Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infection in men attending STD clinics in Brazil

INTRODUCTION: The study aimed to assess the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections and identify demographic, behavioral and clinical factors correlated withsuch infections in men attending six sexually transmitted disease clinics in Brazil. METHODS: Multicentric, cross-sectional study performed among men attending STD clinics in Brazil. The study included STD clinics in six cities distributed throughout the five geographic regions of Brazil in 2005. Patients provided 20 ml of first catch urine for testing for NG and CT by DNA-PCR. RESULTS: A total of 767 (92.9%) men were included in the study. The mean age was 26.5 (SD 8.3) years-old. Prevalence of Chlamydia infection was 13.1% (95%CI 10.7%-15.5%) and gonorrhea was 18.4% (95%CI 15.7%-21.1%). Coinfection prevalence was 4.4% (95%CI 2.95%-5.85%) in men who sought attendance in STI clinics. Factors identified as associated with C. trachomatis were younger age (15-24) [OR=1.4 (95%CI 1.01-1.91)], present urethral discharge [OR=4.8 (95%CI 1.52-15.05)], genital warts [OR=3.0 (95%CI 1.49-5.92)] and previous history of urethral discharge [OR=2.4 (95%CI 1.11-5.18)]. Variables associated with gonorrhea were younger age (15 to 24) [OR=1.5 (95%CI 1.09-2.05)], presence of urethral discharge [OR=9.9 (95%CI 5.53-17.79)], genital warts [OR=18.3 (95%CI 8.03-41.60)] and ulcer present upon clinical examination [OR=4.9 (95%CI 1.06-22.73)]. CONCLUSIONS: These findings have important implications for education and prevention actions directed toward men at risk of HIV/STD. A venue-based approach to offer routine screening for young men in STD clinics should be stimulated.

Recurrent herpes simplex infections: laser therapy as a potential tool for long-term successful treatment

Herpes simplex virus types 1 and 2 are the main infectious agents associated with oral and genital ulcerations. These infections are now widely recognized as sexually transmitted diseases. Among treatment options, low-level laser therapy (LLLT) has shown promising clinical results as a longer-lasting suppression therapy. Two clinical cases are described with recurrent labial herpes for which LLLT was used. Following treatment, both patients remained symptom free during the 17-month clinical follow-up period.

Evolutionary dynamics of Chlamydia trachomatis genome and identification of molecular patterns of hypothetical protein coding genes

The obligate intracellular bacterium Chlamydia trachomatis is a human pathogen of major public health significance. Strains can be classified into 15 main serovars (A to L3) that preferentially cause ocular infections (A-C), genital infections (D-K) or lymphogranuloma venereum (LGV) (L1-L3), but the molecular basis behind their distinct tropism, ecological success and pathogenicity is not welldefined. Most chlamydial research demands culture in eukaryotic cell lines, but it is not known if stains become laboratory adapted. By essentially using genomics and transcriptomics, we aimed to investigate the evolutionary patterns underlying the adaptation of C. trachomatis to the different human tissues, given emphasis to the identification of molecular patterns of genes encoding hypothetical proteins, and to understand the adaptive process behind the C. trachomatis in vivo to in vitro transition. Our results highlight a positive selection-driven evolution of C. trachomatis towards nichespecific adaptation, essentially targeting host-interacting proteins, namely effectors and inclusion membrane proteins, where some of them also displayed niche-specific expression patterns. We also identified potential "ocular-specific" pseudogenes, and pointed out the major gene targets of adaptive mutations associated with LGV infections. We further observed that the in vivo-derived genetic makeup of C. trachomatis is not significantly compromised by its long-term laboratory propagation. In opposition, its introduction in vitro has the potential to affect the phenotype, likely yielding virulence attenuation. In fact, we observed a "genital-specific" rampant inactivation of the virulence gene CT135, which may impact the interpretation of data derived from studies requiring culture. Globally, the findings presented in this Ph.D. thesis contribute for the understanding of C.trachomatis adaptive evolution and provides new insights into the biological role of C. trachomatishypothetical proteins. They also launch research questions for future functional studies aiming toclarify the determinants of tissue tropism, virulence or pathogenic dissimilarities among C. trachomatisstrains.

