Estudo Comparativo De Métodos De Detecção De Lesões Precursoras De Carcinoma Espinocelular Anal Pós-Tratamento De Condilomas Acuminados Anais.

Objective: To Evaluate The Presence Of Remaining Anal Canal And Margin Subclinical Hpv-Induced Lesions With Cytology, Anal Colposcopy And Hpv Genotyping By Pcr In Newly Treated Individuals With No Macroscopically Visible Hpv-Induced Lesions, And To Verify The Influence Of The Immunological Status On The Results. Methods: A Prospective Study Of 79 Male Patients Over 18 Years Of Age Consecutively Included After 30 Days Of Anal Warts Treatment By Topical Medication Or Surgery, With No Visible Macroscopic Lesions. During A Single Appointment, They Were Submitted To The Collection Of Two Brush Samples For Cytopathological Study Of The Anal Canal And Another For Pcr, Then To Anal Colposcopy With 3% Acetic Acid In The Margin And In The Anal Canal. The Individuals Were Grouped According To Hiv Infection Status: I) Hiv-Negative; Ii) Hiv-Positive With A Cd4 T Lymphocyte Count Above 350 Cells/Mm3; Iii) Hiv-Positive Cd4 T-Lymphocyte Count Below 350 Cells/Mm 3. After That We Regrouped: A) Satisfactory Cd4 T Lymphocytes (GObjetivos: Avaliar A Presença De Lesões Hpv-Induzidas De Margem E Canal Anal Subclínicas Remanescentes Com Citologia, Colposcopia Anal E Genotipagem Do Hpv Pela Pcr Em Indivíduos Recentemente Tratados E Sem Lesões Anais Benignas Pelo Hpv Macroscopicamente Visíveis, Além De Verificar A Influência Do Estado Imunológico Nos Resultados Encontrados. Métodos: Estudo Prospectivo De 79 Pacientes Do Sexo Masculino E Maiores De 18 Anos, Incluídos De Maneira Consecutiva 30 Dias Após A Erradicação De Verrugas Anais Com Tratamento Com Tópicos Ou Operatório, E Sem Lesões Macroscópicas Visíveis. Em Uma Mesma Consulta, Esses Foram Submetidos À Coleta De Duas Amostras Com Escova Para Estudo Citopatológico Do Canal Anal E Outra Para Pcr, Além Da Colposcopia Anal Com Ácido Acético A 3% Na Margem E No Canal Anal. Foram Agrupados Os Indivíduos De Acordo Com Status De Infecção Pelo Hiv: I) Hiv-Negativo; Ii) Hiv-Positivo Com Contagem De Linfócitos T Cd4 Acima De 350 Células/Mm3; Iii) Hiv-Positivo Com Contagem De Linfócitos T Cd4 AbDados abertos - Sucupira - Teses e dissertações (2018

Intestinal spirochetosis

The intestinal spirochetosis (IS) is a histologically defined by the presence of spirochetal microorganisms connected to the apical cell membrane of the colorectal epithelium. The disease is caused by a heterogeneous group of bacteria. In humans, Brachyspira aalborgi and Brachyspira pilosicoli are prevalent. The incidence ranges from 1% in developed countries to 34% in poorer areas. It affects 62.5% of colonized areas, as well as men who have intercourse with men (MSM) and those with the human immunodeficiency virus (HIV) infected. Clinical significance of such colonization is still not clear. Most infected people are asymptomatic. At the presence of gastrointestinal symptoms, treatment with metronidazole is effective. Due to unknown reasons, MSM and HIV-positive men are more likely to be symptomatic. Treponema pallidum infection must be excluded, since this agent may cause serious and permanent complications, and because the treatment is different

Quanto a escova deve ser introduzida no canal anal para avaliação citológica mais eficaz? How deep must the brush be introduced in the anal canal for a more effective cytological evaluation?

OBJETIVO: A sensibilidade da citologia anal varia amplamente na literatura, entre 45% e 98%, o que pode ocorrer devido à falta de padronização quanto à distância que a escova deve ser introduzida no canal anal. Desta forma, nosso objetivo foi investigar se o local de coleta influencia no resultado desse exame. MÉTODOS: Colhemos amostras com escova introduzida 4 cm no canal anal de 114 doentes (Grupo A) e 2 cm em outros 94 pacientes (Grupo B), antes do exame proctológico. Realizamos cinco rotações com a escova antes de retirá-la e a esfregar sobre lâmina de vidro, posteriormente submetida ao exame citopatológico padrão. Todos os doentes são HIV-positivo. Submetemos os resultados à avaliação estatística. RESULTADOS: No Grupo A, 39 doentes possuíam condilomas no canal anal e a citologia foi positiva em 29 deles (74,3%). Também observamos alterações citológicas em 30 de 75 doentes (40%) sem lesões clínicas no canal anal. No Grupo B, havia 54 doentes com condilomas no canal anal e em 13 (24,1%) houve confirmação citológica. Em 40 outros, sem lesões clínicas pelo HPV, notamos que em nove (22,5%) havia anormalidades citológicas. Os testes estatísticos revelaram que os exames realizados nos doentes do Grupo A foram mais eficientes. CONCLUSÃO: Os espécimes coletados com escovas inseridas mais profundamente no canal anal melhoraram a eficácia do exame.<br>OBJECTIVE: In literature, sensitivity of Pap smears ranges widely from 45 to 98%. Possibly this is because there is no standard for how far the brush should be introduced into the anal canal. The aim was to evaluate whether the sampling site has an influence on the results of anal Pap smears. Design and setting. This is a non-randomized, non-blinded, retrospective review carried out in the Proctology and Pathology Sectors, Emilio Ribas Infectious Diseases Institute. METHOD: We obtained specimens with brushes introduced 4 cm into the anal canal in 114 patients (Group A) and 2 cm in 94 patients (Group B), before anorectal examination. These brushes were rotated five or six times before being withdrawn and rubbed on a slide that underwent Pap testing using standard cytopathology laboratory equipment. All patients were HIV-infected. Statistical tests were used. RESULTS: In Group A, 39 patients had anal canal condylomas and the cytology was positive in 29 of them (74.3%). We also observed cytological alterations in 30 of 75 patients (40%) without clinical lesions in the anal canal. In Group B, there were 54 patients with condylomas and 13 of them (24.1%) were confirmed by cytology. In 40 patients with no clinical lesions, we observed that nine (22.5%) had cytological abnormalities Statistical analysis revealed that examination in Group A was more efficient. CONCLUSION. Specimens collected by inserting the brush deeper into the anal canal improved the efficiency of anal Pap smears