Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(3):154-159
To correlate the expression of high-risk HPV E6 mRNA with pap smear, colposcopy, and biopsy results in women with high grade squamous intraepithelial lesion (HSIL).
A cross-sectional study was performed on women referred for primary care services after cytological diagnosis of HSIL. We evaluated the expression of E6/E7 mRNA of HPV types 16,18,31,33, and 45 and correlated the results with those of Pap smear, colposcopy, and biopsy. For amplification/detection of mRNA E6 / E7 we used NucliSENSEasyQ kit to detect HPV mRNA by polymerase chain reaction with primers/ probes for HPV types 16, 18, 31, 33, and 45.
Out of 128 valid tests, the results of 30 (23.4%) tests were negative and 98 (70%) tests were positive. Only one type of HPV was detected in 87.7% of the E6/E7 mRNA positive cases. HPV16 was detected in 61.2% of the cases, followed by HPV33 (26.5%), HPV31 (17.3%), HPV18 (10%), and HPV45 (4.08%). Pap smear tests revealed that the E6/E7 test was positive in 107 (83.8%) women with atypical squamous cells - high grade (ASC-H), HSIL, or higher. The E6/E7 test was positive in 69 (57.5%) specimens presenting negative cytology results. When analyzing the association with colposcopy results, the frequency of positive E6/E7 results increased with the severity of the injury, ranging from 57.1% in women without colposcopy-detected injury to 86.5% in those with higher levels of colposcopy findings. Of the 111 women who underwent biopsy and E6/E7 testing, the E6/E7 test was positive in 84.7% of the women who presented with lesions of cervical intraepithelial neoplasia (CIN) grade 2 or higher. Finally, 41.2% of women with a negative biopsy presented a positive E6/E7 test.
E6/E7mRNA expression was higher in women with HSIL and CIN grade 2 or higher.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):416-422
DOI 10.1590/SO100-720320140004995
The aim of this study was to evaluate the human papillomavirus genotypes and the frequency of multiple human papillomavirus infections, as well as to assess the association between human papillomavirus genotype, cyto-histopathological abnormalities and age range.
A retrospective cross-sectional study was carried out between June 2010 and October 2013 in Salvador, Bahia, Brazil. We analyzed 351 results of positive human papillomavirus genotyping performed using the PapilloCheck(r) test, designed to detect 24 human papillomavirus types. The cyto-histopathological abnormalities were classified as negative (negative cytology and histopathology), low-grade lesions (cytologic low-grade squamous intraepithelial lesion diagnosis or histopathologic cervical intraepithelial neoplasia 1 or vaginal intraepithelial neoplasia 1 diagnosis) and high-grade lesions (cytologic high-grade squamous intraepithelial lesion diagnosis or histopathologic cervical intraepithelial neoplasia 2+ or vaginal intraepithelial neoplasia 2+ diagnosis).
The most frequently detected high risk human papillomavirus genotype was HPBV 16, with 18.5%, 95% confidence interval (95%CI) 14.6-23.0, followed by HPV 56 (14%; 95%CI 10.5-18.0) and HPV 39 (13.4%; 95%CI 9.5-16.8). HPV 18 (5.4%; 95%CI 3.3-8.3) was among the least frequent types. Among the low risk types, HPV 42 (15.7%; 95%CI 12.0-20.0), HPV 6 (11.4%; 95%CI 8.3-15.2) and HPV 44/55 (11.1%; 95%CI 8.0-14.9) were the most frequent, while HPV 11 (2.8%; 95%CI 1.4-5.2) was the least common. The proportion of HPV 16-positive women increased with severity of cyto-histopathological abnormalities: 13.8% (12/87) in low-grade lesion and 42.4% (14/33) in high-grade lesion. There was association between low- or high-grade cyto-histopathological lesion and the high risk genotypes, HPV16, HPV 52, HPV 73 and HPV 82, and the low risk type, HPV 43. Women under 30 years showed a significantly higher frequency of HPV 16 (22.2 versus 12.9%, p =0.01), HPV 42 (19.7 versus 10.9%, p=0.01) and HPV 45 (6.6 versus 1.4%, p=0.01), and multiple human papillomavirus infections (58.1 versus 47.4%, p=0.04).
We observed variability of human papillomavirus genotype distribution in women from the state of Bahia. HPV 16 was the most frequently detected high risk human papillomavirus, as also reported for other geographic areas of Brazil and for the world in general. HPV 56 and HPV 39 were the second and the third most common genotypes, whereas HPV 18 was among the least frequent types. HPV 42, 6 and 44/55 were the most frequently detected low risk human papillomavirus, and HPV 11 was the least common.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):404-409
DOI 10.1590/SO100-720320140005073
To evaluate the effect of 8 weeks of functional training on body composition in postmenopausal women.
