Carga viral de seis tipos de Virus del Papiloma Humano de alto riesgo y su asociacion con lesiones cervicales

Introducción: La infección por un tipo de Virus del Papiloma Humano de alto riesgo (VPH-AR), es el factor principal en el desarrollo de Cáncer de Cérvix (CC). La carga viral puede modular esta asociación, por lo que resulta importante su cuantificación y el establecimiento de su relación con lesiones precursoras de CC. Metodología: 60 mujeres con lesiones escamosas intraepiteliales (LEI) y 120 mujeres sin LEI, confirmadas por colposcopia, fueron incluidas en el estudio. Se determinó la carga viral de 6 tipos de VPH-AR, mediante PCR en tiempo real. Se estimaron OR crudos y ajustados para evaluar la asociación entre la carga viral de cada tipo y las lesiones cervicales. Resultados: 93.22% de mujeres con LEI y 91.23% de mujeres negativas, fueron positivas para al menos un tipo de VPH. VPH-18 y VPH-16 fueron los tipos más prevalentes, junto con VPH-31 en mujeres sin LEI. No se encontraron diferencias estadísticamente significativas de las cargas virales entre éstos dos grupos, aunque se observó un mayor carga viral en lesiones para algunos tipos virales. Una mayor frecuencia de lesiones se asoció a infecciones con carga baja de VPH-16 (ORa: 3.53; IC95%: 1.16 – 10.74), en comparación a mujeres con carga alta de VPH-16, (ORa: 2.63; IC95%: 1.09 – 6.36). En infecciones por VPH-31, la presencia de carga viral alta, se asoció con una menor frecuencia de lesiones (ORa: 0.34; IC95%: 0.15 – 0.78). Conclusiones: La prevalencia tipo-específica de VPH se corresponde con las reportadas a nivel mundial. La asociación entre la carga viral del VPH y la frecuencia de LEI es tipo específica y podría depender de la duración de la infección, altas cargas relacionadas con infecciones transitorias, y bajas cargas con persistentes. Este trabajo contribuye al entendimiento del efecto de la carga viral en la historia natural del CC; sin embargo, estudios prospectivos son necesarios para confirmar estos resultados.

Actitudes hacia el VIH/SIDA, el cáncer y la enfermedad de Alzheimer

Esta revisión de la literatura tuvo como objetivo describir las actitudes hacia el VIH/SIDA, el cáncer y la Enfermedad de Alzheimer desde el modelo tripartito. Se revisaron 109 artículos publicados entre 2005 y 2015 en algunas bases de datos especializadas y herramientas de análisis de impacto. También se incluyeron fuentes secundarias ampliándose la búsqueda a los últimos 20 años (1995-2015). Los resultados mostraron que la mayoría de los estudios realizados sobre las actitudes hacia estas tres enfermedades son de tipo cuantitativo y la información se analizó con base en los componentes del modelo tripartito. Algunos aspectos sociodemográficos como el sexo y la edad están asociados con las actitudes hacia las tres enfermedades y predominan las creencias erróneas sobre ellas respecto a sus causas, curso y tratamiento. También predominan actitudes negativas hacia las tres enfermedades y las conductas e intenciones conductuales son diversas hacia cada una de ellas. No se hallaron antecedentes empíricos del estudio de la estructura de las actitudes propuesta por el modelo tripartito hacia las tres enfermedades. La Salud Pública ha liderado la investigación con base en el modelo de conocimientos, actitudes y prácticas propuesto por la OMS.

Hematologically important mutations: X-linked chronic granulomatous disease (third update)

Chronic granulomatous disease (CGD) is an immunodeficiency disorder affecting about 1 in 250,000 individuals. The disease is caused by a lack of superoxide production by the leukocyte enzyme NADPH oxidase. Superoxide is used to kill phagocytosed micro-organisms in neutrophils, eosinophils, monocytes and macrophages. The leukocyte NADPH oxidase is composed of five subunits, of which the enzymatic component is gp91-phox, also called Nox2. This protein is encoded by the CYBB gene on the X chromosome. Mutations in this gene are found in about 70% of all CGD patients. This article lists all mutations identified in CYBB in the X-linked form of CGD. Moreover, apparently benign polymorphisms in CYBB are also given, which should facilitate the recognition of future disease-causing mutations. (C) 2010 Elsevier Inc. All rights reserved.

