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Objetivo: Describir tres situaciones clínicas en las que se presentan distintas manifestaciones bucales para una misma entidad patológica. En los tres casos la sospe- cha diagnóstica de sífilis primaria se basó en la presencia de una adenopatía. Los estudios de laboratorio permitieron confirmar el diagnóstico de sífilis. Por su polimorfismo y variabilidad clínica en sus diferentes etapas evolutivas, la sífilis es descripta clásicamente como "la gran simuladora". Este artículo propone que la presencia de adenomegalias características puede ser una clave para orientar el diagnós- tico de la patología, lo cual no ha sido aún reportado en la literatura. Casos clínicos: Se presentan tres casos clínicos de pa- cientes que acudieron a una consulta estomatológica privada y al Servicio de Estomatología del Hospital Alemán de Bue- nos Aires. Los tres acuden con signos y síntomas diferentes, pero compartiendo la presencia de adenopatías múltiples, en las que se destaca un elemento ganglionar más voluminoso (AU)

Aim: To describe three clinical cases that present dif- ferent oral manifestations for the same pathological entity. In all three cases, the suspected diagnosis of primary syph- ilis was based on the presence of an adenopathy. Labora- tory studies confirmed the diagnosis of syphilis. Due to its polymorphism and clinical variability in the different evo- lutionary stages, syphilis is classically described as "the great simulator". This article proposes that the presence of characteristic adenomegalies can be a key to guide the di- agnosis, which has not yet been reported in the literature. Clinical reports: Three clinical cases of patients who attended a private stomatology consultation and the Stoma- tology Service of the Hospital Alemán de Buenos Aires are presented. The three patients showed different signs and symptoms but shared the presence of multiple adenopathies with a more voluminous ganglial element (AU)

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Abstract Objective To evaluate the assistance provided to women victims of sexual violence and their participation in the follow-up treatment after the traumatic event, presenting a sociodemographic profile, gynecological background, and circumstances of the event, and reporting the results, acceptance, and side effects of prophylaxis for sexually transmitted infections (STIs) and pregnancy. Methods A retrospective cohort study comprising the period between 2007 and 2016. All women receiving medical care and clinical follow-up after a severe episode of sexual violence were included. Records of domestic violence, male victims, children, and adolescents who reported consensual sexual activity were excluded. The present study included descriptive statistics as frequencies and percentages. Results A total of 867medical records were reviewed and 444 cases of sexual violence were included. The age of the victims ranged from10 to 77 years old, most of them selfdeclared white, with between 4 and 8 years of education, and denying having a sexual partner. Sexual violence occurred predominantly at night, on public thoroughfare, being committed by an unknown offender. Most victims were assisted at the referral service center within 72 hours after the violence, enabling the recommended prophylaxis. There was high acceptance of antiretroviral therapy (ART), although half of the users reported side effects. Seroconversion to human immunodeficiency virus (HIV) or to hepatitis B virus (HBV) was not detected in women undergoing prophylaxis. Conclusion In the present cohort, the profile of victims of sexual violence was loweducated, young, white women. The traumatic event occurred predominantly at night, on public thoroughfare, being committed by an unknown offender. Assistance within the first 72 hours after sexual violence enables the healthcare center to provide prophylactic interventions against STIs and unwanted pregnancies.

