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1.
Med Oral Patol Oral Cir Bucal ; 28(4): e347-e354, 2023 Jul 01.
Article in English | MEDLINE | ID: mdl-36641745

ABSTRACT

BACKGROUND: gingival/alveolar mucosal reactive hyperplastic lesions (GRHL), including fibrous hyperplasia (FH), pyogenic granuloma (PG), peripheral ossifying fibroma (POF) and peripheral giant cell lesion (PGCL), are a common group of oral diseases. The aim of the present study was to access the frequency and distribution of the clinical and histological features of these disorders in a Brazilian population. MATERIAL AND METHODS: all specimens diagnosed as GRHL in three Oral Pathology laboratories were selected for the study. Clinical information was retrieved from the laboratory biopsy forms and hematoxylin and eosin stained histological slides were reviewed for analysis of the histological characteristics. RESULTS: final sample was composed of 996 specimens, including 463 FH (47%), 280 PG (28%), 183 POF (18%) and 70 PGCL (7%). Females were more affected by FH, PG, and POF, and most cases affected adults with mean ages ranging from 40 to 53 years. FH, PG, and POF were more common in the upper gingiva/alveolar mucosa. Most PG, POF and PGCL were pedunculated, in contrast with FH (p<0.001). PG, FH and POF were mostly red or normal mucosal in color, while PGCL were mostly red/purple (p<0.001). PGCL were larger, followed by POF, FH and PG (p<0.001). Some histological features were characteristically found in some conditions, but they were also encountered in other lesions with variable frequencies. CONCLUSIONS: Oral medicine specialists, oral pathologists and periodontists are usually the professionals in contact with patients presenting GRHL and it is of upmost relevance that they should be familiarized with their clinical and histological profile.


Subject(s)
Fibroma, Ossifying , Gingival Neoplasms , Granuloma, Pyogenic , Adult , Female , Humans , Middle Aged , Gingiva , Retrospective Studies , Hyperplasia/pathology , Gingival Neoplasms/pathology , Fibroma, Ossifying/epidemiology , Fibroma, Ossifying/pathology , Granuloma, Pyogenic/epidemiology , Granuloma, Pyogenic/pathology
2.
Clin Lymphoma Myeloma Leuk ; 22(1): e1-e6, 2022 01.
Article in English | MEDLINE | ID: mdl-34429274

ABSTRACT

BACKGROUND: Myelodysplastic Syndrome (MDS) with isolated deletion 5q is associated with a low risk to leukemic evolution and long overall survival (OS); it comprises 3%-4.5% of MDS cases in Latin America classified according to the World Health Organization 2008. This study aims to describe clinical, laboratory and the outcome of patients according to the newest World Health Organization 2016 proposal. METHODS: We retrospectively reviewed patients from four Brazilian (BR) and four Argentinean (AR) centers diagnosed between 1999 and 2019. RESULTS: The 58 patients (16-AR and 42-BR) presented a median age of 67 (IQR 61-75) years old, women predominance (70.7%) and transfusion dependency (62.5%) at diagnosis. Median hemoglobin level was 8.1g/dL, 27.5% and 44.4% presented thrombocytosis and neutropenia, respectively. Bone marrow (BM) was predominantly hypercellular (43.1%) with 66% showing dysplasia >1 lineage and 37.9% with >2% of blasts. Deletion 5q was mostly isolated (79.3%) and a variety of abnormalities were observed in remaining cases. Most patients were treated with erythropoietin-stimulating agents (ESA), 18 with lenalidomide and 15 with thalidomide. Median follow-up was 7.6 years, with a median OS of 3.5 years and an 8-years leukemic evolution rate of 18.4%. Multivariate analysis showed that age >75 years (HR 2.19), ECOG ≥2 (HR 5.76), BM blasts >2% (HR 2.92) and lenalidomide treatment (HR 0.25) independently influenced the OS. CONCLUSION: Older age, worse performance status and higher percentage of blasts, that can be easily assessed, were associated to a worse prognosis. Also, our results corroborate the protective influence of lenalidomide in terms of OS in this South American series.