Noninvasive Evaluation of Oral Lesions Using Depth-sensitive Optical Spectroscopy

BACKGROUND: Optical spectroscopy is a noninvasive technique with potential applications for diagnosis of oral dysplasia and early cancer. In this study, we evaluated the diagnostic performance of a depth-sensitive optical spectroscopy (DSOS) system for distinguishing dysplasia and carcinoma from non-neoplastic oral mucosa. METHODS: Patients with oral lesions and volunteers without any oral abnormalities were recruited to participate. Autofluorescence and diffuse reflectance spectra of selected oral sites were measured using the DSOS system. A total of 424 oral sites in 124 subjects were measured and analyzed, including 154 sites in 60 patients with oral lesions and 270 sites in 64 normal volunteers. Measured optical spectra were used to develop computer-based algorithms to identify the presence of dysplasia or cancer. Sensitivity and specificity were calculated using a gold standard of histopathology for patient sites and clinical impression for normal volunteer sites. RESULTS: Differences in oral spectra were observed in: (1) neoplastic versus nonneoplastic sites, (2) keratinized versus nonkeratinized tissue, and (3) shallow versus deep depths within oral tissue. Algorithms based on spectra from 310 nonkeratinized anatomic sites (buccal, tongue, floor of mouth, and lip) yielded an area under the receiver operating characteristic curve of 0.96 in the training set and 0.93 in the validation set. CONCLUSIONS: The ability to selectively target epithelial and shallow stromal depth regions appeared to be diagnostically useful. For nonkeratinized oral sites, the sensitivity and specificity of this objective diagnostic technique were comparable to that of clinical diagnosis by expert observers. Thus, DSOS has potential to augment oral cancer screening efforts in community settings. Cancer 2009;115:1669-79. (C) 2009 American Cancer Society.

Statistical coupling analysis of aspartic proteinases based on crystal structures of the Trichoderma reesei enzyme and its complex with pepstatin A

The crystal structures of an aspartic proteinase from Trichoderma reesei (TrAsP) and of its complex with a competitive inhibitor, pepstatin A, were solved and refined to crystallographic R-factors of 17.9% (R(free)=21.2%) at 1.70 angstrom resolution and 15.81% (R(free) = 19.2%) at 1.85 angstrom resolution, respectively. The three-dimensional structure of TrAsP is similar to structures of other members of the pepsin-like family of aspartic proteinases. Each molecule is folded in a predominantly beta-sheet bilobal structure with the N-terminal and C-terminal domains of about the same size. Structural comparison of the native structure and the TrAsP-pepstatin complex reveals that the enzyme undergoes an induced-fit, rigid-body movement upon inhibitor binding, with the N-terminal and C-terminal lobes tightly enclosing the inhibitor. Upon recognition and binding of pepstatin A, amino acid residues of the enzyme active site form a number of short hydrogen bonds to the inhibitor that may play an important role in the mechanism of catalysis and inhibition. The structures of TrAsP were used as a template for performing statistical coupling analysis of the aspartic protease family. This approach permitted, for the first time, the identification of a network of structurally linked residues putatively mediating conformational changes relevant to the function of this family of enzymes. Statistical coupling analysis reveals coevolved continuous clusters of amino acid residues that extend from the active site into the hydrophobic cores of each of the two domains and include amino acid residues from the flap regions, highlighting the importance of these parts of the protein for its enzymatic activity. (C) 2008 Elsevier Ltd. All rights reserved.