Resumo Objetivo Avaliar a assistência prestada às mulheres vítimas de violência sexual e seu acompanhamento após o evento traumático, caracterizando o perfil sociodemográfico, antecedentes ginecológicos e circunstâncias do evento, além de relatar a aceitação e os efeitos colaterais da profilaxia para infecções sexualmente transmissíveis (ISTs) e a ocorrência de gravidez resultante da violência sexual. Métodos Estudo de coorte retrospectivo compreendendo o período entre 2007 e 2016. Foram incluídas todas as mulheres em acompanhamento médico e clínico após episódio de violência sexual. Foram excluídos registros de violência doméstica, vítimas do sexo masculino e crianças e adolescentes que relataram atividade sexual consensual. O estudo incluiu estatísticas descritivas, com frequências e percentuais. Resultados Foram revisados 867 prontuários e 444 casos de violência sexual foram incluídos. A faixa etária foi 10 a 77 anos; a maioria das vítimas se autodeclarou branca, com entre 4 e 8 anos de escolaridade, e negou ter um parceiro sexual fixo. A violência sexual ocorreu predominantemente à noite, em via pública, por um agressor desconhecido. A maioria foi atendida no serviço de referência em até 72 horas após a violência, possibilitando profilaxias preconizadas. Houve alta aceitação da terapia antirretroviral (TARV), embora metade das usuárias relatasse efeitos colaterais. A soroconversão para o vírus da imunodeficiência humana (HIV, na sigla em inglês) ou para o vírus da hepatite B (HBV, na sigla em inglês) não foi detectada entre as vítimas. Conclusão Nesta coorte, o perfil das vítimas de violência sexual foi de mulheres brancas, de baixa escolaridade, e jovens. O evento traumático ocorreu predominantemente à noite, em via pública, por um agressor desconhecido. A assistência nas primeiras 72 horas após a violência sexual permite que o serviço de saúde realize intervenções profiláticas contra ISTs e gravidez indesejada.

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Rab proteins belong to the Ras superfamily of small monomeric GTPases. These G proteins are the main controllers of vesicular transport in every tissue, among them, the endometrium. They are in charge of to the functional subcellular compartmentalization and cargo transport between organelles and the plasma membrane. In turn, intracellular trafficking contributes to endometrial changes during the menstrual cycle, secretion to the uterine fluid, and trophoblast implantation; however, few reports analyze the role of Rab proteins in the uterus. In general, Rab proteins control the release of cytokines, growth factors, enzymes, hormones, cell adhesion molecules, and mucus. Further, the secretion of multiple compounds into the uterine cavity is required for successful implantation. Therefore, alterations in Rab-controlled intracellular transport likely impair secretory processes to the uterine fluid that may correlate with abnormal endometrial development and failed reproductive outcomes. Overall, they could explain recurrent miscarriages, female infertility, and/or assisted reproductive failure. Interestingly, estrogen (E2) and progesterone (P) regulate gene expression of Rab proteins involved in secretory pathways. This review aims to gather information regarding the role of Rab proteins and intracellular trafficking in the endometrium during the different menstrual phases, and in the generation of a receptive stage for embryo implantation, modulated by E2 and P. This knowledge might be useful for the development of novel reproductive therapies that overcome low implantation rates of assisted reproductive procedures.

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INTRODUCCIÓN Los hombres gays, bisexuales y hombres que tienen sexo con hombres (HGByHSH) especialmente los jóvenes, continúan presentando prevalencias de infecciones de transmisión sexua (ITS) elevadas en Argentina. Desde la perspectiva de los determinantes sociales de la salud, sdestaca la importancia de investigar los factores psicosociales (salud mental, consumo d sustancias, experiencias de homofobia). OBJETIVOS Describir la situación de salud sexual y menta en adolescentes y jóvenes HGByHSH residentes en el Área Metropolitana de Buenos Aires, determinar los correlatos psicosociales y sociodemográficos de conductas sexuales sin preservativo y adquisición de ITS. MÉTODOS Se enrolaron 150 jóvenes HGByHSH entre 18 y 30 años. Se realizó un estudio longitudinal. En la vista basal se realizó testeo rápido de VIH y sífilis, screening de gonorrea, clamidia y hepatitis, y una entrevista psicosocial para relevar información sociodemográfica, comportamiento sexual, salud mental, consumo de sustancias, y experiencias de homofobia y violencia. RESULTADOS La ITS con mayor prevalencia fue la sífilis (15,5%). Más de la mitad reportó haber tenido sexo anal sin preservativo con al menos una pareja en el último me(54,5% receptivas y 52,4% insertivas). El 60,8% exhibió síntomas depresivos significativos y 30,7%, ideación suicida en la última semana. El 76,9% usó alguna sustancia antes o durante la relaciones sexuales en los últimos 3 meses. Los principales correlatos de sexo anal sin preservativo fueron para las receptivas, violencia verbal por parte de miembros de la familia, y uso de sustancia antes o durante las relaciones sexuales; para las insertivas, hacer trabajo sexual, ser migrante violencia verbal y sexual por parte de la familia. DISCUSIÓN Se requieren intervenciones preventivas en salud sexual dirigidas a jóvenes HGByHSH desde un enfoque interseccional y que contemplen componentes de reducción de daños y atención de salud mental.

