To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors assoc... more To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among ...
DOAJ (DOAJ: Directory of Open Access Journals), Aug 1, 2014
Background: This study was conducted to investigate factors associated with thrombocytopenia in a... more Background: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. Patients and Methods: This is a retrospective study including 374 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil. All patients had diagnosis of leptospirosis, and acute kidney injury (AKI) was defined according to the RIFLE criteria. Thrombocytopenia was defined as platelets count lower than 100,000/mm3. Results: A total of 374 patients were included, with a mean age of 36.1±15.5 years, and 83.4% were male. Thrombocytopenia was present at hospital admission in 200 cases (53.5%) and developed during hospital stay in 150 cases (40.3%). Patients with thrombocytopenia had a higher frequency of dehydration (53% vs. 35.3%, p=0.001), epistaxis (5.7% vs. 0.8%, p=0.033), hematemesis (13% vs. 4.6%, p=0.006), myalgia (91.5% vs. 84.5%, p=0.038), hematuria (54.8% vs. 37.6%, p=0.011), metabolic acidosis (18% vs. 9.2%, p=0.016) and hypoalbuminemia (17.8% vs. 7.5%, p=0.005). Independent risk factors associated with thrombocytopenia during hospital stay were length of disease (OR: 1.2, p=0.001) and AKI (OR: 6.6, p=0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p=1.000) or during hospital stay (12.6% vs. 11.3%, p=0.748). Conclusions: Thrombocytopenia is a frequent complication in leptospirosis, which was present in more than half of patients at hospital admission. The length of disease and AKI are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality. Advanced age and oliguria were independent risk factors for death.
To estimate hypertension prevalence and associated factors among female correctional officers (FC... more To estimate hypertension prevalence and associated factors among female correctional officers (FCO) in female Brazilian prisons.
Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco asso... more Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto...
The majority of the women in prisons comes from the poorest strata of society with limited access... more The majority of the women in prisons comes from the poorest strata of society with limited access to education, income and health services. This contributes to the fact that female prisoners have a higher burden of adverse health events than both male prisoners and women in general population We objectived to estimate the prevalence of different morbidities and risk factors among female prisoners in Brazil. A total of 1,327 women were recruited in this cross-sectional study. Data were collected using a using audio computer-assisted self-interviewing questionnaire, rapid antibody tests and physical examination. The higher prevalences was of syphilis, infection sexually disease, arterial hypertense, asthma, common mental disorders and severe physical violence. Regarding risk factors, 36.3% have good knowledge about HIV, 55.8% were smokers, 72.3% had ever used any illicit drug, 92.1% are sedentary and 92.1% maintained an unhealthy diet. Female prisoners are disproportionately affected ...
Journal of the Association of Nurses in AIDS Care, 2020
Brazil has the third largest prison population in the world and is also experiencing a high and r... more Brazil has the third largest prison population in the world and is also experiencing a high and rising rate of syphilis infection. To establish the gaps in syphilis testing, we examined data from a nationally representative sample of incarcerated women in Brazil. Data originated from a cross-sectional survey designed to represent all regions of Brazil (N = 1,327). Data were collected by Audio Computer-Assisted Self-Interview, including variables in several blocks or domains. 49.2% had a lifetime history of being tested for syphilis. Increased likelihood of syphilis testing was significantly associated with completed elementary education (odds ratio ajustado [AOR] 1.75, 95% confidence interval [CI] 1.28–2.40), completed high school or more (AOR 2.04, 95% CI 1.36–3.06), income below minimum wage (AOR 1.46, 95% CI 1.10–1.94), homelessness (AOR 1.83, 95% CI 1.21–2.76), having heard of the female condom (AOR 1.92, 95% CI 1.25–2.95), received a condom in prison (AOR 1.56, 95% CI 1.11–2.21...
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2021
Background Mycobacterium leprae was the first microorganism directly associated with a disease, h... more Background Mycobacterium leprae was the first microorganism directly associated with a disease, however, there are still important gaps in our understanding of transmission. Although household contacts are prioritized, there is evidence of the importance of extrahousehold contacts. The goal of this article is to contribute to our understanding of the transmission of leprosy ex-household. Methods We compare co-location data of 397 leprosy cases and 211 controls drawn from the Centro de Dermatologia Sanitária D. Libânia in Fortaleza, Brazil. We collected lifetime geolocation data related to residence, school attendance and workplace and developed novel methods to establish a critical distance (Rc) for exposure and evaluated the potential for transmission for residence, school and workplace. Results Our methods provide different threshold values of distance for residence, school and workplace. Residence networks demonstrate an Rc of about 500 m. Cases cluster in workplaces as well. Sch...
Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, incr... more Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM). Objectives: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO). Methods: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile’s Successive Sampling estimator. Results: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), mor...
