RESUMO
Chlamydia trachomatis infection was examined as a cause of invasive cervical cancer (ICC) among women with human papillomavirus (HPV) infection. In total, 499 women with incident ICC (ICC patients) and 539 control patients from São Paulo, Brazil, and Manila, the Philippines, were included. C. trachomatis antibodies were detected by microimmunofluorescence assay. Presence of HPV DNA in cervical specimens was determined by a polymerase chain reaction-based assay. C. trachomatis seropositivity was associated with sexual behavior but not with HPV infection. C. trachomatis increased the risk of squamous cervical cancer among HPV-positive women (odds ratio, 2.1; 95% confidence interval, 1.1-4.0). Results were similar in both countries. There was a suggestion of increasing squamous cancer risk with increasing C. trachomatis antibody titers. This large study examined C. trachomatis and cervical cancer, taking into account the central role of HPV infection. C. trachomatis infection was found to be a possible cofactor of HPV in the etiology of squamous cervical cancer, and its effect may be mediated by chronic inflammation.
Assuntos
Infecções por Chlamydia/complicações , Chlamydia trachomatis/isolamento & purificação , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Infecções Tumorais por Vírus/complicações , Neoplasias do Colo do Útero/etiologia , Adulto , Idoso , Anticorpos Antibacterianos/sangue , Brasil , Chlamydia trachomatis/imunologia , DNA Viral/análise , Feminino , Humanos , Pessoa de Meia-Idade , Filipinas , Estudos Soroepidemiológicos , Neoplasias do Colo do Útero/virologiaRESUMO
OBJECTIVE: To determine whether vomiting after mild head injury in children is related to migraine and to identify predictors of vomiting after head injury. METHODS: A series of consecutive children admitted to the observation unit of an emergency department after mild head injury was identified by chart review. A telephone interview with the parents or child or both was then conducted by using a structured questionnaire. RESULTS: Of 47 eligible children with acute head injury, 44 (94%) were contacted. The mean age at head injury was 7.4 years. Twenty-nine children (66%) vomited after the head injury. The likelihood of vomiting was increased if the child had a history of recurrent headache (p = 0.05). If the headaches were migrainous, the likelihood of vomiting increased further (p <0.002). All 15 children with a history of motion sickness vomited after the head injury. Family history of migraine, particularly maternal (n = 21), also predicted recurrent vomiting (p <0.001). If more than one of these predictive variables was present, the likelihood of vomiting was 100%. CONCLUSIONS: History of motion sickness, migraine headaches, and family history of migraine are highly predictive of vomiting after a mild head injury.