Oral infection by the Human Papilloma Virus in women with cervical lesions at a prison in São Paulo, Brazil

Carcinoma of the head and neck is the 6th cause of death by cancer in the world. In recent decades the human papillomavirus (HPV) has been implicated in the etiology of this disease. OBJECTIVE: To characterize the types of HPV detected in the oral mucosa in women with cytological abnormalities suggesting intraepithelial squamous lesions in the uterine cervix. METHODS: four-hundred-nine cervical-vaginal and oral pap-smears of women interned in a Female Prison in São Paulo were examined. The relationship between cervical and oral lesion was analyzed by PCR/RFLP and DNA sequencing. RESULTS: Of 27 (6.67%) specimens showing cervical cytological abnormalities suggesting LSIL and HSIL, 22 (81.48%) had oncogenic high-risk HPV infection, of which HPV 59 was the most prevalent. Three (11.1%) samples showed cytological changes suggesting mild dysplasia in the oral cavity. CONCLUSION: Our study suggests an association between carcinoma of the oral cavity and HPV infection, regardless of the virus type.O carcinoma de cabeça e pescoço é 6ª maior causa de mortes por neoplasia no mundo. Nas últimas décadas, tem-se associado a relação da infecção pelo Papilomavírus Humano (HPV) e seu envolvimento na etiologia desta doença, bem como acontece com o câncer de colo de útero. OBJETIVO: A caracterização molecular dos tipos de HPV diagnosticados na mucosa oral de mulheres que apresentavam alterações citológicas compatíveis com lesão escamosa no colo uterino. MÉTODOS: Foram estudadas 409 amostras cérvico-vaginais e de cavidade oral de mulheres internas no Presídio Feminino da cidade de São Paulo. A correlação entres lesões cervicais e orais foram avaliadas em 27 mulheres que apresentavam lesões pré-malignas e malignas no colo uterino pela caracterização molecular dos tipos de HPV por PCR/ RFLP e Sequenciamento. RESULTADOS: Das 27 (6,67%) amostras compatíveis com LSIL e HSIL no colo uterino, 22 (81,48%) apresentaram infecção pelo HPV de alto risco oncogênico, sendo o HPV 59 o mais prevalente, dentre elas, três amostras (11,1%) evidenciaram alterações celulares compatíveis com displasia leve na cavidade oral. CONCLUSÃO: Nosso estudo sugere uma relação entre o desenvolvimento de lesões da cavidade oral e a infecção pelo HPV, independentemente do tipo viral presente.UNIFESPLaboratório Afip departamento de biologia molecularUNIFESPSciEL

Liquid-based medium used to prepare cytological breast nipple fluid improves the quality of cellular samples automatic collection

Background: Breast cancer is the second cause of death in women worldwide. The spontaneous breast nipple discharge may contain cells that can be analyzed for malignancy. Halo® Mamo Cyto Test (HMCT) was recently developed as an automated system indicated to aspirate cells from the breast ducts. The objective of this study was to standardize the methodology of sampling and sample preparation of nipple discharge obtained by the automated method Halo breast test and perform cytological evaluation in samples preserved in liquid medium (SurePath™). Methods: We analyzed 564 nipple fluid samples, from women between 20 and 85 years old, without history of breast disease and neoplasia, no pregnancy, and without gynecologic medical history, collected by HMCT method and preserved in two different vials with solutions for transport. Results: From 306 nipple fluid samples from method 1, 199 (65%) were classified as unsatisfactory (class 0), 104 (34%) samples were classified as benign findings (class II), and three (1%) were classified as undetermined to neoplastic cells (class III). From 258 samples analyzed in method 2, 127 (49%) were classified as class 0, 124 (48%) were classified as class II, and seven (2%) were classified as class III. Conclusion: Our study suggests an improvement in the quality and quantity of cellular samples when the association of the two methodologies is performed, Halo breast test and the method in liquid medium

Efeitos de exercícios físicos sobre fatores de risco cardiovascular em idosos hipertensos