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BACKGROUND: Chlamydia trachomatis (C trachomatis) is one of the most frequent sexually transmitted infections and a source of deleterious effects on the reproductive health of men and women. Because this infection is likely asymptomatic and is associated with subfertility, ectopic pregnancy, and chronic pain, its presence needs to be confirmed. Technologies available for the diagnosis of C trachomatis infection can be classified into tests performed in a laboratory and rapid tests at the point of care (POC tests). Laboratory-based tests include culture, nucleic acid amplification tests, enzyme immunoassays (EIA), direct fluorescent antibody, nucleic acid hybridization, and transformation tests. Rapid tests include solid-phase EIA and solid-phase optical immunoassay. POC tests can be performed within 30 minutes without the need for expensive or sophisticated equipment. The principal advantage of this technology is the immediate presentation of results with the subsequent possibility to start the treatment of infected patients immediately. OBJECTIVES: To determine the diagnostic accuracy of rapid point-of-care (POC) testing for detecting urogenital C trachomatis infection in nonpregnant women and men of reproductive age, as verified with nucleic acid amplification tests (NAATs) as the reference standard. SEARCH METHODS: In November 2019 we searched CENTRAL, MEDLINE, Embase and LILACS. We also searched Web of Science, two trials registries and an abstract database. We screened reference lists of included studies for additional references. SELECTION CRITERIA: We included diagnostic accuracy studies of symptomatic or asymptomatic nonpregnant women and men reproductive age. Included trials should have prospectively enrolled participants without previous diagnostic testing, co-infections or complications and consecutively or through random sampling at primary or secondary care facilities. Only studies reporting that all participants received the index test and the reference standard and presenting 2 x 2 data were eligible for inclusion. We excluded diagnostic case-control studies. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts for relevance. Two review authors independently, and in duplicate, assessed eligibility, extracted data, and carried out quality assessment. We resolved differences through consensus or by involving a third review author. We assessed studies for methodological quality using QUADAS-2 and used meta-analysis to combine the results of studies using the bivariate approach to estimate the expected sensitivity and specificity values. We assessed the quality of the evidence using GRADE criteria and explored sources of heterogeneity. MAIN RESULTS: We included a total of 19 studies, with 13,676 participants, that assessed the diagnostic accuracy of POC tests for C trachomatis infection in nonpregnant women and men of reproductive age, as verified with NAATs as the reference standard. Rapid tests were provided by the distributors in nine studies. Seven studies recruited a predominantly high risk or symptomatic population; the studies were conducted in America, Asia, Africa, Europe and Oceania, with a median prevalence of 10% (range 8% to 28%); nine different brands were assessed. The mean sensitivity for rapid tests for detecting urogenital infection was 0.48 (95% confidence interval (CI) 0.39 to 0.58; low-quality evidence) with a mean specificity of 0.98 (95% CI 0.97 to 0.99; moderate-quality evidence). We explored sources of heterogeneity by looking into differences in diagnostic accuracy according to the specimen (endocervical versus urine or vaginal), symptoms among participants (symptomatic versus asymptomatic), and setting (low/middle-income versus high-income countries). Likelihood ratio tests were not significantly different in terms of sensitivity or specificity by specimen (P = 0.27) or setting (P = 0.28); for this reason, these covariates do not appear to explain the observed variability. Included studies did not provide enough information to assess the 'presence of symptoms' covariate. We downgraded the quality of evidence because of some limitations in applicability and heterogeneity. AUTHORS' CONCLUSIONS: Based on the results of this systematic review, the POC test based on antigen detection has suboptimal sensitivity but good specificity. Performance of this test translates, on average, to a 52% chance of mistakenly indicating absence of infection and a 2% chance of mistakenly pointing to the presence of this condition. Because of its deleterious consequences for reproductive health, and considering the current availability of safe and effective interventions to treat C trachomatis infection, the POC screening strategy should not be based on a rapid diagnostic test for antigen detection. Research in this topic should focus on different technologies.

