Percorrer por autor "Pista, A."
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- [Cervix uteri lesions and human papiloma virus infection (HPV): detection and characterization of DNA/HPV using PCR (polymerase chain reaction)]Publication . Serra, H.; Pista, A.; Figueiredo, P.; Urbano, A.; Avillez, F.; Oliveira, C.F.The prevalence of human papillomavirus (HPV) genotypes was estimated by the polymerase chain reaction (PCR), in archival paraffin was embedded tissues. The case group consisted of 84 women aged 21-67 years (mean, 40 years) who were referred to the Department of Gynaecology (Oncology Centre, Coimbra) with citopathologically abnormal smears. This group was selected from a population of women who had undergone a screening programme (1990/94) in Central Region of Portugal. All these patients (n = 84) had a colposcopic directed cervical biopsy. HPV detection and typing was performed by the PCR method in the Department of Virology (National Health Care Institute, Lisbon). The prevalence of DNA/HPV found, concerning all epithelial cervical lesions studied and classified as squamous intra-epithelial lesions (SIL) and cervical cancer was 97.8%. On the basis of the data presented in this study, it was estimated that there was a statistically significant prevalence of low risk HPV types (HPV 6/11) in low grade SIL, 83.3%, and a statistically significant prevalence of high risk HPV types (HPV 16,18,31,33,51) in high grade SIL, 58.4%, as well as cervical cancer lesions in 100%. We conclude that there was a statistically significant difference between women with low and high grade SIL for HPV infection, with low and high risk HPV types, respectively. The risk factors for cervical cancer investigated (age at first sexual intercourse, multiple sexual partners, parity, use of oral contraceptives) were not associated to statistically significant differences concerning low grade SIL and high grade SIL. The clinical and therapeutic procedures were evaluated for the same five years (1990/94). It may be concluded that there would be no significant difference in clinical procedure for high grade lesions and cervical cancer, in which the treatment had been frequently radical (cone biopsies, simple or radical hysterectomy) and in which the HPV infection persisted frequently and was associated to high risk types (HPV 16 in 50% of these cases). On the other hand, it may be concluded that HPV detection in cervical biopsies, especially for low grade SIL lesions, which were evaluated in this study with a more conservative procedure (clinical evaluation only, punch biopsies, loop diathermy, CO2 laser vaporisation, cone biopsies), could identify women with high risk HPV types who might be at risk of developing dysplasia and cervical cancer.
- Chlamydia trachomatis infection in patients selected for HPV detectionPublication . Santo, I.; Azevedo, J.; Borrego, M.J.; Gomes, João Paulo; Verdasca, N.; Pista, A.Background: The significance of the association between the human papillomavirus (HPV) and other sexually transmitted infections in the development of cervical, penile or anal neoplasias has been investigated, and the more consistent data have pointed to an association with Chlamydia trachomatis. In Portugal, the lack of information on STI precludes any knowledge on this subject. Objective: To determine CT infection in a group of individuals selected for HPV detection in the major Portuguese STD clinic. Methods: This opportunistic screening comprehended 177 outpatients (148 women, 29 men; age: 16-61 years) suspected of HPV infection (warts, abnormal histology) between 2008 and 2010. Demographic and sexual behaviour data and a full medical history were obtained at enrolment. Genital samples (cervical, vulvar, vaginal, penile or anal) were collected from all the subjects. HPV DNA was detected by CLART HPV2 assay, which allowed the detection of 35 genotypes. CT DNA was detected by Cobas 4800. Results and Discussion: Overall, 84.5% of the individuals had at least one of the infections. Evidencing an excellent correlation with clinical signs, HPV infection was detected in 68.2% of the women and in 75.9% of the men, where CT positivity was 10.1% and 13.8%, respectively. Coinfection was observed in 8.9% of the women and in 13.8% of the men. No correlation with HPV or CT genotypes could be established. HPV infection was more frequent in CT negative (87.1%) than in CT positive women (13.8%), and the same was observed for men (81.8% versus 18.2%). Full results will be presented and discussed. Conclusions: No correlation between HPV-CT coinfection, and clinical signs was observed. However, further long-term studies are needed to elucidate the effects of HPV-CT coinfection in the clinical history of the infected patient, which would greatly contribute towards a better management of patients.