Objetivo: Avaliar os efeitos de um programa de exercícios na redução dos fatores de risco cardiovascular em idosos sedentários e hipertensos. Métodos: Trata-se de ensaio clínico não randomizado, realizado em uma clínica escola de fisioterapia em São Paulo, em 2016, com amostra de 34 idosos que realizaram um programa de exercícios de noventa minutos, duas vezes por semana, durante o período de três meses. As variáveis avaliadas foram: pressão arterial, índice de massa corporal, frações de colesterol, colesterol total e triglicérides. Houve comparação dos dados em dois momentos, antes do início e ao término do programa de exercícios, considerando-se p<0,0001 em todos os casos pelo teste de Wilcoxon. Resultados: Encontrou-se idade mediana dos avaliados (intervalo interquartis) de 63 (61-66) anos, sendo 25 (74%) do sexo feminino. Após três meses, houve redução estatisticamente significativa do peso, índice de massa corpórea, pressão arterial sistólica (PAS) e diastólica (PAD) dos idosos avaliados (p < 0,0001 em todos os casos). Conclusão: O efeito do programa de exercícios foi eficaz na redução dos fatores de risco cardiovascular dos idosos sedentários e hipertensos estudados

IMPACTOS DO TREINAMENTO INTERVALADO DE ALTA INTENSIDADE DE CURTA E LONGA DURAÇÃO EM ADULTOS JOVENS

INTRODUÇÃO: O treinamento intervalado de alta intensidade é caracterizado por períodos curtos de exercícios muito intensos, e ainda há poucas evidências que determinem diferenças nos resultados obtidos com os diferentes tempos de duração desse tipo de treinamento. OBJETIVO: Avaliar o impacto do treinamento intervalado de alta intensidade de curta e longa duração em adultos jovens. MÉTODOS: Ensaio clínico controlado com 44 universitários, que foram divididos em três grupos: Grupo 1 (controle), Grupo 2 (curta duração) e Grupo 3 (longa duração), sendo que os grupos 2 e 3 realizaram quatro minutos de exercícios com 8 séries de 20 segundos e diferenciando-se apenas nas pausas de 10 segundos (passiva) e 90 segundos (ativa/corrida). Foram realizados testes para avaliar a capacidade aeróbia e o volume máximo de oxigênio estimado (VO2máx) e resistência muscular de flexão de braços e abdominal, além de testes de composição corporal e coletas de sangue para análise do perfil lipídico, tanto no basal quanto ao final do estudo. RESULTADOS: Não foram encontradas diferenças estatisticamente significantes entre os grupos quanto as variáveis composição corporal, flexão de braços, flexão abdominal e VO2máx estimado. Entretanto, houve maior distância percorrida pelo grupo 3 no teste de Cooper (Teste de Kruskal-Wallis, p = 0,04). CONCLUSÕES: Os treinamentos intervalados de alta intensidade de curta e longa duração proporcionaram melhor performance dos participantes no Teste de Cooper. Esse achado suscita a importância desta estratégia de treinamento para melhorar a resistência aeróbica de adultos jovens

Trace elements: critical insights from 15 years of monitoring in the Venice Lagoon catchment basin (Italy)

The study focused on selected trace elements (As, Cd, Cr, Hg, Ni, Pb) monitored in surface waters of the Venice Lagoon catchment basin (North East Italy) over the period 2000-2015. The monitoring was undertaken to verify the achievement of the quality objectives set by the European and national legislations. The available results have been analyzed to evaluate the chemical status of water bodies. The limit of quantification (LOQ) of the applied analytic techniques appears critical for the adequate water monitoring; for some parameters, the percentage of not visible values due to non-satisfactory LOQ was higher in the beginning of the period; the subsequent improvement of LOQ allowed assessing the respect of environmental quality standards (EQSs). The study analyzes time trends in single stations and the differences between detected concentrations in the considered stations. Moreover, maximum concentrations and water flows have been considered to understand the potential correlation. Cumulated frequency curves for the most critical parameters have been built to identify situation of potential overtaking of the EQSs in force. The most polluted sampling stations of the drainage basin for the six trace elements were found in Cuori and Fiumazzo rivers. Although LOQs changed over time, the recorded trends show a quality improvement and a good compliance with respect to EQSs set by European legislation, while considering EQSs set by local special legislation, the objectives are not yet satisfied. Arsenic is ubiquitous; thus, it can be supposed to be originated as a background environmental concentration, while nickel appears of industrial origin according to its point and local presence

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6&nbsp;years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P &lt; 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100&nbsp;years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease