Condyloma acuminata in the tongue and palate of a sexually abused child: a case report

Condyloma acuminata caused by human papilloma viruses, (HPV) is a sexually transmitted disease (STD) appearing most frequently as soft, pink cauliflower like growths in moist areas, such as the genitalia, mouth and other places. The disease is highly contagious, can appear singly or in groups, small or large. In children, the isolation of a sexually transmitted organism may be the first indication that an abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist. The authors report the clinical case of a five-year-old Caucasian male with lesions located in the dorsal surfaces of the posterior tongue and palate. Both lesions had a firm consistency, reddish appearance and presence of whitish areas and regions of ulceration. During the interview, the mother reported that the boy had been sexually abused. Sexually transmitted disease may occur during sexual abuse. Dentists as well as pediatricians have a role to play in identifying and treating these children. The diagnosis is essentially clinical (anamnesis and physical examination), but also the use of cytology eventually resorts to biopsy of the suspicious lesions for histological examination. The therapeutic option was the excision of the lesions.

ANALISE ANTIGENICA DE PROTEASES DE DIFERENTES CEPAS DE TRICHOMONAS VAGINALIS ISOLADAS DE PACIENTES DA REGIAO DE ARARAQUARA, SP, BRASIL

Trichomonas vaginalis is the flagellate that causes trichomonadiasis, a sexually transmitted disease. Immunological methods have been proposed for the study of antigenic characterization using strains isolated from different patients. This work compares protease profiles from the different strains using gelatin containing polyacrylamide gels to analyse the protease activity. High molecular weight proteases (20 to 100 kDa) were found on gels showing quantitative differences. Human IgG antiproteases were detected by immunoblotting using the same extracts. These proteases could be related with T. vaginalis pathogenesis.

Abuso sexual, transtornos mentais e doencas fisicas

Objective: to review and describe the different organic and psychic consequences of sexual abuse. Methodology: 71 papers were sorted in a ten-year literature search (1987-1997) in MedLine and Lilacs (South American Literature Index), besides 14 books in the subject. Results: sexual abuse is much less frequent (or less reported) in Brazil: 7% of the population, while in the USA the prevalence is 12.9% to 28% of women and 2% to 9% of men. Results showed women being more frequently sexually abused but less differences in physical abuse were found between genders. There was a significant association between sexual abuse and the following: eating disorders, depression, irritable bowel, chronic pain (mainly pelvic), neurological, rheumatic and venereal disorders. This association was not observed in chronic constipation, Chron disease and dissociative disorders. Conclusions: although it is important to think of sexual/physical abuse as a predisposing factor to several illnesses, caution is necessary specially in cultures with different moral and ethical values. Research in this subject in Brazil should be conducted with patients in treatment, using control groups, in order to take advantage of the existing rapport. It would be also quite important to separate acute and chronic abuse effects, as well as getting to know the meaning of the experienced abuse to each person.

Adesão de protozoários ̀a superfície de dispositivos intra-uterinos

Intrauterine devices (IUD) have been used by approximately hundred million of women in the world. IUD are unprescribed to women who have pelvic inflammation disease predisposition which is caused in general by non-treated sexually transmitted diseases (STD). Trichomoniasis, one of the most important vaginal infections, is caused by a flagellated protozoan, Trichomonas vaginalis, transmitted by sexual contact and also asyntomatic women are able to transmit it. The objective of this work was verify by scanning microscopy the adhesion of this protozoan on plastic and metalic IUD surfaces. IUD fragments were added in Diamond medium containing T. vaginalis and after 3 days at 37°C incubation, they were taken out and treated as necessary for scanning microscopy. The analysis showed showed the adhesion of the protozoans on plastic and metalic IUD surfaces. Even though the IUD were not yet directly associated with high incidence of the inflammation pelvic disease, it would become an infection reservoir of potencial pathogenic organisms.

