Genital manifestations of schistosomiasis mansoni in women: important but neglected

Egg-induced lesions in the upper and the lower female reproductive tract are important complications of the infection with Schistosoma mansoni. The understanding of the pathophysiology and pathology of genital lesions is only rudimentary, simple and reliable diagnostic tools are not at hand, epidemiological data do not exist and how to treat best the women affected, is not known. In view of recent advances in the understanding of genital lesions induced by S. haematobium the existing literature is critically analysized and possible consequences of female genital schistosomiasis are outlined. We estimate that 6 to 27 % girls and women with intestinal schistosomiasis, at least temporarily, suffer from pathology induced by eggs sequestered somewhere in their genital organs. This is a mattern of concern and warrants more research into the epidemiology, pathology, diagnosis and therapy of this disease entity.

Genital morphology of the male South American fur seal (Arctocephalus australis) and biological implications

Male capacity for spreading genes to a great number of descendents and to determine population dynamics depend directly on the genital organs. Morphological studies in pinnipeds are scarce and the functional meaning of some characteristics has never been discussed. We hypothesized that Arctocephalus australis (A. australis) shows morphophysiological adaptations in order to guarantee the perpetuation of the species in the unique annual mating season. Seven males, dead from natural causes, had their genital organs collected and fixed for morphological description. Some features differ from other described mammalian males and are closely related to the biology and reproductive cycle of this species, as the scrotal epidermis, absence of glandular portion in the ductus deferens and spermatogenic epithelium suggest a recrudescent testis period. The corona glandis exhibits a singular arrangement: its erectile border looks like a formation of petals and its association with the os penis gives a "lily-flower" form to this region. We propose the name margo petaliformis to this particular erectile border of the corona glandis because of its similarity to a flower corola. The male genital organs of A. australis show morphological features compatible with adaptation to environment requirements and reproductive efficiency.

Ultrastructure of the adults of Bunostomum phlebotomum (Nematoda: Ancylostomatidae)

The morphology of the male and female of Bunostomum phlebotomum are described based on scanning electron microscope (SEM) observations. The attachment of the worms to the small intestinal mucosa and during the copula were observed. Structures of the bucal capsule and genital organs were also studied.

Métodos de diagnóstico malacológico

Specific identification of the snail vectors: (a) shell features; (b) animal features (genital organs); (c) biochemical techniques (electrophoresis). The snail infection rates: (a) exposure to light and cercarial identification; (b) snail crushing and identification or the larval forms in the tissues.

Specific Identification of Biomphalaria tenagophila and Biomphalaria occidentalis Populations by the Low Stringency Polymerase Chain Reaction

Although Biomphalaria occidentalis and B. tenagophila are indistinguishable on the basis of shell morphology and the majority of their genital organs, only the latter is susceptible to infection with Schistosoma mansoni. Thus, the identification of these species is fundamental to epidemiological studies of schistosomiasis. Here we describe a simple and rapid method for differentiating B. tenagophila from B. occidentalis based on low stringency polymerase chain reaction and using a pair of primers specific for the amplification of the 18S rRNA gene. Analysis of the low stringency product profiles of populations of these snails from different geographical regions confirmed this approach as being applicable to the identification of B. tenagophila and B. occidentalis in cases where classical morphology is inconclusive

Identification of Biomphalaria havanensis and Biomphalaria obstructa populations from Cuba using polymerase chain reaction and restriction fragment length polymorphism of the ribosomal RNA intergenic spacer

In Cuba, several Biomphalaria species have been reported such as B. orbignyi, B. schrammi, B. helophila, B. havanensis and B. peregrina; only the latter three are considered as potential hosts of Schistosoma mansoni. The specific identification of Biomphalaria species is based on anatomical and morphological characters of genital organs and shells. The correct identification of these snails is complicated by the high variation in these characters, similarity among species and in some cases by the small size of the snails. In this paper, we reported the classical morphological identification, the use of PCR and RFLP analysis of the internal transcribed spacer region of the ribosomal RNA genes for molecular identification of seven snail populations from different localities in Cuba. Using morphological and molecular analysis, we showed that among the studied Cuban Biomphalaria populations only B. havanensis and B. obstructa species were found.

Genitourinary changes in hamsters infected and reinfected with Trypanosoma cruzi

Authors describe genitourinary changes in male hamsters infected and reinfected with Trypanosoma cruzi. Changes in genital organs have been described in human and in experimental chagasic infection. Genital dysfunctions in chronic chagasic patients affect ejaculation, libido and sexual potency, and testis biopsies may show arrested maturation of germ cells, oligozoospermia and azoospermia. Sixty-five male hamsters were inoculated and reinoculated with 2x10³ trypomastigotes of T. cruzi VIC strain, and 22 non-infected animals constituted the control group. Animals were necropsied and fragments from testis, epididymis, seminal vesicle and bladder were collected and stained with hematoxylin-eosin. Peroxidase anti-peroxidase procedure was utilized to detect tissue parasitism. T. cruzi nests were found in testis, epididymis and seminal vesicle of these hamsters. Such parasitism plays a role in the origin of genital lesions observed in humans and laboratory animals during chronic chagasic infection.