A clinical decision support system for cancer diseases

The second main cause of death in Brazil is cancer, and according to statistics disclosed by National Cancer Institute from Brazil (INCA) 466,730 new cases of cancer are forecast for 2008. The analysis of tumour tissues of various types and patients' clinical data, genetic profiles, characteristics of diseases and epidemiological data may lead to more precise diagnoses, providing more effective treatments. In this work we present a clinical decision support system for cancer diseases, which manages a relational database containing information relating to the tumour tissue and their location in freezers, patients and medical forms. Furthermore, it is also discussed some problems encountered, as database integration and the adoption of a standard to describe topography and morphology. It is also discussed the dynamic report generation functionality, that shows data in table and graph format, according to the user's configuration. © ACM 2008.

A medical information system to manage a cancer database

Cancer is the second main cause of death in Brazil, and according to statistics disclosed by INCA - National Cancer Institute 466,730 new cases of the disease are forecast for 2008. The storage and analysis of tumour tissues of various types and patients' clinical data, genetic profiles, characteristics of diseases and epidemiological data may provide more precise diagnoses, providing more effective treatments with higher chances for the cure of cancer. In this paper we present a Web system with a client-server architecture, which manages a relational database containing all information relating to the tumour tissue and their location in freezers, patients, medical forms, physicians, users, and others. Furthermore, it is also discussed the software engineering used to developing the system.

Análise experimental do comportamento fluidodinâmico e da secagem de sementes de linhaça (Linum usitatissimum L.) em leito de jorro

A linhaça é a semente da planta do linho (Linum usitatissimum L.), uma espécie polimorfa originária do linho, sendo considerada uma das 6 plantas atualmente reconhecidas pelo Instituto Nacional do Câncer dos Estados Unidos (US National Cancer Institute - NCI) por suas propriedades específicas no combate ao câncer. Parte desse reconhecimento deve-se a notável característica de ser a fonte mais rica de precursores de lignina (esteróide vegetal de ação análoga ao estrógeno de mamíferos) na dieta humana. A variedade utilizada neste trabalho foi a “Linseed” de cor marrom e o objetivo deste trabalho foi analisar a fluidodinâmica dessa partícula em leito de jorro, estabelecida pelas medidas de tomadas de queda de pressão no leito a partir das deflexões em relação às velocidades de ar crescente e decrescente, obtendo assim informações para a determinação de parâmetros correlacionados ao processo, como: velocidade de mínimo jorro, queda de pressão máxima, queda de pressão no jorro estável e queda de pressão no mínimo jorro. Estes valores foram comparados aos correspondentes valores obtidos por equações empíricas citadas na literatura. Foi também avaliado o comportamento da secagem da matéria prima, mediante um planejamento estatístico 2², tendo com as variáveis de entrada temperatura do gás (T_g) e o tempo de operação (t), para a quantificação das variáveis de resposta razão de umidade (Xr, adim.), germinação (G, %) e o índice de velocidade de germinação (IVG, t^-1) e analisadas estatisticamente pelo planejamento fatorial completo com três repetições no ponto central. A cinética de secagem das sementes de linhaça, previamente umidificadas, foi realizada nas temperaturas de 45, 55 e 65 °C, e dentre os três modelos propostos, o modelo de Midilli et al., foi que melhor descreveu aos dados experimentais. Para os parâmetros fluidodinâmicos observou-se que a correlação de Gorshtein e Mukhlenov (1965) apresentou os menores desvios para queda e pressão de mínimo jorro e jorro estável, Abdelrazek (1969) apresentou o menor desvio para a velocidade no mínimo jorro e Pallai e Németh (1969) descreveu adequadamente a queda de pressão máxima. Foi observado que a carga de sementes e a temperatura exerceram influência significativa nos parâmetros fluidodinâmicos em leito de jorro. Com base na análise do planejamento estatístico proposto pode-se concluir que os parâmetros de entrada temperatura do gás e tempo de operação exerceram influência significativa sobre todas as variáveis de resposta, sendo observada influência quadrática das variáveis de entrada ao se observar a significância da curvatura sobre os parâmetros: Razão de umidade, Germinação e Índice de Velocidade de Germinação, propondo-se modelos representativos destes parâmetros com a presença da curvatura, apresentando um coeficiente de determinação (R²) superior a 99 %.