Sexual transmission of Toxoplasma gondii in sheep

Male sheep of reproductive age were distributed into three groups: GI, a sheep inoculated (oral) with 2.0×105 oocysts of the P strain of Toxoplasma gondii; GII, a sheep infected (subcutaneous) with 1.0×106 tachyzoites of the RH strain of T. gondii; and GIII, a sheep kept as a control (not infected). After the inoculation of the males, 12 breeding ewes, which were not pregnant and which were serologically negative for reproductive diseases (particularly toxoplasmosis), were distributed into three groups, synchronized, and subsequently exposed to natural mating with previously inoculated males. The distribution was as follows: five ewes that underwent natural mating with the GI male, five ewes that were exposed to natural mating with the GII male, and two ewes that were mated with the non-infected male (control). Serum samples of all the ewes were collected on days -30, -14, -7, -1, and 0 (days before natural mating) and on days 1, 3, 5, 7, 11, 14, and weekly until birth; the presence of serum antibodies against T. gondii was assessed by IFAT. Using a bioassay and PCR, T. gondii was isolated from the semen of the infected reproducing sheep before mating. Following natural mating, 5 of the 12 females displayed antibodies specific for T. gondii; of these animals, two of the ewes underwent natural mating with the male inoculated with oocysts (GI) and three with the male infected with tachyzoites (GII). One of the females that displayed antibodies specific to this coccidian and that underwent natural mating with the GII sheep had a macerated fetus on the 70th day following coverage. Using a bioassay after the birth, it was possible to isolate T. gondii from samples of the pool of tissues from the five females that seroconverted after natural mating and from their respective lambs. Using PCR, the DNA of T. gondii was isolated from the pool of tissues from one and two females exposed to natural mating with the reproductive males infected with the oocysts and tachyzoites, respectively. Using this technique, it was also possible to diagnose the presence of the parasite in the pool of tissues from the lambs of one female that underwent natural mating with the male sheep infected with oocysts. These results demonstrated the sexual transmission of T. gondii in the sheep species with consequent vertical transmission to their lambs. © 2013 Elsevier B.V.

Prevenção e diagnóstico de lesões HPV induzidas e carcinoma anal em mulheres atendidas na rede básica de saúde da cidade de Botucatu pelo método escovado do canal anal

Pós-graduação em Bases Gerais da Cirurgia - FMB

Prevalence of anogenital warts in Men with HIV/AIDS and associated factors

Infection with human papilloma virus (HPV) is the most common sexually transmitted disease in the world. Among the 630 million new cases of HPV that occur each year, 30 million develop anogenital warts. Although subclinical infection with HPV is the most common cause, genital warts are also associated with immunosuppression caused by HIV. In view of the high prevalence of HPV/HIV co-infection particularly among men who have sex with men, the objectives of this study were to determine the prevalence of anogenital warts in men with HIV/AIDS and to identify associated factors. A cross-sectional study was conducted on 159 men with HIV/AIDS consecutively selected at a referral service in Botucatu, São Paulo, Brazil, in which the association between sociodemographic, behavioral and clinical variables and the presence of anogenital warts was evaluated. After hierarchical analysis of the data, variables presenting a p value ≤ 0.2 were entered into an unconditional multivariate logistic regression model. Forty-nine (31%) of the HIV-positive patients had anogenital warts. The mean age was 44.6 ± 9.6 years. The main factors associated with the presence of anogenital warts were irregular antiretroviral treatment and genital herpes(HSV). The present study demonstrate that anogenital warts occur in almost one-third of the male population infected with HIV and factors associated with a higher risk of being diagnosed with anogenital warts were irregular cART use and co-infection with HSV, other variables could not be associated.

Acquired immunodeficiency syndrome in Brazil

Aim. To describe the acquired immunodeficiency syndrome (AIDS) epidemic in Brazil and analyze the impact of federal government measures addressing the problem since its onset.Method. Retrospective review of AIDS epidemic data from its onset in 1980 up to the last published data in June 2001.Results. AIDS was first reported in Brazil in 1980. By 1988, all 27 Brazilian states had diagnosed cases, and until June 2000 more than half of Brazilian municipalities had recorded at least one case of the disease. The AIDS incidence reached its peak between 1996 and 1997 (14.7 per 100,000 population), and then declined between 1998 and 2000 to 9 per 100,000 population. In the last two decades, the proportion of deaths has been also significantly reduced. These were not random events, but reflected the efficiency of the program implemented by the Brazilian Health Ministry's Coordination on Sexually Transmitted Diseases and AIDS. The program includes an epidemiological surveillance modeling system, which records cases from several regular epidemiological bulletins; national network of diagnosis and monitoring of HIV-infected individuals (ill or not); highly active antiretroviral therapy available free to all patients; mother-infant protection program; educational programs on condom use; the introduction of the female condom; development of AIDS studies in different areas to provide practical solutions; constant preoccupation about drug costs accounting for the patent breaking; and national production of many drugs currently in use.Conclusion. Well-planned and implemented national program against AIDS can significantly reduce the burden of this disease to the population.