TWO UNUSUAL NEW GENERA OF PARAMPHISTOMIDAE (TREMATODA, DIGENEA) FROM FRESHWATER FISH OF THE BRAZILIAN AMAZON

Two new genera and species of Paramphistomidae (Tremadota, Digenea) are described from freshwater fish of the Brazilian Amazon. Anavilhanatrema robustagen. et sp. nov. is characterized as having a cylindrical body with an anterior expansion, small suckers, a small cirrus sac, large lobate testes, a lobate ovary, long ceca and extensive vitellaria. Pacudistoma turgidagen. et sp. nov., on the other hand, is distinguished by having a stout, cylindrical body, a large oral sucker with internal diverticula, a large genital sucker, smaller lobate testes, a spherical ovary, long ceca and relatively extensive vitellaria. Both species appear to be host specific with A. robustafound in Pristobrycon striolatus(STEINDACHNER) while P. turgidaoccurus in Hyleus pacu(SCHOMBURCK).

Brasergasilus guaporensis sp. n. (COPEPODA: ERGASILIDAE) DAS BRÂNQUIAS DE Leporinus fasciatus (BLOCH, 1890) (CHARACIFORMES: ANOSTOMIDAE) DA AMAZÔNIA BRASILEIRA

Brasergasilus guaporensissp. n. (Copepoda, Poecilostomatoida, Ergasilidae) é proposta. Os espécimens foram coletados dos filamentos branquiais de Leporinus fasciatus(BLOCH, 1890) do Rio Guaporé, próximo a Pimenteiras, Rondônia, Brasil. A nova espécie difere das outras conhecidas do gênero no formato da garra da antena e na presença de ornamentações no somito genital duplo e abdômen.

Surface morphology of some Amphistomes (Trematoda) of Amazonian Fishes and the description of a new genus and species

The surface morphology of specimens from ten different genera of amphistomes (Trematoda, Cladorchiidae) from Amazonian fishes is described and illustrated. The importance of body shape as a generic character is considered. Morphological changes as a result of growth are shown and explained in relation to the species Dadaytrema oxycephala. Additionally, Doradamphistoma bacuensis gen. et sp. n. is described from the catfish, Megalodoras irwini Eigenmann, 1925.The new genus and species is elongate and flattened, with external pharyngeal pouches, an esophageal bulb, a spherical cirrus sac, a post-bifurcal genital pore and pre-equatorial testes.

Clear cell adenocarcinoma of the cervix in a young woman: a diagnostic challenge

Clear cell adenocarcinoma of the cervix is a rare tumor, classically related with in utero diethylstilbestrol (DES) exposure. The authors report a rare case of clear cell adenocarcinoma of the cervix in a 21-yearold woman who had no history of in utero DES exposure, presenting with intermittent vaginal bleeding. It stresses the relevance to always clarify the etiology of abnormal genital bleeding and consider the possibility of cervicovaginal tumors.

Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions

Bacterial vaginosis (BV) is the most common genital tract infection in women during their reproductive years and it has been associated with serious health complications, such as preterm delivery and acquisition or transmission of several sexually transmitted agents. BV is characterized by a reduction of beneficial lactobacilli and a significant increase in number of anaerobic bacteria, including Gardnerella vaginalis, Atopobium vaginae, Mobiluncus spp., Bacteroides spp. and Prevotella spp.. Being polymicrobial in nature, BV etiology remains unclear. However, it is certain that BV involves the presence of a thick vaginal multi-species biofilm, where G. vaginalis is the predominant species. Similar to what happens in many other biofilm-related infections, standard antibiotics, like metronidazole, are unable to fully eradicate the vaginal biofilm, which can explain the high recurrence rates of BV. Furthermore, antibiotic therapy can also cause a negative impact on the healthy vaginal microflora. These issues sparked the interest in developing alternative therapeutic strategies. This review provides a quick synopsis of the currently approved and available antibiotics for BV treatment while presenting an overview of novel strategies that are being explored for the treatment of this disorder, with special focus on natural compounds that are able to overcome biofilm-associated antibiotic resistance.