Vitamin or mineral supplement intake and the risk of head and neck cancer: pooled analysis in the INHANCE consortium

To investigate the potential role of vitamin or mineral supplementation on the risk of head and neck cancer (HNC), we analyzed individual-level pooled data from 12 casecontrol studies (7,002 HNC cases and 8,383 controls) participating in the International Head and Neck Cancer Epidemiology consortium. There were a total of 2,028 oral cavity cancer, 2,465 pharyngeal cancer, 874 unspecified oral/pharynx cancer, 1,329 laryngeal cancer and 306 overlapping HNC cases. Odds ratios (OR) and 95% confidence intervals (CIs) for self reported ever use of any vitamins, multivitamins, vitamin A, vitamin C, vitamin E, and calcium, beta-carotene, iron, selenium and zinc supplements were assessed. We further examined frequency, duration and cumulative exposure of each vitamin or mineral when possible and stratified by smoking and drinking status. All ORs were adjusted for age, sex, race/ethnicity, study center, education level, pack-years of smoking, frequency of alcohol drinking and fruit/vegetable intake. A decreased risk of HNC was observed with ever use of vitamin C (OR = 0.76, 95% CI = 0.590.96) and with ever use of calcium supplement (OR = 0.64, 95% CI = 0.420.97). The inverse association with HNC risk was also observed for 10 or more years of vitamin C use (OR = 0.72, 95% CI = 0.540.97) and more than 365 tablets of cumulative calcium intake (OR = 0.36, 95% CI = 0.160.83), but linear trends were not observed for the frequency or duration of any supplement intake. We did not observe any strong associations between vitamin or mineral supplement intake and the risk of HNC.

Using Prior Information from the Medical Literature in GWAS of Oral Cancer Identifies Novel Susceptibility Variant on Chromosome 4-the AdAPT Method

Background: Genome-wide association studies (GWAS) require large sample sizes to obtain adequate statistical power, but it may be possible to increase the power by incorporating complementary data. In this study we investigated the feasibility of automatically retrieving information from the medical literature and leveraging this information in GWAS. Methods: We developed a method that searches through PubMed abstracts for pre-assigned keywords and key concepts, and uses this information to assign prior probabilities of association for each single nucleotide polymorphism (SNP) with the phenotype of interest - the Adjusting Association Priors with Text (AdAPT) method. Association results from a GWAS can subsequently be ranked in the context of these priors using the Bayes False Discovery Probability (BFDP) framework. We initially tested AdAPT by comparing rankings of known susceptibility alleles in a previous lung cancer GWAS, and subsequently applied it in a two-phase GWAS of oral cancer. Results: Known lung cancer susceptibility SNPs were consistently ranked higher by AdAPT BFDPs than by p-values. In the oral cancer GWAS, we sought to replicate the top five SNPs as ranked by AdAPT BFDPs, of which rs991316, located in the ADH gene region of 4q23, displayed a statistically significant association with oral cancer risk in the replication phase (per-rare-allele log additive p-value [p(trend)] = 2.5 x 10(-3)). The combined OR for having one additional rare allele was 0.83 (95% CI: 0.76-0.90), and this association was independent of previously identified susceptibility SNPs that are associated with overall UADT cancer in this gene region. We also investigated if rs991316 was associated with other cancers of the upper aerodigestive tract (UADT), but no additional association signal was found. Conclusion: This study highlights the potential utility of systematically incorporating prior knowledge from the medical literature in genome-wide analyses using the AdAPT methodology. AdAPT is available online (url: http://services.gate.ac.uk/lld/gwas/service/config).

