77 resultados para Papanicolaou


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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

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Pós-graduação em Biopatologia Bucal - ICT

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Dentre as manifestações ginecológicas mais importantes nas mulheres soropositivas para o HIV, estão o câncer do colo uterino e as neoplasias intra-epiteliais cervicais que lhe são as lesões precurssoras. Neste estudo foram analisadas 36 mulheres soropositivas para o vírus da imunodeficiência humana e 54 soro negativas, com a finalidade de analisar a freqüência de lesões precursoras do câncer uterino cervical. Todas as pacientes foram submetidas ao exame clínico ginecológico, colheita de colpocitologia cérvico-vaginal, colposcopia e à biópsia genital quando o exame colposcópico revelava achados anormais. Nas pacientes soropositivas foram quantificados os linfócitos com receptores CD4 e verificado a aderência ao esquema antiretroviral. Os resultados demonstraram que a freqüência das neoplasias intra-epiteliais cervicais foi semelhante nos dois grupos estudados. Observamos ainda que a maioria das pacientes soropositivas apresentavam contagem de CD4 acima de 200 células / mm3, ou seja eram consideradas imunocompetentes. E que trinta e três pacientes das trinta e seis estudadas eram aderentes ao esquema antiretroviral. Concluímos que as mulheres HIV soropositivas consideradas imunocompetentes e em uso de antiretrovirais apresentaram freqüência de neoplasias intraepiteliais cervico-uterinas semelhantes às mulheres soro negativas incluídas neste estudo. Observamos, ainda, que o HPV é importante cofator no desenvolvimento das neoplasias intra-epiteliais cervicais.

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Esta pesquisa teve como objetivos identificar as representações sociais de mulheres sobre o câncer do colo do útero, e descrever a relação dessas representações sociais para o cuidado preventivo. A abordagem utilizada foi do tipo qualitativo-exploratório, adotando a teoria das representações sociais como suporte teórico-conceitual. Duas técnicas de coleta foram utilizadas para obtenção dos dados: a livre associação de palavras e a entrevista semidirigida com perguntas abertas. Para a interpretação dos dados foi utilizada a técnica de análise temática. A pesquisa teve como resultado duas unidades temáticas: câncer cérvico-uterino - uma ferida tratável e o preventivo - o fazer por temer. Observou-se que as mulheres temem muito o câncer cérvico-uterino e, por esse motivo, admitem a importância da realização do exame preventivo, considerando-o como um ato de cuidado com a própria saúde.

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O Papilomavírus humano infecta as células basais do epitélio estratificado, induzindo o desenvolvimento de lesões proliferativas benignas na pele ou mucosas. As infecções apresentam distribuição universal. Muitos estudos têm demonstrado a forte associação da infecção por espécies de alto risco com casos de câncer cervical. Sendo assim, o presente estudo visou determinar a prevalência da infecção pelo HPV em um grupo de mulheres investigadas para o câncer cervical. No período de janeiro de 2008 a dezembro de 2009 foram coletadas amostras cervicais de 180 mulheres atendidas no Laboratório de Citopatologia da UFPA, sendo 162 elegíveis para o estudo. De cada participante foi coletada duas amostras, uma destinada à confecção do esfregaço para posterior análise citológica, através do Método de Papanicolaou e a outra destinada à análise por biologia molecular a fim de se investigar a presença do HPV, na qual utilizou-se os iniciadores MY09 e MY11. As espécies de HPV foram identificadas através da técnica de seqüenciamento de bases nucelotídicas da ORF L1 do HPV. A análise do perfil epidemiológico do grupo estudado demonstrou que a média de idade correspondia a 37,5 anos. A maioria (49,38%) era casada, 37,65% havia iniciado a atividade sexual entre 13 e 17 anos de idade e 58,64% não usava preservativos durante as relações sexuais. A prevalência global do HPV encontrada foi de 18,52%. Treze espécies diferentes foram identificadas, sendo que a maioria (66,67%) pertencia ao grupo de baixo risco, no qual o HPV-11 foi mais freqüente. Dentre o grupo de alto risco (30%) o HPV-31 foi encontrado em quatro casos. A distribuição das espécies de HPV de acordo com o resultado citológico demonstrou que a ocorrência da infecção foi maior no grupo de mulheres cujo esfregaço era livre de alterações citológicas (43,33%). No grupo de mulheres com alterações pré-malignas só observou-se infecções por espécies de baixo risco (10%). A infecção pelo HPV mostrou associação estatisticamente significativa com a atividade sexual e com a freqüência na realização do exame preventivo. A prevalência encontrada no estudo corrobora com outros achados descritos na literatura. A predominância da infecção em mulheres com citologia normal reforça a idéia de que a infecção é, em sua maioria, assintomática e que o método de Papanicolaou é menos eficiente na detecção da infecção em relação às técnicas de biologia molecular. Entretanto, ao se tratar de detecção de doença pré-maligna ou maligna, a biologia molecular não se aplica e, portanto não deve substituir o PCCU.