Subject(s)
Chromosomes, Human, Pair 5/genetics , Lenalidomide/therapeutic use , Myelodysplastic Syndromes/drug therapy , Age Factors , Aged , Chromosome Deletion , Female , Humans , Lenalidomide/pharmacology , Male , Middle Aged , Myelodysplastic Syndromes/mortality , Retrospective Studies , Survival Analysis , Treatment Outcome
3.
Clin Oral Investig ; 25(12): 6653-6659, 2021 Dec.
Article in English | MEDLINE | ID: mdl-33895916

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the preventive effect of ozonated oil on the development of MRONJ-like lesions at tooth extraction sites in rats submitted to zoledronic acid treatment. MATERIALS AND METHODS: Twelve rats were divided into two groups. Each rat received an injection of zoledronic acid solution once a week for 5 weeks before having its upper first molar extracted. In group 1, the clotted socket was maintained, while in the group 2, the socket was treated with ozonated oil for 10 min/day during 3 days. After euthanasia, block resection was performed for histological analysis. Necrotic bone was defined as the area of the bone with empty osteocyte lacunae and vital bone as the area with osteocyte-occupied lacunae. RESULTS: There was no statistically significant difference between the groups in the average area of vital bone (p = 0.2248) and the average area of necrotic bone (p = 0.1208). However, the average area of vital bone in group 1 was smaller (24.1 ± 2.9 cells/cm2) than in group 2 (26.8 ± 4.2 cells/cm2), and the average area of necrotic bone in group 1 was higher (7.0 ± 2.5 cells/cm2) than in group 2 (4.0 ± 1.1 cells/cm2), indicating that ozonated oil may reduce the development of osteonecrosis. CONCLUSIONS: Our findings suggest that ozonated oil might prevent MRONJ-like lesions at tooth extraction sites in rats submitted to a disease induction protocol. Further research should be conducted to confirm this hypothesis. CLINICAL RELEVANCE: MRONJ has been reported as a complication of surgical dental procedures, and there are currently no predictable preventive therapies.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Density Conservation Agents , Animals , Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control , Diphosphonates , Rats , Tooth Extraction , Zoledronic Acid
4.
Med Oral Patol Oral Cir Bucal ; 24(3): e305-e313, 2019 May 01.
Article in English | MEDLINE | ID: mdl-31011141

ABSTRACT

BACKGROUND: To evaluate the frequency of maxillary dentures-related lesions and the possible associated risk factors. MATERIAL AND METHODS: Ninety-seven participants were selected, and a complete anamnesis, physical examination and tests of occlusion vertical dimension (OVD), retention and stability of the denture, biofilm quantification, cytopathology, sialometry, pH analysis and buffer capacity of the saliva were performed. Statistical analyses were performed with the Pearson's chi-square, Mann-Whitney tests, and Pearson's coefficient (p<0.05). RESULTS: In 78% of the participants at least one denture-related lesion was found. Denture-associated stomatitis (63%), inflammatory fibrous hyperplasia (19%) and traumatic ulceration (11%) were the 3 most frequent lesions. The habit of night use of the denture was considered an independent risk factor for the development of oral lesions [OR=3.0 (95% CI 1.09-8.56); p<0.05]. Furthermore, the longest period of use of the same denture and biofilm also had statistically significant relation to oral lesions. The biofilm seems to be more related to the prevalence of oral lesions according to the multiple logistic regression [OR=1.3 (95% CI: 1.01-1.83) p<0.05]. The lack of a dentures' cleaning solution and detrition of the prothesis were independent risk factors for denture-associated stomatitis. Male gender, loss of OVD and bad buffer capacity were risk factors for angular cheilitis. Fractures of the base and repair of broken dentures were risk factors for traumatic ulcers. CONCLUSIONS: These results show a high frequency of denture-related lesions. Besides, participants hygiene habits and poor quality of the dentures were the main factors for the development of these lesions.


Subject(s)
Dentures , Stomatitis, Denture , Cross-Sectional Studies , Humans , Male , Maxilla , Risk Factors
5.
Int Endod J ; 51(7): 738-746, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29363148