Prevalência de doenças sexualmente transmissíveis em mulheres profissionais do sexo, em um município do interior paulista, Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tele-education environment and didactic iconography in sexual transmitted diseases

The field of advertising has developed techniques of mass communication and rapid transmission of information. Among these techniques are slogans and iconographies. This work used such tools for educational purposes and was divided into three modules. Module 1 evaluated the use of simplified textual communication (slogans) about the subject Sexually Transmitted Diseases. It was applied to third-year medical students, which had not taken the course on this theme. To evaluate the impact of the textual communication form (slogans), long phrases were elaborated in scientific language containing 15 topics. From these long phrases, compact phrases were developed using techniques of the advertising area for elaboration of slogans. Three forms of didactic material about that theme were developed. The first form consisted of long phrases in descriptive topics, using scientific language. The second was constituted exclusively of compact phrases in the form of slogans, and the third was composed of the combination of the two previous forms. Then, 10 multiple-choice questions were elaborated and applied in two phases. In the first phase, application occurred immediately after the reading of didactic texts; in the second phase, it happened 60 days after the reading. For statistical analysis, Snedcor's F test was used for analysis of variance, at 5% significance level. There was an increase in memorization by students who read the material containing the association between long phrases and slogans, which indicates that the latter, when used as an auxiliary model of learning, can bring significant benefits for education. Module 2 consisted of analyzing the elaboration of educational videos produced in graphic computing (called iconographies) for development of dynamic communication means. The theme Hair Cycle was utilized. Viability of high quantities of information in few minutes of animation could be demonstrated together with the advantage of presenting the process in a dynamic form without wasting scientific details. Module 3 presented the inclusion of slogans in educational videos produced in graphic computing about the Hair Cycle, showing a new tool for rapid and efficient transference of data. Slogans and iconographies, when utilized in educational material, can bring significant benefits for the student's learning.

Hydatidiform mole resulting from sexual violence

Background. Hydatidiform mole (HM) is characterized by abnormal proliferation of human trophoblast with producers functioning tissues of human chorionic gonadotropin. It can evolve with ovarian cysts tecaluteínicos, hypertension of pregnancy or hyperthyroidism. The incidence of HM is variable and its etiology poorly known, associated with nutritional factors, environmental, age, parity, history of HM, oral contraceptives, smoking, consanguinity or defects in germ cells. There is no reference in literature on HM resulting from sexual violence, objective of this report. Method. Description of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital Pérola Byington, São Paulo, from July 1994 to August 2011. Results. The cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection. Conclusion. The incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition. © 2012 Drezzet et al; licensee BioMed Central Ltd.

Oral manifestations of secondary syphilis in the elderly - A timely reminder for dentists

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. Cases of syphilis have increased in frequency and are challenging when affecting the elderly. The main causes of increased prevalence of syphilis are sexual promiscuity, lack of knowledge about the disease and decreasing use of barrier protection. Clinically, the oral manifestation of syphilis may resemble other entities, which hampers the correct diagnosis. We report a case of a 79-year-old male with weight loss and feeding difficulties. In the oral cavity there were ulcerative lesions in the hard palate and bilaterally in the buccal mucosa. The incisional biopsy revealed only a non-specific ulceration of the oral mucosa. After 20 days, the patient was re-evaluated and presented maculopapular lesions in the palmar and plantar areas. Positive serological venereal disease reference laboratory (VDRL) tests confirmed the diagnosis of secondary syphilis. The patient was treated with Benzathine penicillin G. After two weeks of treatment the oral lesion disappeared and the patient returned to normal feeding and gained weight. This case report reinforces the need to alert physicians and dentists to include sexually transmitted infections such as syphilis in the differential diagnosis of oral ulcerative lesions in elderly sexually active patients. © 2013 Australian Dental Association.

Fatores sócio-demográficos e antecedentes obstétricos relacionados à sífilis na gestação em uma amostra de gestantes do Distrito Federal

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Aspectos clínicos, microbiológicos e da regulação da imunidade inata na vaginose bacteriana

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Percepción de un grupo de mujeres acerca del hecho de ser portadoras del VPH

Background: The possibility to acquire sexually transmitted diseases generates bio-psycho-social conflicts affecting daily life of women. Objective: To investigate the knowledge of women on the concept of being infected by the human papilloma virus (HPV) and to understand the significance they attributed to their condition as HPV carriers. Material and method: It is a qualitative study in which ten women were interviewed, after the result of a cytopathological exam suggesting HPV. Data were collected at the Center of Health School of the Universidade Estadual Paulista -UNESP-Brazil. Results: The significant items were: deception and preoccupation about the cure, since they indicate that it is very deceptive to be infected with an incurable disease by a person whom they trust; the method of having sexual relations and being infected again; the necessity of care and of being optimistic to face the disease and the threat of cervix cancer originating anxiety. Discussion: Orientations made by health professionals were efficacious to clarify the relationship with cancer development. It is possible to understand the necessity of assistance orientations and the opportunity to hear them, offering individualized quality care. This study also offers important elements to reinforce the educational role of health professionals, principally those referring to sexually transmitted infection and cancer, seeking prevention and early treatment with the offered information. However, there is no desire of finishing the subject regarding perception, thus there is much to discover about diseases related to human papilloma virus. Key words: women carriers of HPV, feelings attributed by women.