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Bovine leptospirosis is often associated with host-adapted leptospires infections, such as strains belonging to the Sejroe serogroup. Although bovine leptospirosis by adapted strains may result in abortions, fetal death, premature births and the birth of weak and/or low-weight calves, this infection is more closely associated with subtler syndromes, such as subfertility and early embryonic death. In this way, this silent disease can go unnoticed and undiagnosed, compromising reproductive efficiency with a consequent decrease in the productivity of herds over long periods. For many years, genital tract infection has been considered a secondary effect of renal infection with the assumption being that leptospires are found in the genital tract due to bacteremia caused by renal colonization. In contrast to this hypothesis, there is some evidence in the literature that suggests that genital leptospirosis should be considered a specific syndrome dissociated from renal/systemic disease. Therefore, this paper aims to gather and critically analyze information about genital leptospirosis in cattle, considering the disease a distinct syndrome, herein denominated bovine genital leptospirosis (BGL), that requires a unique approach to diagnosis and treatment.

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Estudo descritivo, quanti-qualitativo, realizado no Rio de Janeiro, em uma universidade pública, que teve o objetivo de analisar as práticas de prevenção de Infecções Sexualmente Transmissíveis adotadas por jovens universitárias. Os dados quantitativos foram aplicados a uma amostra de 276 estudantes que responderam a um questionário, em 2017. Os qualitativos foram coletados com 27 estudantes que participaram de grupos focais. As informações foram armazenadas com auxílio dos softwares Excel 2007 e Word 2010. Os achados quantitativos foram analisados com emprego da estatística descritiva e os discursivos com emprego da técnica de análise de conteúdo temático categorial. Todos os procedimentos éticos de pesquisa envolvendo seres humanos, recomendados pelo Conselho Nacional de Saúde, foram respeitados. Resultados: Na análise qualitativa, emergiram duas categorias: A informação como recurso para a prevenção de IST e Práticas de cuidado com a saúde adotada pelas jovens; e uma subcategoria: Aspectos influenciadores no uso do preservativo. Na análise dos achados verificou-se que a maioria das participantes têm idades entre 18-24 anos; são heterossexuais; tiveram a primeira relação sexual na faixa etária de 15 a 18 anos; usaram preservativos na primeira relação sexual, mas não utilizam esse recurso em todas as relações. As estudantes não utilizam preservativos nos relacionamentos afetivos com parceiros fixos, contudo empregam-no em relacionamentos com parcerias eventuais. Pode-se notar que o uso de preservativos nas relações sexuais tem associação direta com o tipo de parceria, sendo mais empregado quando não existe confiança no parceiro sexual. Quanto ao preservativo feminino, a maioria das estudantes não adota em função da falta de conhecimento, pela dificuldade de acesso e pelo desconforto. A negociação do uso de preservativos não é uma prática habitual das mulheres, e na maioria das situações essa é uma decisão dos parceiros sexuais, já que muitas não verbalizam a sua opinião. O álcool é outro fator que influencia diretamente no uso de preservativos. As participantes informaram fazer uso de álcool de forma esporádica, porém não utilizaram antes do último intercurso sexual. As jovens buscaram atendimento de saúde no último ano, fizeram exame ginecológico e de Papanicolau. Conclusão: As participantes do estudo relacionam a prática de cuidado com a saúde sexual com o uso de preservativos, embora nem sempre usem esse recurso. O uso de preservativos sofre influencia de diversos fatores que afetam diretamente a adoção desse recurso pelas jovens. As universitárias destacaram a importância da educação em saúde para oferecer informações de qualidade aos jovens sendo uma importante ferramenta para dirimir duvidas e prevenir agravos para a saúde sexual.