ABSTRACT

AIM: To evaluate the association between the presence of selected bacterial species/groups in the apical root canal and expression of mediators of soft and bone tissue destruction in apical periodontitis lesions. Relationships between bacteria and some other features of apical periodontitis were also investigated. METHODOLOGY: Seventeen freshly extracted teeth with pulp necrosis and apical periodontitis were included. The apical root segment was sectioned and cryopulverized; DNA was extracted and evaluated for the presence of 9 bacterial species/groups using real-time polymerase chain reaction. Lesions were processed for histopathological and immunohistochemical analyses, which targeted matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9), receptor activator of NFκB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG). Associations of the target bacteria with expression of these mediators, presence of symptoms, lesion size and histopathological diagnosis were evaluated. Data were analysed using the chi-square, Fisher's exact, Mann-Whitney and Pearson tests. P values lower than 0.05 were considered significant. RESULTS: All pulverized apical root samples were positive for bacteria. The most prevalent taxa were Actinobacteria (53%), Streptococcus species (35%), Fusobacterium species and Parvimonas micra (18%). The target mediators exhibited a high mean expression in the lesions (MMP-2: 82%; MMP-9: 73%; RANK: 78%; RANKL; 81%; OPG; 83%). Mean RANKL:OPG ratio was significantly higher in granulomas than cysts (P < 0.05, Mann-Whitney test). Actinobacteria were associated with granulomas, higher MMP-2 expression, lower OPG expression, and higher RANKL:OPG ratio (P < 0.05 for all, Fisher's exact test or Mann-Whitney test). No other significant associations were found. CONCLUSION: Actinobacteria may play an important role in the active phase of soft and bone tissue destruction in apical periodontitis.


Subject(s)
Dental Pulp Cavity/microbiology , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , Matrix Metalloproteinases/metabolism , Osteoprotegerin/metabolism , Periapical Periodontitis/microbiology , RANK Ligand/metabolism , Receptor Activator of Nuclear Factor-kappa B/metabolism , Tooth Apex/microbiology , Adult , Aged , Dental Pulp Cavity/metabolism , Dental Pulp Necrosis/metabolism , Dental Pulp Necrosis/microbiology , Female , Fusobacterium , Humans , Male , Middle Aged , Periapical Periodontitis/metabolism , Real-Time Polymerase Chain Reaction , Streptococcus , Tooth Apex/metabolism
6.
Genome Announc ; 5(9)2017 Mar 02.
Article in English | MEDLINE | ID: mdl-28254970

ABSTRACT

Here, we report the complete genome sequence of the BeAn 58058 virus (prototype) strain, isolated from a wild rodent Oryzomys sp. in the Utinga forest, Belém, state of Pará, Brazil in 1963. The genome of this virus showed similarity to the Poxviridae family, suggesting its inclusion in a possible new genus.

7.
Oral Dis ; 22(6): 523-9, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27029007

ABSTRACT

OBJECTIVE: To evaluate comparatively the influence of histopathological features on epithelial dysplasia (ED) and the effectiveness in usage of WHO and binary grading systems in actinic cheilitis (AC). MATERIAL AND METHODS: Cytological and architectural alterations established by WHO for ED were evaluated in 107 cases of AC. Epithelial dysplasia was graded using WHO and binary systems. The comparisons were performed using kappa, chi-square, and phi coefficient tests (P < 0.05). RESULTS: Most cases were classified as mild ED (44.5%) in the WHO system and as low risk for malignant transformation (64.5%) in the binary system. There was a positive correlation between WHO and binary systems (k = 0.33; P < 0.0002). Loss of basal cell polarity (P < 0.001) was associated with severity of ED grade in the WHO system. Anisonucleosis (P < 0.0001), nuclear pleomorphism (P < 0.0001), anisocytosis (P = 0.03), cell pleomorphism (P = 0.002) increased nuclear/cytoplasm ratio (P < 0.0001), increased nuclear size (P < 0.0001), increased number of mitotic figures (P = 0.0006), and dyskeratosis (P = 0.008) were associated with severity of ED grade in the binary system. CONCLUSIONS: It seems that usage of binary ED grading system in AC may be more precise because there is correlation between many of cytological and some of architectural microscopic alterations with increased grade of ED.


Subject(s)
Cheilitis/pathology , Adult , Aged , Aged, 80 and over , Cell Transformation, Neoplastic , Epithelium/pathology , Female , Humans , Male , Middle Aged , World Health Organization , Young Adult
8.
AJNR Am J Neuroradiol ; 36(6): 1039-42, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25678481