Cooperative effects of aminopeptidase N (CD13) expressed by nonmalignant and cancer cells within the tumor microenvironment

Processes that promote cancer progression such as angiogenesis require a functional interplay between malignant and nonmalignant cells in the tumor microenvironment. The metalloprotease aminopeptidase N (APN; CD13) is often overexpressed in tumor cells and has been implicated in angiogenesis and cancer progression. Our previous studies of APN-null mice revealed impaired neoangiogenesis in model systems without cancer cells and suggested the hypothesis that APN expressed by nonmalignant cells might promote tumor growth. We tested this hypothesis by comparing the effects of APN deficiency in allografted malignant (tumor) and nonmalignant (host) cells on tumor growth and metastasis in APN-null mice. In two independent tumor graft models, APN activity in both the tumors and the host cells cooperate to promote tumor vascularization and growth. Loss of APN expression by the host and/or the malignant cells also impaired lung metastasis in experimental mouse models. Thus, cooperation in APN expression by both cancer cells and nonmalignant stromal cells within the tumor microenvironment promotes angiogenesis, tumor growth, and metastasis.

Strategies and results of the oral cancer prevention campaign among the elderly in Sao Paulo, Brazil, 2001 to 2009

Objective. To describe the strategies and results obtained by the early diagnosis and prevention of an oral cancer campaign targeting the population aged 60 years or older developed since 2001 in the state of Sao Paulo. Methods. The main strategies used to develop the campaign were described based on the review of documents issued by the Health Ministry, National Cancer Institute, Sao Paulo State Health Department, Oncocentro Foundation of Sao Paulo, Sao Paulo City Health Department, School of Public Health at the University of Sao Paulo (USP), and Santa Marcelina Health Care Center. The impact of the campaign on the incidence of new cases of oral cancer in the target population was evaluated. Results. In 2001, 90 886 elderly were examined vs. 629 613 in 2009. The following strategies were identified: training of professionals, development of printed materials to guide municipal governments in developing the campaign and using standardized codes and criteria, guidelines for data consolidation, establishment of patient referral flows, practical training with a specialist at the basic health care unit after the follow-up examination of individuals presenting changes in soft tissues, and increase in the number of oral diagnosis services. Between 2005 and 2009, there was a significant reduction in the rate of confirmed cases of oral cancer per 100 000 individuals examined, from 20.89 to 11.12 (P = 0.00003). Conclusions. The campaign was beneficial to the oral health of the elderly and could be extended to include other age groups and regions of the country. It may also provide a basis for the development of oral cancer prevention actions in other countries, as long as local characteristics are taken into account.

Diet and the risk of head and neck cancer: a pooled analysis in the INHANCE consortium

We investigated the association between diet and head and neck cancer (HNC) risk using data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. The INHANCE pooled data included 22 case-control studies with 14,520 cases and 22,737 controls. Center-specific quartiles among the controls were used for food groups, and frequencies per week were used for single food items. A dietary pattern score combining high fruit and vegetable intake and low red meat intake was created. Odds ratios (OR) and 95% confidence intervals (CI) for the dietary items on the risk of HNC were estimated with a two-stage random-effects logistic regression model. An inverse association was observed for higher-frequency intake of fruit (4th vs. 1st quartile OR = 0.52, 95% CI = 0.43-0.62, p (trend) < 0.01) and vegetables (OR = 0.66, 95% CI = 0.49-0.90, p (trend) = 0.01). Intake of red meat (OR = 1.40, 95% CI = 1.13-1.74, p (trend) = 0.13) and processed meat (OR = 1.37, 95% CI = 1.14-1.65, p (trend) < 0.01) was positively associated with HNC risk. Higher dietary pattern scores, reflecting high fruit/vegetable and low red meat intake, were associated with reduced HNC risk (per score increment OR = 0.90, 95% CI = 0.84-0.97).