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Objectives: To evaluate if the prevalence of cervical smear results varies between pregnant and nonpregnant women stratified by age group.Study design: Observational analytical study with a total sample of 1,336,180 pregnant and nonpregnant women, aged between 20 and 34 years, who underwent cervical cancer screening in the Primary Health Care of the national health system in the area of Campinas in Brazil during the period of 2005-2009. The source is the information system for cervical cancer screening. Data collected on abnormal cervical smears were analyzed using the Chi-square test and Fisher's exact test and the magnitude of the association between pregnancy and high-grade squamous epithelial lesions was analyzed by odds ratio (OR) and estimated values with confidence intervals (CI) of 95%.Results: 15,190 pregnant women and 395,961 non-pregnant women were analyzed and fulfilled the inclusion criteria. Regardless of age, no statistical differences were observed for high-grade squamous intraepithelial lesion prevalence (OR 0.90; CI 0.66-1.23). Taking into account the five-year age groups, however, low-grade squamous intraepithelial lesion was less prevalent in pregnant women aged 20-24 (OR 0.71; 0.54-0.95) and 25-29 years (OR 0.56; 0.35-0.89); also, atypical squamous cells of undetermined significance was more prevalent in non-pregnant women aged 25-29 years (OR 0.72; 0.54-0.97).Conclusion: The study showed that the cytological prevalence of high-grade squamous intraepithelial lesion was similar in pregnant and non-pregnant women, regardless of age. The results indicate that there are no reasons for specific approaches to cervical cancer screening for pregnant women. The examination should be carried out only on pregnant women who have not been tested according to current recommendations. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

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Objectives: evaluating the level of information about the examination of uterine cervical cancer and its association with sociodemographic variables in women of a health care unit in the city of Bauru, São Paulo, Brazil. Methods: we conducted a cross-sectional descriptive study with 370 women aged 25 to 59, through structured interviews in their own homes; we used descriptive statistics and the χ2 test. Results: 40.5% of the women had not undergone the Papanicolaou test at the recommended frequency; 58.2% incorrectly defined the test, and 69.5% did not know about the risk factors for the development of cervical cancer; the knowledge about the test showed statistically significant association with schooling and family income of the studied population. Conclusions: women present deficiencies on the proper practice of the Papanicolaou test, on knowledge about the test, risk factors and prevention methods. Therefore, it is necessary to develop primary health actions for the most vulnerable population.

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This paper describes the in vivo Bronchoalveolar lavage (BAL)technique by endoscopy in tapirs (Tapirus terrestris) with clinicalsigns of tuberculosis. The technique was performed in two tapirs, male and female,from Curitiba Zoo, Paraná, Brazil. A flexible endoscope and a polyethylene catheterwere used after the chemical restraint of the animals. For BAL technique, 60mL ofsaline 0.9% were infused with a polyethylene catheter, introduced by the endoscope'working channel, and 15mL of BAL were recovered, analyzed and submitted tocytocentrifugation. Slides were stained by Papanicolaou, periodic acid-Schiff (PAS)and Ziehl-Neelsen methods contained high quantity of inflammatory cells on lightmicroscopy (macrophages 27.5%, lymphocytes 0.5%, neutrophis 67% and eosinophis 5%).BAL samples were submitted to culture, bacilloscopy and PCR and were negative forboth animals. Based on this study, it was concluded that the bronchoalveolar lavagetechnique in tapirs is feasible, simple, noninvasive, practical and fast, providingan important clinical information in vivo regarding the functionalstatus of the lower respiratory tract.