ABSTRACT

BACKGROUND AND PURPOSE: Because evidence-based articles are difficult to recognize among the large volume of publications available, some journals have adopted evidence-based medicine criteria to classify their articles. Our purpose was to determine whether an evidence-based medicine classification used by a subspecialty-imaging journal allowed consistent categorization of levels of evidence among different raters. MATERIALS AND METHODS: One hundred consecutive articles in the American Journal of Neuroradiology were classified as to their level of evidence by the 2 original manuscript reviewers, and their interobserver agreement was calculated. After publication, abstracts and titles were reprinted and independently ranked by 3 different radiologists at 2 different time points. Interobserver and intraobserver agreement was calculated for these radiologists. RESULTS: The interobserver agreement between the original manuscript reviewers was -0.2283 (standard error = 0.0000; 95% CI, -0.2283 to -0.2283); among the 3 postpublication reviewers for the first evaluation, it was 0.1899 (standard error = 0.0383; 95% CI, 0.1149-0.2649); and for the second evaluation, performed 3 months later, it was 0.1145 (standard error = 0.0350; 95% CI, 0.0460-0.1831). The intraobserver agreement was 0.2344 (standard error = 0.0660; 95% CI, 0.1050-0.3639), 0.3826 (standard error = 0.0738; 95% CI, 0.2379-0.5272), and 0.6611 (standard error = 0.0656; 95% CI, 0.5325-0.7898) for the 3 postpublication evaluators, respectively. These results show no-to-fair interreviewer agreement and a tendency to slight intrareviewer agreement. CONCLUSIONS: Inconsistent use of evidence-based criteria by different raters limits their utility when attempting to classify neuroradiology-related articles.


Subject(s)
Evidence-Based Medicine/classification , Periodicals as Topic/standards , Humans , Observer Variation
9.
Braz J Med Biol Res ; 45(11): 1074-9, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22911347

ABSTRACT

Eighty-six newly diagnosed multiple myeloma (MM) patients from a public hospital of São Paulo (Brazil) were evaluated by cIg-FISH for the presence of del(13)(q14), t(4;14)(p16.3;q32) and del(17)(p13). These abnormalities were observed in 46.5, 9.3, and 7.0% of the patients, respectively. In order to identify the possible role of del(13)(q14) in the physiopathology of MM, we investigated the association between this abnormality and the proliferative and apoptotic indexes of plasma cells. When cases demonstrating t(4;14)(p16.3;q32) and del(17)(p13) were excluded from the analysis, we observed a trend towards a positive correlation between the proportion of cells carrying del(13)(q14) and plasma cell proliferation, determined by Ki-67 expression (r = 0.23, P = 0.06). On the other hand, no correlation between the proportion of cells carrying del(13)(q14) and apoptosis, determined by annexin-V staining, was detected (r = 0.05, P = 0.69). In general, patients carrying del(13)(q14) did not have lower survival than patients without del(13)(q14) (P = 0.15), but patients with more than 80% of cells carrying del(13)(q14) showed a lower overall survival (P = 0.033). These results suggest that, when del(13)(q14) is observed in a high proportion of malignant cells, it may have a role in determining MM prognosis. Another finding was a statistically significant lower overall survival of patients with t(4;14)(p16.3;q32) (P = 0.026). In the present study, almost half the patients with t(4;14)(p16.3;q32) died just after diagnosis, before starting treatment. This fact suggests that, in São Paulo, there may be even more patients with this chromosomal abnormality, but they probably die before being diagnosed due to unfavorable socioeconomic conditions. This could explain the low prevalence of this chromosomal abnormality observed in the present study.


Subject(s)
Apoptosis/genetics , Chromosome Aberrations , Multiple Myeloma/genetics , Multiple Myeloma/pathology , Adult , Aged , Aged, 80 and over , Bone Marrow/pathology , Cell Proliferation , Female , Flow Cytometry , Humans , In Situ Hybridization, Fluorescence , Male , Middle Aged , Plasma Cells/pathology , Survival Analysis
10.
Epidemiol Infect ; 139(12): 1818-26, 2011 Dec.
Article in English | MEDLINE | ID: mdl-21396147

ABSTRACT

In order to analyse the impact of vaccination against cytomegalovirus (CMV) on congenital infection incidence using current vaccines tested in phase II clinical trials, we simulated different scenarios by mathematical modelling, departing from the current vaccine characteristics, varying age at vaccination, immunity waning, vaccine efficacy and mixing patterns. Our results indicated that the optimal age for a single vaccination interval is from 2 to 6 months if there is no immunity waning. Congenital infection may increase if vaccine-induced immunity wanes before 20 years. Congenital disease should increase further when the mixing pattern includes transmission among children with a short duration of protection vaccine. Thus, the best vaccination strategy is a combined schedule: before age 1 year plus a second dose at 10-11 years. For CMV vaccines with low efficacy, such as the current ones, universal vaccination against CMV should be considered for infants and teenagers.