Etablierung und Anwendung von biophysikalischen und molekularbiologischen Methoden zur Untersuchung von Wirkmechanismen neuer Indol-, Carbazol- und Oligopyrrolcarboxamid-Derivate als potentielle antitumoraktive Stoffe

Im Rahmen der gezielten Suche nach neuen Leitstrukturen mit antitumoraler Wirkung werden im Arbeitskreis U. Pindur seit Jahren verschiedene Strukturvarianten der Indol-, Carbazol und Pyrrol-Reihe studiert. Durch die Vielzahl neu synthetisierter Verbindungen war es erforderlich, geeignete Screening-Verfahren für die Routineanalyse zu etablieren, die möglichst früh vielversprechende Substanzen detektieren können.Zwei bedeutsame Targets der antitumoralen Wirkstoffe sind die DNA und die Topoisomerase I. Demzufolge war es das Kernziel dieser Arbeit, in erster Linie Assay-Verfahren zu studieren und neu zu etablieren, die eine Wechselwirkung von neu-synthetisierten Verbindungen mit diesen Targets nachweisen könnten.Im Rahmen dieser Arbeit wurden vier Assay-Verfahren neu etabliert und für die Routineanwendung optimiert: die Bestimmung der DNA-Schmelztemperatur, der Ethidiumbromid-Verdrängungsassay, der Unwinding-Assay und die Bestimmung der Topoisomerase I-Hemmung.Mit diesen vier Methoden, die mit Hilfe neuer Synthesesubstanzen und bekannter Standard-Cytostatika in dieser Arbeit aufgebaut, validiert und optimiert wurden, und mit den Ergebnissen der Zytotoxizitätsbestimmung, die im National Cancer Institute durchgeführt wurde, sollten nun erste Basisinformationen zum zukünftigen Aufbau von Struktur-Wirkungsbeziehungen der im Arbeitskreis U. Pindur synthetisierten Verbindungen geliefert werden.Aus der Analyse der Problematik bei der Durchführung der Assays zur Bestimmung der Wechselwirkungen mit der DNA und der damit ermittelten Ergebnisse hat sich eine Reduktion der Lipophilie der Testverbindungen als besonders wichtig herausgestellt, denn die meisten Assays werden in wäßrigem Puffer durchgeführt.In Hinblick auf Struktur-Wirkungsbeziehungen der neu synthetisierten Verbindungen konnten ausgehend von den bisherigen Ergebnissen erste vororientierende Korrelationen zwischen den verschiedenen Assay-Daten aufgestellt werden. Allerdings konnte auf Grund der Heterogenität der rationalen Hintergründe der Testverfahren und der Heterogenität der untersuchten Stoffgruppen noch kein einheitliches weiterführendes Strukturkonzept erarbeitet werden. Lediglich bei den Pyrrolcarboxamid-Derivaten konnte unter Berücksichtigung folgender Informationen eine weitergehende Strukturoptimierung vorgenommen werden. Eine terminale Dimethylaminopropyl-Gruppe sowie mindestens zwei Pyrroleinheiten bzw. drei amidische Gruppen bei den DNA-rinnenbindenden Pyrrolcarboxamid-Ketten sind erforderlich, um eine Wechselwirkung mit der DNA zu erreichen. Der interkalierende Teil der als potentielle „Combilexine“ entwickelten Oligopyrrolcarboxamid-Derivate sollte eine große Affinität zur DNA aufweisen, sonst scheint dieser Strukturabschnitt eher einen sterischen Störeffekt bei der Bindung in die Rinnen der Seitenkette hervorzurufen.Eine Analyse der erforderlichen strukturellen Eigenschaften für die Wechselwirkung mit der Topoisomerase I war nicht möglich, denn Testverbindungen unterschiedlichster Struktur haben eine Hemmung dieses Enzyms gezeigt. Weiterhin ist keine Korrelation zwischen der DNA-Affinität und der Fähigkeit zur Hemmung der Topo I festzustellen. Dennoch konnte die zytotoxische Wirkung bei einer Vielzahl von Verbindungen mit einer Hemmung der Topoisomerase I erklärt.Auf Grund der vorliegenden Ergebnisse sollten nun weitere Verbindungen gezielter synthetisiert werden, deren Analyse mit Hilfe der im Rahmen dieser Arbeit etablierten Verfahren zur Aufklärung weiterer essentieller Punkte für die Wechselwirkung mit der DNA und den Topoisomerasen führen soll.