- Estudo do tipo de Papilomavírus Humano (HPV) no aparelho genital feminino e masculinoPublication . Santo, C.; Pista, A.; Bartolo, E.; Almeida, M.; Ayres, L.; Ferreira, P.; Rodrigo, G.O diagnóstico e tipiflcação do Papiomavírus Humano foi iniciado no Laboratório de Virologia do Instituto Nacional de Saúde em Novembro de 1990. Até Maio de 1991 foram estudadas 81 amostras prvenientes de 70 indivíduos, 57 do sexo feminino e 13 do sexo masculino, observados na Unidade de Patologia Cervico-Vulvar da consulta de ginecologia do Hospital de St’ Maria. De entre os indivíduos do sexo feminino, 49 (86%) tinham evidência colposcópica, histológica e/ou citológica que sugeriam infecção pelo HPV. No sexo masculino, 11 indivíduos (85%) tinham manifestações clínicas e os restantes 2 (15%) correspondiam a casos em que houve contacto sexual com indivíduos infectados, embora até no momento não se observassem lesões aparentes. A detecção do DNA foi positiva em 43 indivíduos (61%), dos quais 42 foram positivos para o HPV-611 1(98%) e 1 para o HPV-16 (2%). Embora preliminares, estes resultados sugerem que também entre nós a infecção genital pelo Papilomavírus Humano deve ser considerada um problema de Saúde Pública no domínio das doenças sexualmente transmissíveis.
- Human Papillomavirus Type Distribution in Cervical Intraepithelial Neoplasia Grade 2/3 and Cervical Cancer in Portugal: a CLEOPATRE II StudyPublication . Pista, A.; Oliveira, C.F.; Lopes, C.; Cunha, M.J.; CLEOPATRE Portugal Study GroupaObjective: Cervical cancer is the third most frequent cancer in women, worldwide, and etiologically associated with infection by human papillomavirus (HPV). Following the results of the first epidemiologic population-based CLEOPATRE study in Portugal, it was important to understand the HPV type-specific distribution in women with cervical intraepithelial neoplasia (CIN) grade 2 and 3 and invasive cervical cancer (ICC). Methods/materials: Observational, multicenter, cross-sectional study with retrospective data collection. Between January 2008 and May 2009, paraffin-embedded samples of histologically confirmed cases of CIN2, CIN3 and ICC were collected from the 5 regional health administrations in mainland Portugal. Eligible samples were sent to two central laboratories for histological reassessment and HPV genotyping. Prevalence estimates were calculated together with 95% confidence intervals. Results: A total of 582 samples, 177 cases of CIN2, 341 of CIN3 and 64 of ICC, were included. The mean age of participants was 41.8 years (20-88 years). The overall HPV prevalence was 97.9% with a higher prevalence of high-risk genotypes, particularly HPV 16. Multiple infections were observed in 11.2% of the cases. HPV prevalence was 95.5% in CIN2, 99.4% in CIN3 and 96.9% in ICC. The eight more frequent genotypes in order of decreasing frequency were HPV 16, 31, 58, 33, 51, 52, 18, and 35 in CIN2 and HPV 16, 31, 33, 58, 52, 35, 18, and 51 in CIN3. In ICC cases, the detected HPV genotypes were HPV 16, 18, 31, 33, 45, 51, 52, 53, 56, 58, 59 and 73. However, HPV 53 and 73 were always associated to other high-risk genotypes. HPV 31, 51, 52, 56, and 59 were detected in one case each. Conclusions: HPV prevalence and patterns of type-specific HPV positivity were comparable with other studies. Current HPV vaccines should protect against HPV genotypes responsible for 77.4% of ICC in Portugal.
- Salmonella Saintpaul outbreak associated with cantaloupe consumption, the United Kingdom and Portugal, September to November 2023Publication . McGeoch, L.J.; Hoban, A.; Sawyer, C.; Rabie, H.; Incident Team; Painset, A.; Browning, L.; Brown, D.; McCarthy, C.; Nelson, A.; Firme, A.; Pista, A.; Moreno, J.; Martins, J.V.; Silveira, L.; Machado, J.; Vasconcelos, P.; Olufon, O.; Inzoungou-Massanga, C.; Douglas, A.; McCormick, J.; Larkin, L.; Balasegaram, S.; , ,In September 2023, the UK Health Security Agency identified cases of Salmonella Saintpaul distributed across England, Scotland, and Wales, all with very low genetic diversity. Additional cases were identified in Portugal following an alert raised by the United Kingdom. Ninety-eight cases with a similar genetic sequence were identified, 93 in the United Kingdom and 5 in Portugal, of which 46% were aged under 10 years. Cases formed a phylogenetic cluster with a maximum distance of six single nucleotide polymorphisms (SNPs) and average of less than one SNP between isolates. An outbreak investigation was undertaken, including a case-control study. Among the 25 UK cases included in this study, 13 reported blood in stool and 5 were hospitalized. One hundred controls were recruited via a market research panel using frequency matching for age. Multivariable logistic regression analysis of food exposures in cases and controls identified a strong association with cantaloupe consumption (adjusted odds ratio: 14.22; 95% confidence interval: 2.83-71.43; p-value: 0.001). This outbreak, together with other recent national and international incidents, points to an increase in identifications of large outbreaks of Salmonella linked to melon consumption. We recommend detailed questioning and triangulation of information sources to delineate consumption of specific fruit varieties during Salmonella outbreaks.