Subject(s)
Cytomegalovirus Infections/prevention & control , Cytomegalovirus Vaccines/immunology , Models, Immunological , Adolescent , Adult , Age Factors , Brazil/epidemiology , Child , Computer Simulation , Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/epidemiology , Cytomegalovirus Infections/transmission , Humans , Infant , Seroepidemiologic Studies , Young Adult
11.
Epidemiol Infect ; 137(12): 1809-15, 2009 Dec.
Article in English | MEDLINE | ID: mdl-19470195

ABSTRACT

Seroprevalence data from a representative population were used to estimate the annual incidence of congenital toxoplasmosis in São Paulo Metropolitan Region (SPMR). Retrospective anti-toxoplasma IgG serological analysis was conducted to determine age-dependent seroprevalence, force of infection, average age of acquisition of infection and curve of decay of maternally derived antibodies. Seroprevalence was used to calculate the number of new infections. Toxoplasmosis in pregnant women was estimated by total number of deliveries in a given year as a proxy for the number of pregnancies per year. Toxoplasma seroprevalence was 64.9% in women of childbearing age. Average age of acquisition of toxoplasmosis was 10.74 years. The estimated annual incidence of congenital toxoplasmosis varied from 9.5 to 10.6/1000 births in the studied period. The toxoplasmosis seroprevalence model allowed a good incidence estimation of congenital disease in SPMR compared to other published data, indicating that this mathematical approach is useful in calculating the potential demand of congenital disease due to Toxoplasma gondii in a given community.


Subject(s)
Toxoplasma/immunology , Toxoplasmosis/epidemiology , Adolescent , Adult , Age Distribution , Animals , Antibodies, Protozoan/blood , Brazil/epidemiology , Child , Child, Preschool , Cities , Female , Humans , Immunoglobulin G/blood , Infant , Infant, Newborn , Pregnancy , Seroepidemiologic Studies , Time Factors , Toxoplasmosis/blood , Young Adult
12.
Int J Oral Maxillofac Surg ; 38(8): 855-60, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19395238

ABSTRACT

Lichen sclerosus is a chronic inflammatory mucocutaneous disease, rarely involving the mouth. There are only 20 well-documented cases of oral lichen sclerosus reported in the English-language literature. This report describes the clinicopathological features of 6 cases of oral lichen sclerosus; 5 in women. There were 12 lesions, mainly on the lips (50%) and buccal mucosa (25%). The affected areas appeared as irregular whitish patches, harder than the surrounding tissue. Half of the patients were symptomatic and presented with no associated skin and/or genital lesions. All cases were biopsied, and histopathological features were evaluated using hematoxylin-eosin and Verhoeff's stains, S-100 immunohistochemical reaction and transmission electron microscopy. Management of the oral lesions consisted of surgical excision, intralesional triamcinolone acetonide, oral colchicine, and regular follow-up. There is no effective curative treatment, but there are some options for patient management; and colchicine may be considered an additional choice.


Subject(s)
Lichen Sclerosus et Atrophicus/pathology , Mouth Diseases/pathology , Administration, Oral , Adolescent , Adult , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Biopsy , Child , Colchicine/administration & dosage , Colchicine/therapeutic use , Diagnosis, Differential , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Humans , Immunohistochemistry , Injections, Intralesional , Lichen Sclerosus et Atrophicus/drug therapy , Lichen Sclerosus et Atrophicus/surgery , Lip Diseases/drug therapy , Lip Diseases/pathology , Lip Diseases/surgery , Male , Microscopy, Electron, Transmission , Mouth Diseases/drug therapy , Mouth Diseases/surgery , Mouth Mucosa/pathology , Retrospective Studies , S100 Proteins/analysis , Tongue Diseases/drug therapy , Tongue Diseases/pathology , Tongue Diseases/surgery , Treatment Outcome , Triamcinolone Acetonide/administration & dosage , Triamcinolone Acetonide/therapeutic use , Young Adult
13.
Vaccine ; 26(49): 6281-91, 2008 Nov 18.
Article in English | MEDLINE | ID: mdl-18674582

ABSTRACT

This study conducts a cost-effectiveness analysis of a childhood universal varicella vaccination program in Brazil. An age and time-dependent dynamic model was developed to estimate the incidence of varicella for 30 years. Assuming a single-dose schedule; vaccine efficacy of 85% and coverage of 80%, the program could prevent 74,422,058 cases and 2905 deaths. It would cost R$ 3,178,396,110 and save R$ 660,076,410 to the society and R$ 365,602,305 to the healthcare system. The program is cost-effective (R$ 14,749 and R$ 16,582 per life-year saved under the societal and the healthcare system's perspective, respectively). The program's cost-effectiveness is highly sensitive to the vaccine price and number of doses.