Descriptive, quantitative and qualitative study, carried out in Rio de Janeiro, at a public university, which aimed to analyze the prevention practices of Sexually Transmitted Infections adopted by young university students. Quantitative data were applied to a sample of 276 students who answered a questionnaire in 2017. Qualitative data were collected from 27 students who participated in focus groups. The information was stored with the help of Excel 2007 and Word 2010 software. The quantitative findings were analyzed using descriptive statistics and the discursive ones using the categorical thematic content analysis technique. All ethical research procedures involving human beings, recommended by the National Health Council, were respected. Results: In the qualitative analysis, two categories emerged: Information as a resource for STI prevention and Health care practices adopted by young women; and a subcategory: Aspects that influence condom use. In the analysis of the findings, it was found that most participants are aged between 18-24 years; they are heterosexual; had their first sexual intercourse in the 15 to 18 age group; used condoms in the first sexual intercourse, but do not use this resource in all relationships. Students do not use condoms in affective relationships with fixed partners, however they do use them in relationships with occasional partners. It can be noted that the use of condoms during sexual intercourse is directly associated with the type of partnership, being more used when there is no trust in the sexual partner. As for the female condom, most students do not adopt due to the lack of knowledge, the difficulty of access and the discomfort. Negotiating the use of condoms is not a common practice for women, and in most situations this is a decision of sexual partners, as many do not verbalize their opinion. Alcohol is another factor that directly influences the use of condoms. The participants reported making sporadic use of alcohol, but did not use it before the last sexual intercourse. The young women sought health care in the last year, underwent gynecological and Pap tests. Conclusion: Study participants relate the practice of caring for sexual health with the use of condoms, although they do not always use this resource. Condom use is influenced by several factors that directly affect the adoption of this resource by young women. The university students highlighted the importance of health education to offer quality information to young people, being an important tool to resolve doubts and prevent injuries to sexual health.

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RESUMO Objetivos Identificar as condutas de saúde dos homens jovens universitários; conhecer a percepção dos homens jovens universitários sobre o cuidar de sua saúde; e descrever as práticas adotadas para a prevenção das infecções sexualmente transmissíveis. Método Estudo descritivo e exploratório, com abordagem qualitativa, desenvolvido com 25 jovens universitários entre 18-29 anos numa universidade pública do Rio de Janeiro. Para análise dos dados, utilizou-se a técnica de análise de conteúdo. Resultados Os homens jovens universitários percebem o cuidar como feminino, desconhecendo suas próprias particularidades, com a percepção de que não adoecem e, com isso, só procuram o serviço de saúde em situações de emergência. Conclusão e Implicações para a prática Existem desafios a serem vencidos na prática da assistência, como a visão de invulnerabilidade desses homens, a ausência na busca pelos serviços de saúde, o despreparo dos serviços de saúde para atender às necessidades desses jovens, com base em estratégias que contemplem, de forma singular e holística, essa população. As brechas identificadas no estudo permitem levantar futuras questões e provocar mudanças de atitudes voltadas a situações do contexto masculino, a fim de reverter vulnerabilidades ainda existentes e, também, as consequências dessas atitudes na saúde desses homens.

RESUMEN Objetivos Identificar las conductas de salud de hombres jóvenes universitarios; conocer la percepción de ellos sobre el cuidado de su salud; y describir las prácticas adoptadas para la prevención de las infecciones de transmisión sexual. Método Estudio descriptivo y exploratorio, de enfoque cualitativo, desarrollado con 25 universitarios entre 18-29 años en una universidad pública en Rio de Janeiro. Se utilizó la técnica de análisis de contenido. Resultados Los jóvenes perciben el cuidado como algo femenino, sin darse cuenta de sus propias peculiaridades, con la percepción de que no se enferman y, con esto, solo buscan el servicio de salud en situaciones de emergencia. Conclusión e Implicaciones para la práctica Hay desafíos que superar en la práctica de la atención, como la visión de la invulnerabilidad masculina, la ausencia en la búsqueda de servicios de salud, servicios de salud no preparados para satisfacer las necesidades de estos jóvenes a través de estrategias que contemplan de manera única y holística esa población. Las lagunas identificadas nos permiten plantear preguntas futuras y provocar cambios en las actitudes relacionadas con situaciones del contexto masculino, a fin de revertir las vulnerabilidades existentes y también las consecuencias de estas actitudes en la salud de estos hombres.