The study was conducted on 38 postmenopausal women, divided into two groups: Training Group (TG) and Control Group (CG). TG women (n=21) performed a program of physical exercise for a period of 8 weeks, 3 times a week on nonconsecutive days, with 90 minutes per session. For the same period, CG women (n=17) did not perform any systematic physical activity. All participants were assessed at baseline and after 8 weeks. The evaluations were performed by the same trained raters. Analysis of body composition was performed using dual-energy X-ray absorptiometry (DEXA), which allows estimation of body composition in the whole body and by segment. TG participants performed a functional exercise program 3 days a week (non-consecutive), with 11 stations consisting of exercises developed in circuit format sessions. The objectives of the exercises were the development of strength, agility, coordination and proprioception, followed by aerobic exercise (walking). After normality of the data was determined by the Shapiro-Wilk test (p<0.05), we applied the Student t-test for independent samples to check for possible differences in anthropometric variables and body composition between groups at both times of intervention (pre and post-test). All analyses were performed using the SPSS software v. 17.0 (SPSS Inc., Chicago, IL, USA) with the level of significance set at 5%.
At baseline, no significant difference was observed between groups regarding anthropometric body variables or age composition, indicating homogeneity of the groups. After 8 weeks of training, significant differences were observed between TG and CG regarding fat - CG=0.2±0.7 and TG=-0.4±0.5, total body fat (kg) - CG=0.2±1.3 and TG=-0.7±0.8, and total weight - CG=0.4±1.4 and TG=-0.6±1.1. Percent body fat was reduced in terms of absolute values, although without significance: CG=0.1±1.5 and TG=-0.8±1.5.
Functional training in circuit format can be used as a strategy to alter body composition in postmenopausal women, particularly in terms of reduction of adipose tissue. This is a model that promotes high adhesion on the part of the participants, suggesting that it is an attractive proposal for the investigated age group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):176-181
DOI 10.1590/S0100-7203201400040003
To determine the relationship between total body and trunk fat mass and gait performance in postmenopausal women.
Thirty-nine postmenopausal women aged 50 years or more were studied. The following items were determined: weight and height to calculate body mass index (BMI), body composition using the technique of Dual-Energy X-ray Absorptiometry (DXA), and gait using baropodometry. The body composition variables used were total body fat, percent body fat and trunk fat, while the gait variables were percent double stance time and single stance time and gait speed. The women were divided into two groups according to the median for each body composition variable: less and more body fat, less and more percent body fat and less and more trunk fat. To compare the gait variables between groups, we used the Mann-Whitney test. To evaluate the possible relationships between body composition variables and gait variables, we used the Spearman correlation test. All analyses were performed with the level of significance set at 5%.
The group with more trunk fat showed longer double stance time (p=0.007) and lower values of single stance time (0.033) than the group with less trunk fat. We found significant and positive correlations between trunk fat and double stance time (R=0.40) and negative correlations between trunk fat and single stance time (R=-0.32).
Postmenopausal women with a greater amount of trunk fat tended to have impaired gait performance.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(10):453-457
DOI 10.1590/S0100-72032013001000005
PURPOSE: To quantify the number of defense cells and immunoglobulin E (IgE) levels in peripheral blood sampled from women with recurrent vulvovaginal candidiasis. METHODS: A cross-sectional study was conducted on 60 women, 40 with vulvovaginal candidiasis and 20 controls. The defense cells were identified using an impedance system combined with flow cytometry and total and specific IgE was measured by chemiluminescence. The Mann-Whitney test was used for nominal variables and the Spearman test was used to determine the correlation of IgE concentration and eosinophils in peripheral blood. RESULTS: The number of eosinophils in peripheral blood from patients with recurrent vulvovaginal candidiasis, 302.60 (±253.07), was significantly higher compared to control, 175.75 (±109.24) (p=0.037). Serum levels of total and specific IgE were similar in the groups of women with and without recurrent vulvovaginal candidiasis (p=0.361). However, there was a moderate positive correlation between eosinophils and total serum IgE in the candidiasis group (r=0.25). CONCLUSION: Women with recurrent vulvovaginal candidiasis are more likely to have eosinophils in peripheral blood.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(7):295-300
DOI 10.1590/S0100-72032013000700003
PURPOSE: To evaluate the prevalence of women aged 50 years or more who are sexually active and their self-perception with respect to their sexual lives. Associated factors were also assessed. METHODS: A cross-sectional, population-based, self-reported household survey involving 622 Brazilian women aged 50 years or more. Sociodemographic, clinical, and behavioral factors were evaluated. The sexual life self-perception was classified as very good, good, fair, poor, or very poor. Data were analyzed using the χ² test, Fisher's exact test, and Poisson multiple regression analysis. Prevalence ratios and their 95% confidence intervals were also calculated. RESULTS: Of the women in this sample, 228 (36.7%) reported having a sexual life and, of these, 53.5% classified it as very good or good, while 46.5% considered it fair, poor, or very poor. The bivariate analysis indicated that being postmenopausal (p=0.025) and using natural remedies to treat the menopause (p=0.035) were factors associated with the woman classifying their sexual lives as fair, poor, or very poor. Multiple regression analysis showed that more women who had used or were currently using natural remedies for the menopause scored their sexual lives as fair, poor, or very poor. CONCLUSIONS: More than half the women aged 50 years or more in this study were not sexually active. A poorer sexual life self-perception was associated with the use of natural remedies to treat menopausal symptoms. This may indicate a need to improve the way in which these women are evaluated and treated. Women's assessment of their own sexual lives may prove a useful tool in clinical practice.