RESUMO
The purpose was to study the perinatal transmission of human papillomavirus DNA (HPV-DNA) in 63 mother-newborn pairs, besides looking at the epidemiological factors involved in the viral DNA transmission. The following sampling methods were used: (1) in the pregnant woman, when was recruited, in cervix and clinical lesions of the vagina, vulva and perineal region; (2) in the newborn, (a) buccal, axillary and inguinal regions; (b) nasopharyngeal aspirate, and (c) cord blood; (3) in the children, buccal was repeated in the 4th week and 6th and 12th month of life. HPV-DNA was identified using two methodologies: multiplex PCR (PGMY09 and MY11 primers) and nested-PCR (genotypes 6/11, 16, 18, 31, 33, 42, 52 and 58). Perinatal transmission was considered when concordance was found in type-specific HPV between mother/newborn or mother/child. HPV-DNA genital was detected in 49 pregnant women submitted to delivery. Eleven newborns (22.4%, n = 11/49) were HPV-DNA positive. In 8 cases (16.3%, n = 8/49) there was type specific HPV concordance between mother/newborn samples. At the end of the first month of life three children (6.1%, n = 3/49) became HPV-DNA positive, while two remained positive from birth. In 3 cases (100%, n = 3/3) there was type specific HPV concordance between mother/newborn samples. In the 6th month, a child (2%, n = 1/49) had become HPV-DNA positive between the 1st and 6th month of life, and there was type specific HPV concordance of mother/newborn samples. All the HPV-DNA positive children (22.4%, n = 11/49) at birth and at the end first month of life (6.1%, n = 3/49) became HPV-DNA negative at the age of 6 months. The HPV-DNA positive child (2%, n = 1/49) from 1st to the 6th month of life became HPV-DNA negative between the 6th and 12th month of life and one child had anogenital warts. In the twelfth month all (100%, n = 49/49) the children studied were HPV-DNA negative. A positive and significant correlation was observed between perinatal transmission of HPV-DNA and the immunodepression of maternal variables (HIV, p = 0.007). Finally, the study suggests that perinatal transmission of HPV-DNA occurred in 24.5% (n = 12/49) of the cases studied.
Assuntos
DNA Viral/isolamento & purificação , Transmissão Vertical de Doenças Infecciosas , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/transmissão , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Adolescente , Adulto , Colo do Útero/virologia , DNA Viral/genética , Feminino , Genótipo , Humanos , Recém-Nascido , Epidemiologia Molecular , Mucosa Bucal/virologia , Nasofaringe/virologia , Papillomaviridae/classificação , Papillomaviridae/genética , Períneo/virologia , Reação em Cadeia da Polimerase/métodos , Gravidez , Vagina/virologia , Adulto JovemRESUMO
This paper aimed at studying the transplacental transmission of HPV and looking at the epidemiological factors involved in maternal viral infection. The following sampling methods were used: (1) in the pregnant woman, (a) genital; (b) peripheral blood; (2) in the newborn, (a) oral cavity, axillary and inguinal regions; (b) nasopharyngeal aspirate, and (c) cord blood; (3) in the placenta. The HPV DNA was identified using two methods: multiplex PCR of human beta-globin and of HPV using the PGMY09 and PGMY11 primers; and nested-PCR, which combines degenerated primers of the E6/E7 regions of the HPV virus, that allowed the identification of genotypes 6/11, 16, 18, 31, 33, 42, 52 and 58. Transplacental transmission was considered when type-specific HPV concordance was found between the mother, the placenta and the newborn or the mother and cord blood. The study included 49 HPV DNA-positive pregnant women at delivery. Twelve placentas (24.5%, n = 12/49) had a positive result for HPV DNA. Eleven newborn were HPV DNA positive in samples from the nasopharyngeal or buccal and body or cord blood. In 5 cases (10.2%, n = 5/49) there was HPV type-specific agreement between genital/placenta/newborn samples. In one case (2%, n = 1/49) there was type specific HPV concordance between genital/cord blood and also suggested transplacental transmission. A positive and significant correlation was observed between transplacental transmission of HPV infection and the maternal variables of immunodepression history (HIV, p = 0.011). In conclusion the study suggests placental infection in 23.3% of the cases studied and transplacental transmission in 12.2%. It is suggested that in future HPV DNA be researched in the normal endometrium of women of reproductive age. The possible consequence of fetal exposure to HPV should be observed.
Assuntos
Alphapapillomavirus/fisiologia , Transmissão Vertical de Doenças Infecciosas , Troca Materno-Fetal , Infecções por Papillomavirus/transmissão , Complicações Infecciosas na Gravidez/virologia , Adulto , Alphapapillomavirus/genética , Alphapapillomavirus/isolamento & purificação , Brasil/epidemiologia , Estudos Transversais , Feminino , Sangue Fetal/virologia , Genitália Feminina/virologia , Humanos , Recém-Nascido , Masculino , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Placenta/virologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos ProspectivosRESUMO
Endometrial stromal sarcoma is a rare neoplasm of the uterus. Extrauterine locations of this neoplasm, excluding metastases or local extension, are even more unusual and are usually associated with the presence of endometriosis. The authors report a case of endometrial stromal sarcoma presenting as a vaginal wall nodule, without any sign of primary uterine tumor after extensive evaluation or presence of endometriosis. The morphology, immunohistochemical profile, differential diagnoses, and pathogenesis are discussed, as well as a review of the literature on this issue.
Assuntos
Neoplasias do Endométrio/patologia , Sarcoma do Estroma Endometrial/patologia , Neoplasias Vaginais/patologia , Adulto , Antígenos CD/metabolismo , Biomarcadores Tumorais/metabolismo , Diagnóstico Diferencial , Intervalo Livre de Doença , Neoplasias do Endométrio/metabolismo , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Sarcoma do Estroma Endometrial/metabolismo , Sarcoma do Estroma Endometrial/cirurgia , Semaforinas/metabolismoRESUMO
The clinical, surgical and pathological features of a case of pulmonary sclerosing hemangioma (benign sclerosing pneumocytoma) are presented. We emphasize the fact that the clinical presentation of this rare benign tumor is mostly as a solitary tumor and therefore enters the differential diagnosis of solitary pulmonary nodule.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Hemangioma , Neoplasias Pulmonares , Hemangioma/cirurgia , Hemangioma/diagnóstico , Hemangioma/patologia , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologiaRESUMO
Os autores apresentam um caso de germinoma da glândula pineal tratado por remoçao cirúrgica e radioterapia. Os tumores da pineal ocupam um segmento relativamente pequeno, aproximadamente 0,5 por cento dos tumores intracranianos. Sao discutidas as características clínicas, patológicas e cirúrgicas e tratamento complementar com radioterapia.