As mulheres durante as fases pré e pós-menopausa apresentam carência de estrogênio, o que acarreta diversos sintomas, destacando os vasomotores, principalmente os fogachos. Existem diversos tratamentos de reposição hormonal para o controle dessas manifestações clínicas, dentre eles, terapias com a espécie medicinal Trifolium pratense L., conhecida popularmente como trevo-vermelho ou Red clover. No Brasil, existem fitoterápicos desta espécie registrados na Agência Nacional de Vigilância Sanitária, e descritos no Memento terapêutico e no Formulário de Fitoterápicos como um coadjuvante terapêutico no tratamento do climatério. Este trabalho é uma revisão integrativa e narrativa de estudos clínicos randomizados com T. pratense no controle dos fogachos em mulheres nos períodos de pré e pós-menopausa. A pesquisa de literatura foi realizada nas bases: Cochrane, CINHAL, LILACS, MEDLINE, PsycINFO e Web of Science empregando os descritores: “Trifolium pratense”, “clinical trial” e “hot flashes”.  Foram analisados 7 artigos; em 3 (três) estudos, houve diferença significante na redução dos episódios de fogachos quando comparados com os grupos placebo, no entanto estes apresentavam problemas metodológicos, como falta de padronização dos fitoterápicos e tamanho amostral inadequado. Estudos demonstram a necessidade de uma microbiota intestinal especifica para transformação das isoflavonas na sua forma ativa S-equol. Dessa forma, concluiu-se que produtos de Trifolium pratense podem ser alternativas no controle dos fogachos principalmente para pacientes que possuem restrição ao uso de estrogênio, com a ressalva de avaliar se a paciente apresenta bactérias produtoras de S-equol, sendo necessários estudos clínicos randomizados para validação dessa espécie vegetal no controle desse sintoma vasoativo.

Aim Estimate the frequency of Human papilloma virus (HPV) 16 lineages in specimens of cervical cancer, relate the pathological factors in those variants and assess the response to treatment with radical chemoradiotherapy. Methods Samples of cervical cancer were collected from women referred to reference cancer hospital to test the presence of Human papilloma virus types DNA. The standard protocol of the service consisted of cisplatin based chemotherapy 40 mg/m² plus conventional pelvic irradiation in the dosis of 45-50.4 Gy and high dose rate brachytherapy of 28–30 Gy to Point A. The response to chemotherapy was avaliated after three months in those patients with HPV − 16 lineage. Results HPV DNA was detected in out 104 (88.1%) of the 118 patients. HPV-16 present in 63 patients (53%). Lineages of HPV 16 identified in 57 patients being: 33 (57.8%) lineage A, 2 lineage B (3.5%), 2 lineage C (3.5%) and 20 (35.0%) lineage D. The median age of the patients was 48.4 years (range 25–85 years). Squamous cell carcinoma was detected 48 times (84.2%). Adenocarcinoma were more likely to occur in lineage D, as three of the four cases occurred in this lineage. A total of 11patientes with HPV-16 variant were treated with chemoradiotherapy. After three months, was observed that nine of the eleven patients (81.8%) achieved complete response: five of the lineage A, two of the lineage C and two of the lineage D. The cases of partial response and progression of disease, one each, occurred in the lineage A. Conclusion Besides the small number of patients and HPV variants, we notice better response in patients with HPV 16 lineage A. Increasing the sample could be helpful to better associate the impact of HPV variants on cervical cancer treatment.