Diagnostic Importance of Female External Genital Structure of Phlebotomine Sand Flies (Diptera:Psychodidae) as Observed by Scanning Electron Microscopy

Morphological description of sand flies has remained a neglected area. The different organs used in taxonomy have not yet been described adequately with the scanning electron microscopy (SEM). We have examined the external genital structures of females of three Old World phlebotomine sand flies under SEM and recorded the morphological variations of the organs. We have found the female external genital structures of the three species varied considerably in morphology. The importance of the female external genital structures in sand fly identification is indicated

Detecção de HPV na mucosa oral e genital pela técnica PCR em mulheres com diagnóstico histopatológico positivo para HPV genital

A infecção do papilomavírus humano (HPV) é uma das mais freqüentes doenças sexualmente transmissíveis em todo o mundo. A relação entre o HPV genital e oral permanece incerta, assim como o seu papel na carcinogênese oral. O objetivo deste estudo foi verificar a presença do DNA do HPV na mucosa oral e genital de mulheres com infecção genital por HPV, pela técnica de reação em cadeia de polimerase (PCR). FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Trata-se de um estudo piloto, prospectivo, com 30 mulheres, idade de 14 a 51 anos, portadoras de infecção genital por HPV confirmada pelo exame de histopatológico. Todas as pacientes foram submetidas a exame e coleta por raspagem da cavidade oral e genital para pesquisa do DNA do HPV pela técnica PCR. RESULTADOS: Nenhuma das amostras da cavidade oral foi positiva para HPV, enquanto no genital, o HPV foi detectado em 17 (57%) das 30 pacientes, principalmente o HPV 6b e 16. CONCLUSÃO: Os resultados mostraram maior porcentagem do HPV genital em relação à cavidade oral, e sugerem que o HPV genital não parece ser fator predisponente para a infecção oral no mesmo paciente.

Prevalencia de microorganismos asociados a secreción genital femenina, Argentina

OBJETIVO: Hay un aumento significativo de pacientes con Secreción Genital Femenina, en el Sector Público del gran Buenos Aires. Fue necesario actualizar la prevalencia de los microorganismos asociados a los efectos de revisar el apoyo necesario de laboratorio y ajustar las medidas de prevención y control. MÉTODOS: Se incorporan a este estudio, la totalidad de los casos atendidos (1997-1998): 84 adolescentes (15 a 19 años) y 784 adultas (20 a 60 años) sintomáticas. El protocolo incluye (secreción vaginal y endocervical) detección de Neisseria gonorrhoeae, Streptococcus agalactiae, Trichomonas vaginalis, Candida spp y vaginosis bacteriana. Aplicando métodos específicos directos y cultivo, Chlamydia trachomatis (detección de antígeno), Ureaplasma urealitycum y Mycoplasma hominis (cultivos) fueron estudiados en parte de la población total. RESULTADOS: El aumento de la demanda de consulta fue continuo desde 1997 y aumentó 2.10 veces del primero al último semestre de 1998. En las mujeres adultas se encontró: vaginosis bacteriana, 23,8%; Candida spp 17,8%; S. agalactiae 5,6%; T. vaginalis 2,4%. En 50,3% no se detecto ninguno. En adolescentes se detectó: vaginosis bacteriana, 17,8%; Candida spp 29,7%; S. agalactiae 3,6%, T. vaginalis 2,4%: En 46,4% de los casos el resultado fue negativo. En el grupo de mujeres adultas sintomáticas, no en la totalidad, se detectó: C. trachomatis (7/400) 1,76%, U. urealyticum (209/340) 61,4% y M. hominis (45/272) 16,5%. CONCLUSIONES: El aumento significativo de consultas se debe a problemas sociales en la población, no al aumento de ninguna patología en especial. Impacta como problema clínico concreto la prevalencia de vaginosis bacteriana y Candida spp. Llama la atención, la nula incidencia de N. gonorrhoeae y la baja circulación de T. Vaginalis y C. trachomatis, en este tipo de población. La prevalencia de U. urealyticum y M. hominis es alta, pero su real participación en la patología genital de adultas debe ser reconsiderada. Las prevalencias establecidas motivan la necesidad de adecuar los manuales de procedimientos apuntando a la aplicación de metodologías simples de alto valor predictivo.