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Genital bleeding may be a common symptom among women with cervical cancer. Cross-sectional study evaluating whether the prevalence of cervical smear results is different in women with and without clinical information about concurrent genital bleeding. The sample consisted of 2 324 836 smears; of these, 0.4% had clinical information on genital bleeding. When stratified by age group, women with genital bleeding had a higher chance of a cytological result of a high-grade squamous intraepithelial lesion [30-49 years odds ratio (OR) 2.38; 95% confidence interval (CI) 1.60-3.53 and ≥50 years OR 6.30; 95%CI 3.72-10.67), of squamous cell carcinoma (SCC) (30-49 years OR 24.70; 95%CI 11.96-51.03 and ≥50 years OR 48.91; 95%CI 31.28-76.47) and of atypical glandular cells (30-49 years OR 5.72; 95%CI 3.30-9.93 and ≥50 years OR 11.56; 95%CI 5.96-22.45); there was also a higher chance of adenocarcinoma for women ≥50 years (OR 53.13; 95%CI 28.08-100.51). The sensitivity of genital bleeding for women aged 18-29 years was 0.4% for high-grade squamous intraepithelial lesion (HSIL); for women 30-49 years old the rate was 0.9% for HSIL, 8.6% for SCC and 2.1% for atypical glandular cells of undetermined significance (AGUS), while for women aged from 50 years or more the rates were 2.0% for HSIL, 13.7% for SCC, 3.6% for AGUS and 14.7% for adenocarcinoma. Women ≥30 years old with genital bleeding should be referred for colposcopy to rule out the possibility of cervical cancer.

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This paper describes a new method for the preparation of sodium 4-[5-(4-hydroxy-3-methoxyphenyl)-3-oxo-penta-1,4-dienyl]-2-methoxy-phenolate, DM-1, and 3-oxo-penta-1,4-dienyl-bis (2-methoxy-phenolate), DM-2. The aim of this work was to evaluate the antitumor effects of DM-1 in adjuvant chemotherapy for breast cancer treatment. Mice bearing mammary adenocarcinomas (Ehrlich ascites tumors) were treated with paclitaxel alone, DM-1 alone, and paclitaxel + DM-1. Tumor samples were used to perform cytological analysis by the Papanicolaou method and apoptosis analysis by annexin V and phosphorylated caspase 3. The paclitaxel + DM-1 group had decreased tumor areas and tumor volumes, and the frequency of metastasis was significantly reduced. This caused a decrease in cachexia, which is usually caused by the tumor. Furthermore, treatment with paclitaxel + DM-1 and DM-1 alone increased the occurrence of apoptosis up to 40% in tumor cells, which is 35% more than in the group treated with paclitaxel alone. This cell death was mainly caused through phosphorylated caspase 3 (11% increase in paclitaxel + DM-1 compared to the paclitaxel group), as confirmed by reduced malignancy criteria in the ascitic fluid. DM-1 emerges as a potential treatment for breast cancer and may act as an adjuvant in chemotherapy, enhancing antitumor drug activity with reduced side effects.

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The spin-1 anisotropic antiferromagnet NiCl2-4SC(NH2)(2) exhibits a field-induced quantum phase transition that is formally analogous to Bose-Einstein condensation. Here we present results of systematic high-field electron spin resonance (ESR) experimental and theoretical studies of this compound with a special emphasis on single-ion two-magnon bound states. In order to clarify some remaining discrepancies between theory and experiment, the frequency-field dependence of magnetic excitations in this material is reanalyzed. In particular, a more comprehensive interpretation of the experimental signature of single-ion two-magnon bound states is shown to be fully consistent with theoretical results. We also clarify the structure of the ESR spectrum in the so-called intermediate phase.

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Objective: To assess the risk factors for delayed diagnosis of uterine cervical lesions. Materials and Methods: This is a case-control study that recruited 178 women at 2 Brazilian hospitals. The cases (n = 74) were composed of women with a late diagnosis of a lesion in the uterine cervix (invasive carcinoma in any stage). The controls (n = 104) were composed of women with cervical lesions diagnosed early on (low-or high-grade intraepithelial lesions). The analysis was performed by means of logistic regression model using a hierarchical model. The socioeconomic and demographic variables were included at level I (distal). Level II (intermediate) included the personal and family antecedents and knowledge about the Papanicolaou test and human papillomavirus. Level III (proximal) encompassed the variables relating to individuals' care for their own health, gynecologic symptoms, and variables relating to access to the health care system. Results: The risk factors for late diagnosis of uterine cervical lesions were age older than 40 years (odds ratio [OR] = 10.4; 95% confidence interval [CI], 2.3-48.4), not knowing the difference between the Papanicolaou test and gynecological pelvic examinations (OR, = 2.5; 95% CI, 1.3-4.9), not thinking that the Papanicolaou test was important (odds ratio [OR], 4.2; 95% CI, 1.3-13.4), and abnormal vaginal bleeding (OR, 15.0; 95% CI, 6.5-35.0). Previous treatment for sexually transmissible disease was a protective factor (OR, 0.3; 95% CI, 0.1-0.8) for delayed diagnosis. Conclusions: Deficiencies in cervical cancer prevention programs in developing countries are not simply a matter of better provision and coverage of Papanicolaou tests. The misconception about the Papanicolaou test is a serious educational problem, as demonstrated by the present study.