Background: HPV is strongly related to cervical cancer. HPV lineages can contribute to a response to cervical cancer therapy. The aim of this research was to estimate the frequency of human papillomavirus (HPV)-16 lineages in specimens of cervical cancer, relate the pathological factors in these variants, and assess their response to treatment with radical chemoradiotherapy. Methods: Samples of cervical cancer were collected from women who were referred to a reference cancer hospital to test the presence of human papillomavirus-type DNA. The standard protocol of this service consisted of cisplatin-based chemotherapy of 40 mg/m2, plus conventional pelvic irradiation in doses of 45–50.4 Gy and high dose-rate brachytherapy of 28–30 Gy to Point A. The response to chemotherapy was evaluated after three months in patients with the HPV-16 lineage. Results: HPV DNA was detected in 104 (88.1%) of the 118 patients. HPV-16 was present in 63 patients (53%). Lineages of HPV-16 were identified in 57 patients and comprised 33 instances of (57.8%) lineage A, 2 instances of lineage B (3.5%), 2 instances of lineage C (3.5%), and 20 instances of (35.0%) lineage D. The median age of the patients was 48.4 years (range 25–85 years). Squamous cell carcinoma was detected 48 times (84.2%). Adenocarcinoma was more likely to occur in lineage D, as three of the four cases occurred in this lineage. A total of 11 patients with the HPV-16 variant were treated with chemoradiotherapy. After three months, it was observed that nine of the eleven patients (81.8%) achieved a complete response, five with the lineage A type, two with the lineage C type, and two with the lineage D type. The two cases of partial response and disease progression, one of each, occurred in lineage A. Conclusions: In addition to the small number of patients and HPV variants, we noticed a better response in patients with the HPV-16 lineage A. Increasing the sample size could be helpful to better assess the impact of HPV variants on cervical cancer treatment.

Chikungunya, Dengue, and Zika viruses are endemic to Brazil, with a high annual incidence rate. It is a serious public health issue and is responsible for outbreaks and epidemics worldwide. As COVID-19 emerged as a pandemic, the diagnosis of arboviruses was underestimated. Hence, this study aimed to characterize the sociodemographic and clinical aspects of arboviruses in the con-text of the COVID-19 pandemic in the state of Maranhão, Brazil. Sociodemographic and clinical data were obtained by applying questionnaires to 179 patients treated at health units in São José de Ribamar, Paço do Lumiar, Raposa, Santa Inês, and Vargem Grande municipalities. Serologi-cal and polymerase chain reaction analyses were performed do detect Chikungunya, Zika, Den-gue, and COVID-19 infections. The Maranhão state registered 706 probable cases of Chikungunya from 2019 to 2020. In 2020, the cases were reduced by 74.8% compared to those reported in 2019. The test results were analyzed separately. Here, 46.3% of the Chikungunya virus test results were negative, and 36.8% were positive. For the Zika virus tests, most (79.9%) were positive, as well as the DENV1, DENV2, DENV3, and DENV4 tests (88.3%, 88.3%, 89.4%, and 65.9%, respectively). For the COVID-19 tests, of the 146 individuals tested, 52.7% were reactive when considering the anti-S test, and 17.8% were positive when considering the anti-N test. Fever and myalgia were the symptoms most frequently reported by patients. Our results emphasize the importance of contin-uous epidemiological surveillance of arboviruses in northeastern Brazil, and simultaneous test-ing for Chikungunya, Dengue, and Zika viruses among suspected patients.

Objective: To evaluate the plasma cytokine levels during T cell-mediated inflammatory responses and compare the metabolic markers between overweight and obese perimenopausal women without systemic diseases. Methods: Sixty perimenopausal women were divided into two groups (overweight and obese). Participants in both groups had their waist-to-height ratio (WHtR) measured and blood samples collected for the evaluation of estradiol, fasting glucose, leptin, high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, IL-10, IL-17A levels, and lipid profile. Results: In univariate analysis, women with obesity showed increased WHtR, fasting glucose, leptin, and IL-6 (p < 0.05) levels; however, significant differences were not observed in IL-10 or IL-17A (p > 0.05) levels. In the receiver operating characteristic curve, the highest areas under the curve were shown for leptin (0.856) and IL-6 (0.706). IL-6 levels correlated with both hs-CRP (r = 0.302, p = 0.020) and leptin (r = 0.294, p = 0.022). However, in multivariate analysis, IL-6 was not associated with a greater likelihood of obesity (OR = 1.61; 95% CI: 0.82-3.15; p = 0.16), when potential confounders were considered. Conclusion: IL-6 levels varied between overweight and obese perimenopausal women, and this association was weaker when adjusted for other clinical variables.