Subject(s)
Chickenpox Vaccine/economics , Chickenpox/epidemiology , Chickenpox/prevention & control , Immunization Programs/economics , Mass Vaccination/economics , Adolescent , Adult , Algorithms , Brazil/epidemiology , Chickenpox Vaccine/therapeutic use , Child , Child, Preschool , Cost of Illness , Cost-Benefit Analysis , Health Care Costs , Hospitalization/economics , Hospitalization/statistics & numerical data , Humans , Infant , Models, Economic , Models, Statistical , Transportation of Patients/economics , Young Adult
14.
Epidemiol Infect ; 133(5): 951-6, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16181518

ABSTRACT

The seroepidemiology of Cryptosporidium infection was investigated in a representative sample of a normal population in the State of Sao Paulo, Brazil using a recombinant form of the immunodominant 27-kDa sporozoite antigen. IgG seropositivity was low in infants following loss of maternal antibody but quickly increased to approximately 60% by 5 years, then 80% by the age of 10 years, after which prevalence remained constant. The broad range of antibody concentrations is consistent with previous reports that the IgG response to C. parvum is short-lived. There is also evidence that average antibody concentrations increase with age. Results suggest that the recombinant antigen may be a more sensitive method of measuring seroprevalence than the native antigen in Western blot. Although cross-sectional studies can provide an insight into the epidemiology of C. parvum in normal populations, further studies investigating the dynamics of the humoral immune responses to Cryptosporidium and the use of serology in epidemiological studies are required.


Subject(s)
Cryptosporidiosis/epidemiology , Cryptosporidium/immunology , Immunoglobulin G/blood , Adolescent , Adult , Age Factors , Animals , Antibodies, Protozoan/blood , Brazil/epidemiology , Child , Child, Preschool , Cryptosporidiosis/blood , Cryptosporidiosis/parasitology , Cryptosporidium/isolation & purification , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Infant , Infant, Newborn , Male , Predictive Value of Tests , Seroepidemiologic Studies , Urban Health
15.
Braz. j. med. biol. res ; 37(5): 771-776, May 2004. tab
Article in English | LILACS | ID: lil-357550

ABSTRACT

The purpose of the present study was to determine the vulnerability of women in prison to HIV infection. The study was carried out from August to October 2000 in a São Paulo State Penitentiary, where 299 female prisoners were serving time. We interviewed and obtained a blood sample from 290 females who agreed to enter the study. Sera were tested for the presence of antibodies to HIV, hepatitis C virus (HCV) and syphilis and the odds ratio (OR) was calculated for variables related to HIV positivity on the basis of a questionnaire. The overall prevalence data were: 13.9 percent for HIV (37 of 267), 22.8 percent for syphilis (66 of 290), and 16.2 percent for HCV (47 of 290). Sexual partnership variables were significantly related to HIV infection. These included HIV-positive partners (OR = 7.36, P = 0.0001), casual partners (OR = 8.96, P = 0.009), injectable drug user partners (OR = 4.7, P = 0.0001), and history of sexually transmitted disease (OR = 2.07, P = 0.05). In addition, a relationship was detected between HIV infection and drug use (OR = 2.48, P = 0.04) and injectable drug use (OR = 4.2, P = 0.002). Even women with only one partner presented a significant OR for HIV infection (OR = 2.57, P = 0.009), reflecting their vulnerability due to their trust in their partner, who did not use a condom. Although the use of injectable substances is associated with HIV infection, our results point to sexual behavior as the most important component of HIV transmission in the female prisoner population.