Gender in the allocation of organs in kidney transplants: meta-analysis

OBJECTIVE To analyze whether gender influence survival results of kidney transplant grafts and patients.METHODS Systematic review with meta-analysis of cohort studies available on Medline (PubMed), LILACS, CENTRAL, and Embase databases, including manual searching and in the grey literature. The selection of studies and the collection of data were conducted twice by independent reviewers, and disagreements were settled by a third reviewer. Graft and patient survival rates were evaluated as effectiveness measurements. Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model. Recipient, donor, and donor-recipient gender comparisons were evaluated.RESULTS : Twenty-nine studies involving 765,753 patients were included. Regarding graft survival, those from male donors were observed to have longer survival rates as compared to the ones from female donors, only regarding a 10-year follow-up period. Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods. In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way. No statistically significant differences were observed in regards to patient survival for gender comparisons in all follow-up periods evaluated.CONCLUSIONS The quantitative analysis of the studies suggests that donor or recipient genders, when evaluated isolatedly, do not influence patient or graft survival rates. However, the combination between donor-recipient genders may be a determining factor for graft survival.

Paracoccidioidomicose genital feminina. Descrição de um caso clínico

A paracoccidioidomicose é doença sistêmica que atinge mais o sexo masculino do que o feminino. Modelos experimentais mostram maior sensibilidade dos machos do que as fêmeas à dsseminação da doença. A literatura médica é rica em relatos de casos de Pbmicose do trato genital masculino. A raridade da Pbmicose sistêmica na mulher devido à ação hormonal tornou inusitada a descrição de um caso com envolvimneto genital. Paciente de 57 anos, branca, procedente de Conchas (SP), queixando-se de dor abdominal há 10 anos, difusa, seguida de eólica periumbelical periódica, com diarréia e obstipação alternadas. Piorou desse quadro e evoluiu para abdome agudo cirúrgico. O anátomo patológico revelou Pbmicose no epiplon e ovário direito. A biópsia do endométrio mostrou endometrite crônica granulomatosa. A radiologia e a planigrafia revelaram nódulo parahilar direito. Os achados clínicos e laboratoriais permitiram explicar a provável origem do envolvimento genital.

Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature

Eleven cases of involvement of the genital tract in paracoccidioidomycosis were collected in a retrospective study of the clinical records of 683 patients seen in Porto Alegre, Rio Grande do Sul, Brazil. These cases are herein summarily reported. Eighteen similar cases were gathered in review of the Brazilian literature. Obtained data are discussed.

Leishmaniasis in the genital area

Two patients from the gold mines of Bolivar State, Venezuela, presenting cutaneous leishmaniasis in the genital region, an unusual location, are described. The first patient showed an ulcerated lesion of the glans penis. Leishmanin skin test was positive. A biopsy specimen revealed a granulomatous infiltrate containing Leishmania parasites. In the second patient, Leishmanin skin test was positive, HIV and VDRL were negative. Leishmania parasites were present in a biopsy of an ulcerated lesion in the scrotum, with an indurated base, infiltrative borders with an yellowish exudate. Patients were treated with meglumine antimoniate and the lesions healed.

Avaliação de parâmetros para o diagnóstico laboratorial de infecção genital feminina pela Chlamydia trachomatis

Foram examinadas prospectivamente189 amostras cervicais de mulheres sintomáticas e assintomáticas. Foram colhidas 2 amostras do canal endocervical, das quais uma foi examinada pela reação de imunofluorescência direta (IFD) com anticorpo monoclonal (MicroTrak), para verificação da adequação das amostras. A segunda amostra foi inoculada em cultura de células McCoy. Uma terceira amostra foi coletada para pesquisa de anticorpos das classes IgG e IgA. A Chlamydia trachomatis foi isolada de 14/166 (8,4%) das mulheres com sintomas e de 3/23 (13%) daquelas sem sintomas. Observamos que as 152 mulheres do grupo sintomático, com cultura negativa, possuiam sintomas equivalentes. Em relação ao número de células epiteliais, verificou-se que 13 das 17 (76,5%) amostras endocervicais positivas pela cultura e pela IFD, todas apresentavam mais de 5 células. Tomando-se como critério de positividade títulos ³ 1:8, foram detectados anticorpos das classes IgG e/ou IgA específicos para C. trachomatis em 11/189 (64,7%) das 17 mulheres com cultura positiva. Conclusões: a) não existe sintoma que seja específico de infecção por clamídia (p > 0,05); b) a quantidade de células epiteliais representariam fator de interferência na positividade da cultura, sendo, portanto, variáveis dependentes (p < 0,001); c) a pesquisa de anticorpos na cérvice não poderia ser utilizada como diagnóstico alternativo, pois a sua detecção depende da fase evolutiva da infecção e da resposta imunitária individual.