Matricídio, seguido de canibalismo e automutilação de pênis e mão em paciente esquizofrênico motivado por delírios religiosos

INTRODUÇÃO: A automutilação em pacientes psiquiátricos ocorre, sobretudo, associada a psicoses esquizofrênicas ou tóxicas, podendo estar relacionada a crenças religiosas, impulsividade, abuso de substâncias e outros sintomas psicóticos como alucinações ou delírios. MÉTODO: Relatamos o caso de um jovem de 22 anos que cometeu matricídio, seguido de canibalismo e automutilação do pênis e mão direita em primeiro surto psicótico, motivado por delírio religioso. RESULTADOS: Relatos de mutilação genital e olhos em pacientes esquizofrênicos são encontrados na literatura médica, contudo são raríssimos os casos que cometeram tais atos em primeiro surto psicótico. O matricídio é menos frequente que o parricídio e o agressor é geralmente filho homem. CONCLUSÃO: Trata-se de um caso grave, complexo e possivelmente o primeiro caso descrito na literatura de matricídio seguido de canibalismo e automutilação do pênis e mão.

CONOCIMIENTO SOBRE EL VIRUS PAPILOMA HUMANO (VPH): SU IMPLICANCIA EN LA PREVENCIÓN DEL CÁNCER ORAL.

El virus del papiloma humano (VPH) es una de las de infecciones de transmisión sexual (ITS) más frecuentes [1]. Varios genotipos de VPH pueden generar verrugas genitales, y otros están fuertemente asociados a displasia cervical, cáncer de cuello uterino, de vulva, ano, pene y de orofaringe. La alta prevalencia de la infección por este virus en caso de lesiones bucal premalignas indica que la infección podría ser un evento temprano en el proceso de transformación maligna de las c. Epitelial de la cavidad bucal. La asociación epidemiológica del VPH con Carcinoma de Células escamosa, así como la evidencia biológica dado por la transformación de las células epitelial por oncogenes del virus sugiere que los VPH específicos son importantes para el proceso de malignización, sin que este determine el tamaño ni el estado del tumor. Objetivos 1) Analizar el grado de conocimiento de la población incluida en una encuesta, respecto de las vías de transmisión del VPH, los métodos de prevención, los factores de riesgo y su asociación con las verrugas genitales y el cáncer de cuello de útero, ano, pene y de orofaringe. 2) Determinar la prevalencia y genotipos del VPH en lesiones preneoplásicas y neoplásicas de las vías aerodigestivas superiores de pacientes adultos que acuden a la Fac de Odontología y evaluar los factores de riesgo asociados (sexuales, hhábito de fumar, etc) 3) Determinar la prevalencia y genotipos del VPH en mucosa sana y que presenten lesiones de pacientes pediátricos que acuden a la Facultad de Odontología de la U.N.C.; Servicio del Hospital de Niños de la Pcia de Córdoba y evaluar los factores de riesgo asociados (sexuales, otras ITS por ej: C.trachomatis, M.genital) MATERIALES Y METODOS: Objetivo 1: Se entregará un cuestionario de 28 ítems, con carácter anónimo no vinculante, a estudiantes (mayores de 18 años de edad) universitarios de primer año de las carreras de Medicina, Odontología, FAMAF, Psicopedagogía del Inst Sup Dr. D.Cabred, de la catedra Bacteriologia y Virologia de la F.C.M., pacientes que asisten a los servicios de: Infectología y Ginecología del H.N.C., Ginecología e Infectología del Hospital Italiano, Urología del Hospital San Roque, Ginecología del H.M.N., Lab de Andrología y Reproducción y Lab de Chlamydias y HPV del Instituto de Virología y a empleados y afiliados que asisten a APROSS. Objetivo 2/3: Las muestras con PAP, serán receptadas en 500µl de PBS, luego se extraerá ADN, utilizando un equipo comercial (Bioneer). Se amplificará por PCR, un segmento (450 pb), correspondientes a la región L1 del genoma viral, utilizando los llamados “primer” degenerados MY09 y MY11. La amplificación del gen de la beta-globina se utilizará para comprobar la presencia de un templado; a partir de los productos VPH positivos se realizará digestión enzimática (BamHI, HaeIII, HinfI, PstI, RsaI, DdeI y Sau3A1) lo que permitirá la identificación del genotipo a por RFLP en gel de agarosa al 2%. Se utilizará para el análisis estadístico el programa Epi Info versión 3.5.1 2008 (http://www.cdc.gov/epiinfo/). Se alinearán las secuencias de ADN empleando el programa Clustal X (23). Las secuencias serán utilizadas para genotipificación por métodos filogenético [o utilizando la herramienta de genotipificación viral del NCBI (http://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi)] El análisis filogenético se realizará empleando el Programa MEGA 3 (11) empleando la metodología de Neighbor Joining y se evaluarán por Bootstrap. Resultados esperados:La encuesta brindará datos que se podrán aprovechar para los programas de prevención de la infección con VPH. Se podrá determinar cuáles son los genotipos circulantes en nuestra población y cuáles son los factores de riesgo asociados. Se podrá establecer cuáles son los genotipos asociados a las lesiones preneoplásicas y neoplásicas de la mucosa oral, y determinar la probabilidad de que la vacunación contra los VPH 6, 11, 16 y 18 pueda prevenir la aparición de estas lesiones.