Subject(s)
Humans , Male , Female , HIV Infections , Prisoners , Seroepidemiologic Studies , Brazil , Risk Factors , Surveys and Questionnaires
16.
Braz J Med Biol Res ; 37(5): 771-6, 2004 May.
Article in English | MEDLINE | ID: mdl-15107941

ABSTRACT

The purpose of the present study was to determine the vulnerability of women in prison to HIV infection. The study was carried out from August to October 2000 in a São Paulo State Penitentiary, where 299 female prisoners were serving time. We interviewed and obtained a blood sample from 290 females who agreed to enter the study. Sera were tested for the presence of antibodies to HIV, hepatitis C virus (HCV) and syphilis and the odds ratio (OR) was calculated for variables related to HIV positivity on the basis of a questionnaire. The overall prevalence data were: 13.9% for HIV (37 of 267), 22.8% for syphilis (66 of 290), and 16.2% for HCV (47 of 290). Sexual partnership variables were significantly related to HIV infection. These included HIV-positive partners (OR = 7.36, P = 0.0001), casual partners (OR = 8.96, P = 0.009), injectable drug user partners (OR = 4.7, P = 0.0001), and history of sexually transmitted disease (OR = 2.07, P = 0.05). In addition, a relationship was detected between HIV infection and drug use (OR = 2.48, P = 0.04) and injectable drug use (OR = 4.2, P = 0.002). Even women with only one partner presented a significant OR for HIV infection (OR = 2.57, P = 0.009), reflecting their vulnerability due to their trust in their partner, who did not use a condom. Although the use of injectable substances is associated with HIV infection, our results point to sexual behavior as the most important component of HIV transmission in the female prisoner population.


Subject(s)
HIV Infections/epidemiology , Prisoners , Brazil/epidemiology , Female , HIV Infections/diagnosis , Humans , Male , Risk Factors , Seroepidemiologic Studies , Surveys and Questionnaires
17.
Phys Rev E Stat Nonlin Soft Matter Phys ; 67(5 Pt 1): 051907, 2003 May.
Article in English | MEDLINE | ID: mdl-12786178

ABSTRACT

In this paper, we analyze the temporal evolution of the age-dependent force of infection and incidence of rubella, after the introduction of a very specific vaccination program in a previously nonvaccinated population where rubella was in endemic steady state. We deduce an integral equation for the age-dependent force of infection, which depends on a number of parameters that can be estimated from the force of infection in a steady state prior to the vaccination program. We present the results of our simulations, which are compared with observed data. We also examine the influence of contact patterns among members of a community on the age-dependent intensity of transmission of rubella and on the results of vaccination strategies. As an example of the theory proposed, we calculate the effects of vaccination strategies for four communities from Caieiras (Brazil), Huixquilucan (Mexico), Finland, and the United Kingdom. The results for each community differ considerably according to the distinct intensity and pattern of transmission in the absence of vaccination. We conclude that this simple vaccination program is not very efficient (very slow) in the goal of eradicating the disease. This gives support to a mixed strategy, proposed by Massad et al., accepted and implemented by the government of the State of São Paulo, Brazil.


Subject(s)
Rubella Vaccine/therapeutic use , Rubella/epidemiology , Rubella/prevention & control , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Middle Aged , Models, Theoretical , Time Factors , Vaccination/methods
18.
Vaccine ; 20(1-2): 226-34, 2001 Oct 12.
Article in English | MEDLINE | ID: mdl-11567768

ABSTRACT

In order to investigate if the changing levels of measles antibody in women resulting from extensive vaccination programs influence the susceptibility of children, we measured the seroprevalence of measles virus antibody of children in the first year of life and of their mothers. We compared maternal antibody decay of two groups of children: those whose mothers were 25 years old or more (mothers born in the pre-vaccination era), and less than 25 years old (mothers born in the vaccination era). Therefore, the 25-year-age cut-off was chosen to distinguish between vaccinated and non-vaccinated mothers. We also compared the immunogenicity of measles vaccine in children from 6 to 12 months of age, in these two groups and also according to their mother's serostatus. The optimal age of vaccination for a routine program was estimated by means of mathematical models. This study was carried out in a sample of 1216 mothers and their respective children. Our results indicate that the optimal age for vaccination of the whole sample was 15 months, 17 months for children born from older mothers, 14 months for children born from younger mothers, 17 months for children born from seropositive mothers and 12 months for children born from seronegative mothers. Therefore, a change to an earlier age of routine vaccination is not justified by our results.