ABSTRACT Objectives To identify the health behaviors of university students, young men, to know the perception of them about caring for their health, and to describe practices adopted for the prevention of sexually transmitted infections. Method Descriptive and exploratory study, with a qualitative approach, developed with 25 students aged 18-29 at a public university in Rio de Janeiro. To the data analyzed, the content analysis technique was applied. Results Those university students perceived caring as a female practice. They were unaware of their health peculiarities, with the perception that they do not get sick. Because of that, they only seek health services in emergency health conditions. Conclusion and Implications for practice There are challenges to overcome in the practice of men's care. As the vision of the invulnerability of these men, there is an absence in the search for health services.Furthermore, a sort of unprepared health services does not meet the needs of these young people through strategies that contemplate them uniquely and holistically. The gaps identified allow us to raise inevitable questions and bring about changes in attitudes toward situations in the male context. It is necessary to reverse existing vulnerabilities and consequences on the men's health of these men.

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RESUMO Objetivo Comparar a efetividade da comunicação verbal e por cartão no comparecimento de parceiros sexuais de pessoas com infecções sexualmente transmissíveis com fatores associados ao seu êxito. Método Ensaio clínico, controlado, randomizado, cuja intervenção consistiu no oferecimento de um cartão de notificação para os pacientes-índices entregarem aos seus parceiros. Resultados A amostra foi de 189 pacientes-índices, 94 do grupo controle que convidaram verbalmente os parceiros sexuais para atendimento e 95 do grupo intervenção que levaram o cartão de notificação de parceiros como forma de convite para atendimento. Houve comparecimento de 52,6% dos parceiros convidados por cartão, e 43,6% dos convidados verbalmente, mas sem diferença estatística significativa (p=0,215). Os fatores associados ao não êxito no comparecimento de parceiros foram: não residir com o parceiro (p=0,0001), não ter parceiros fixos (p=0,0001), ter parceria casual (p=0,028) e usar preservativo com parceiro fixo (p=0,045). O tipo de infecção não influenciou a vinda do parceiro. Conclusão Face à ausência de maior efetividade na notificação por cartão, recomenda-se outro modelo de cartão contendo informações destinadas a parceiros para ser usado combinado a outros métodos. Registro Brasileiro de Ensaios Clínicos: RBR-7jp5mr.

RESUMEN Objetivo Comparar efectividad de comunicación oral y por tarjeta en la comparecencia de parejas sexuales de personas con enfermedades de transmisión sexual y factores asociados a su éxito. Método Ensayo clínico, controlado, randomizado, con participación consistente en entrega de tarjeta informativa para que los pacientes indicados entreguen a sus parejas. Resultados Muestra de 189 pacientes indicados, 94 del grupo control, que invitaron verbalmente a sus parejas sexuales para atención, y 95 del grupo intervención, que entregaron tarjeta de reporte de parejas como medio de citación a su atención. Comparecieron 52,6% de las parejas invitadas vía tarjeta, y 43,6% de citados oralmente, sin diferencia estadísticamente significante (p=0,215). Los factores asociados al fracaso de la comparecencia de parejas fueron: no residir con la pareja (p=0,0001), tener una relación casual (p=0,028) y utilizar preservativos con la pareja fija (p=0,045). El tipo de infección no influyó en la comparecencia de la pareja. Conclusión Considerando carencia de mayor efectividad del reporte vía tarjeta, se recomienda otro modelo de la misma incluyendo información destinada a parejas para utilizarse combinada con otros métodos. Registro Brasileño de Ensayos Clínicos: RBR-7jp5mr.

ABSTRACT Objective To compare the effectiveness of verbal communication and communication by card in getting sexual partners of people with sexually transmitted infections to attend a health service and the factors associated with the success of these types of communication. Method Clinical, controlled, and randomized study, whose intervention was offering a reporting card for index patients to hand to their sexual partners. Results The sample was 189 index patients, 94 of whom were in the control group, and verbally invited their sexual partners to receive care, and 95 were allocated to the intervention group, and took their partner's reporting card to their partners as a way to invite them to receive care. The percentage of partners invited by card who came to the service was 52.6%, in contrast with 43.6% among partners who were invited verbally, but no significant statistical difference was found (p=0.215). The factors associated with failure to convince partners to come to the service were: not living with the partner (p=0.0001); not having a steady partner (p=0.0001); having casual partners (p=0.028); and using condoms with a steady partner (p=0.045). The infection type did not influence the studied partners' visits to the service. Conclusion Given the failure to achieve effectiveness when applying the reporting by card, the authors recommend another card model containing information for partners to be used in combination with other methods. Brazilian Clinical Trials Registry: RBR-7jp5mr.

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