensis, C. lusitaniae and C. guilliermondii. All Candida strains were tested in vitro for production of proteinase and phospholipase. The Candida strains were also injected into Galleria mellonella larvae to induce experimental candidiasis, and after 24 hours, the survival rate was assessed. Results: Phospholipase and proteinase activity were observed in 100% of the C. albicans strains. In the non-albicans species, proteinase and phospholipase activity were observed in 25 and 43% of the studied strains, respectively. The most pathogenic Candida species in G. mellonella were C. albicans, C. dubliniensis and C. lusitaniae, whereas C. glabrata was the least virulent species. Furthermore, a positive significant correlation was found between both enzymatic activities with virulence in G. mellonella. Conclusions: The virulence of Candida strains in G. mellonella is related to the quantity of proteinases and phospholipases production of each strain