Subject(s)
Antibodies, Viral/blood , Immunization Programs , Immunization Schedule , Measles Vaccine/administration & dosage , Measles/prevention & control , Vaccination/methods , Adult , Age Factors , Antibodies, Viral/biosynthesis , Antibodies, Viral/immunology , Brazil , Disease Outbreaks , Female , Humans , Immunity, Maternally-Acquired , Infant , Infant, Newborn , Maternal Age , Measles/epidemiology , Measles Vaccine/immunology , Risk Assessment , Seroepidemiologic Studies , Urban Population , Vaccination/statistics & numerical data
19.
Rev Saude Publica ; 35(2): 124-9, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11359197

ABSTRACT

INTRODUCTION: After the era of rubella vaccine, cytomegalovirus (CMV) infection is one of the most frequently causes of mental retardation and congenital deafness. Seroepidemiological studies are necessary to understand the transmission dynamics of the disease. The purpose of the study was to quantify the transmission rate of CMV disease in a community in the state of São Paulo, Brazil. METHODS: Using ELISA test (IgG), a retrospective serological survey looking for CMV antibodies was performed in an non-immunized community. Frozen sera from 443 individuals, randomly selected by cluster sampling technique in the town of Caieiras, São Paulo, were collected from November 1990 to January 1991. Seroprevalence was stratified by age (0-40 years). Mathematical techniques were applied to determine the age-dependent decay function of maternal antibodies during the first year of life, the age-dependent seroprevalence function and the force of infection for CMV in this community. RESULTS: It was observed a descending phase of seropositivity in the first 9 months, but changes in antibody titration were observed between 8 months old and one year of age. The average age of the first infection was 5.02 months of age and 19.84 years, when the age-dependent seroprevalence and the force of infection were analyzed between 10 months of age and 10 years of age and from 10 to 40 years old, respectively. CONCLUSION: CMV infection is highly prevalent among the population studied and infection occurs in the first year of life. This study shows that most women at reproductive age are vulnerable to the first infection, increasing the risk for congenital infection.


Subject(s)
Cytomegalovirus Infections/epidemiology , Cytomegalovirus/immunology , Adolescent , Adult , Antibodies, Viral/isolation & purification , Brazil/epidemiology , Child , Child, Preschool , Cytomegalovirus Infections/transmission , Female , Humans , Immunoglobulin G/isolation & purification , Infant , Infant, Newborn , Retrospective Studies , Seroepidemiologic Studies
20.
Rev. saúde pública ; 35(2): 124-9, abr. 2001. tab, ilus
Article in English | LILACS | ID: lil-283217

ABSTRACT

Introdução: Após a era da vacinação contra a rubéola, a citomegalovirose tornou-se uma das causas mais freqüentes de surdez congênita e retardamento mental. Estudos soroepidemiológicos são necessários para entender a dinâmica de transmissão da doença. O objetivo do estudo foi quantificar a transmissão dessa doença em comunidade do Estado de São Paulo, Brasil. Métodos: Foi realizado estudo sorológico retrospectivo utilizando anticorpos contra o citomegalovírus (CMV) de classe IgG, pelo método ELISA, em soros congelados de 443 indivíduos, randomizados e selecionados pela técnica de Cluster, provenientes da comunidade de Caieiras, uma pequena cidade localizada nos arredores de São Paulo. As amostras foram colhidas entre novembro de 1990 e janeiro de 1991. No estudo da soroprevalência estratificada por idade (0 a 40 anos), foram aplicadas técnicas matématicas para a determinação da função de decaimento de anticorpos maternos durante o primeiro ano de vida, da função de soroprevalência por idade e da força de infecção para o CMV na comunidade. Resultados: Foi observada uma fase descendente da soropositividade durante os primeiros nove meses, porém ocorreram mudanças nos títulos de anticorpos entre oito meses e um ano de vida. A idade média de aquisição da primeira infecção foi de 5,02 meses e 18,84 anos, quando se analisaram a soroprevalência e a força de infecção, idade dependentes, respectivamente entre 10 meses e 10 anos e 10 e 40 anos. Conclusões: A citomegalovirose é altamente prevalente na população estudada e ocorre precocemente já no primeiro ano de vida. O estudo demonstrou que mulheres em idade reprodutiva se encontravam vulneráveis à primeira infecção, aumentando a chance de doença congênita


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Cytomegalovirus Infections/transmission , Epidemiologic Studies , Enzyme-Linked Immunosorbent Assay , Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/epidemiology , Infectious Disease Transmission, Vertical , Age Factors , Disease Transmission, Infectious
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