Sexually Transmitted Diseases Treatment Guidelines, 2010

These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 18–30, 2009. The information in this report updates the 2006 Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 2006;55[No. RR–11]). Included in these updated guidelines is new information regarding 1) the expanded diagnostic evaluation for cervicitis and trichomoniasis; 2) new treatment recommendations for bacterial vaginosis and genital warts; 3) the clinical efficacy of azithromycin for chlamydial infections in pregnancy; 4) the role of Mycoplasma genitalium and trichomoniasis in urethritis/cervicitis and treatment-related implications; 5) lymphogranuloma venereum proctocolitis among men who have sex with men; 6) the criteria for spinal fluid examination to evaluate for neurosyphilis; 7) the emergence of azithromycin-resistant Treponema pallidum; 8) the increasing prevalence of antimicrobial-resistant Neisseria gonorrhoeae; 9) the sexual transmission of hepatitis C; 10) diagnostic evaluation after sexual assault; and 11) STD prevention approaches.

Revisão do gênero Runibia (Heteroptera, Pentatomidae, Pentatomini)

Runibia Stål, 1861 is redescribed, as well as the species R. dallasi Rider, 1998, R. decorata (Dallas, 1851), R. discoidea (Fabricius, 1787), R. euopta (Walker, 1867) and R. perspicua (Fabricius, 1798). A new species, R. caribeana, is described from Virgin Islands. Strachia alligata Walker, 1867, R. decorata var. alligata, and R. picturata Breddin, 1904 were considered junior synonyms of R. decorata. Lectotypes of R. dallasi, R. euopta and R. alligata were designated. Male and female genitalia for all species are described, except the phallus and ectodermal genital duct for R. dallasi. A key and a geographical distribution map are also provided.

Notas sobre Pseudevoplitus (Heteroptera, Pentatomidae) e descrição de duas espécies novas

Two new species of the Neotropical genus Pseudevoplitus Ruckes,1958 are described, P. amazonicus Grazia & Greve, sp. nov. and P. roraimensis Grazia & Greve, sp. nov. both from the Brazilian Amazonia, with emphasis on genital characters. Additions to the generic description and a new key to the species are presented.

Three new species of Cephalobium (Nematoda, Cephalobiidae) parasites of Gryllodes laplatae (Orthoptera, Gryllidae) from Argentina

Three new species of Cephalobium Cobb, 1920, C. laplata from City Bell, C. polidentatum from Lincoln and C. dispar from Gorina, parasites of Gryllodes laplatae Saussure, 1877 from Buenos Aires, Argentina, are described and illustrated. Cephalobium laplata can be differentiated by having the cheilostom with a dorsal unmovable tooth, telostom with three ventral little teeth and two ventral movable claw teeth and gubernaculum triangular and five pairs of genital papillae. Cephalobium polidentatum has cheilostom with a movable ventral tooth, prostom with four dorsal movable teeth and telostom with three teeth; gubernaculum triangular with projections and with one pair of preanal and six pairs of postanal papillae. Cephalobium dispar is characterized by having telostom with two wings around the spicules and one pair of preanal and six pairs postanal papillae.

Hexamermis paranaense new species (Nematoda, Mermithidae): a parasite of Diloboderus abderus (Coleoptera, Scarabaeidae) in Argentina

A new species, Hexamermis paranaense n. sp. (Nematoda, Mermithidae), a parasite of larvae of Diloboderus abderus Sturm, 1826 (Coleoptera, Scarabaeidae) is described and illustrated. This new species is characterized by amphids small, amphidial opening pocket-shaped, the anterior portion of the vagina muscularized and slightly protruding with a descending branch forming a loop before joining the uterus, and three rows of genital papillae: the ventrolateral divided in two rows with eight papillae in the outer row and with six papillae in the inner one; the ventral row with four pairs and one single preanal papillae, and with two pairs, a triplete, one pair, a single and one pair postanal papillae.