The Pediatric infectious disease journal, Jan 22, 2017
Malnutrition results in serious consequences for growth and cognitive development in children. We... more Malnutrition results in serious consequences for growth and cognitive development in children. We studied select child and maternal biological factors, socio-economic factors, enteric pathogenic burden, and gut function biomarkers in 402 children 6-24 months of age in North-eastern Brazil. In this prospective case-control study, not being fed colostrum (odds ratio [OR] = 3.29, 95% confidence interval [CI] 1.73-6.26), maternal age ≥18 years (OR = 1.88, 95% CI 1.10-3.22), and no electrical fan (OR = 2.46, 95% CI 1.22-4.96) or bicycle (OR = 1.80, 95% CI 1.10-2.95) in the household were positively associated, and higher birth weight (OR = 0.27, 95% CI 0.19-0.38), larger head circumference (OR = 0.74, 95% CI 0.66-0.82), and shortness of breath in the last two weeks (OR = 0.49, 95% CI 0.27-0.90) were negatively associated with malnutrition. Subclinical enteric pathogen infections were common, and enteroaggregative Escherichia coli infections were more prevalent in malnourished children (p...
The objectives of this study is to compare ductus venosus (DV) and cerebral transverse sinus (CTS... more The objectives of this study is to compare ductus venosus (DV) and cerebral transverse sinus (CTS) Doppler velocimetry for predicting acidemia at birth in pregnancies complicated by placental insufficiency. A prospective cross-sectional study involving 69 cases. Doppler assessment of the DV and CTS was carried out in the last 24 hours prior to delivery. The sensitivity, specificity, positive and negative predictive values, and the accuracy and false-positive and false-negative rates were calculated for those parameters considered to be good predictors of acidemia. The McNemar test was used to compare the various parameters. The DV pulsatility index(PI), S/A, and (S - A)/S ratios as well as the CTS PI and the (S - A)/S ratio were good predictors of acidemia. The comparison between DV and CTS showed that for pulsatility index for veins, the sensitivity was 52.4% versus 66.7%, p = 0.508; the specificity was 81.2% versus 77.1%, p = 0.774; and the accuracy was 72.5% versus 73.9%, p = 1.0...
Background Despite the preventive policies adopted, reduction in sexually transmitted infections ... more Background Despite the preventive policies adopted, reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of hepatitis C virus (HCV) infection has increased among the most vulnerable population groups, including MSM. The aim of this study was to estimate the prevalence of HCV infection and to assess risky practices among MSM from 12 Brazilian cities. Methods This study was carried out from June to December 2016 using respondent driven sampling (RDS). Participants completed a self-administered questionnaire to collect behavioral, socioeconomic, and demographic variables. In addition, the rapid diagnostic test (RDT) for HCV was offered. Positive results were sent to Instituto Adolfo Lutz for confirmation. Results A total of 4,176 participants were recruited and 23 samples were sent for confirmation. Of these, 16 were confirmed, resulting in a prevalence of 0.7% (95% CI: 0.3%—1.7%). The Southeast region showed a prevalence ...
Introduction: Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive ... more Introduction: Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neoplasms. However, controversy remains as to whether preoperative staging with breast MRI impacts surgical outcomes and local recurrence. Materials and Methods: BREAST-MRI is a randomized, open-label trial including female breast cancer patients older than 18 years old, with stage 0-III disease, eligible for BCS. We performed a 1:1 stratified randomization by breast density according to ACR-BIRADS to divide patients into two groups; one in which preoperative MRI was used and the control group where the MRI was not used. The primary outcome was local relapse-free survival (LR). Secondary outcomes were overall survival (OS), repeat operation, and the proportion of patients whose surgical management was modified to mastectomy. Results: 524 were randomized, 257 included in the MRI group, and 267 in the control group. The baseline characteristics were similar between groups, except for chemo...
Background Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neo... more Background Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neoplasms. Controversy remains about its impact on the preoperative staging of breast cancer surgery. This study evaluated survival and surgical outcomes of preoperative MRI in conservative breast cancer surgery. Methods A phase III, randomized, open-label, single-center trial including female breast cancer participants, stage 0–III disease, and eligible for breast-conserving surgery. We compared the role of including MRI in preoperative evaluation versus radiologic exam routine with mammography and ultrasound in breast cancer conservative candidates. The primary outcome was local relapse-free survival (LRFS), and secondary outcomes were overall survival (OS), mastectomy rate, and reoperation rate. Results 524 were randomized to preoperative MRI group (n = 257) or control group (n = 267). The survival analysis showed a 5.9-years LRFS of 99.2% in MRI group versus 98.9% in control group (HR =...
This study compares the strains of genotypes of M. leprae from nasal secretions (NS) and skin bio... more This study compares the strains of genotypes of M. leprae from nasal secretions (NS) and skin biopsy (SB) in the same patient, supplementing conventional epidemiology to gain insight into the infection of leprosy in Fortaleza, Brazil. The sample consisted of 38 newly diagnosed leprosy patients attending the National Reference Center of Dermatology Dona Libania (CDERM), in Fortaleza, who tested positive for M. leprae by PCR in DNA extracts of nasal secretions. DNA was also extracted from skin biopsy (SB) scrapings of each patient and used for multiplex PCR amplification of M. leprae VNTR loci. The number of repeats at 15 loci were determined by the fragment length analysis method. Locus VNTR genotypes were achieved in 38 NS, and in 38 SB specimens. M. leprae strains differed in their genotypes in paired specimens in all but two of 38 patients. The genotype similarity in the remainder ranged from 53% to 87%. M. leprae 15 VNTR loci genotypes of paired nasal and biopsy skin samples from five patients were identical, while as many as seven loci differed in the 33 other patients. When the NS and biopsy genotypes were pooled and compared, it was found that there was a great variability among different VNTR markers. It is important to investigate other molecular markers suitable for typing genetic variations of the bacilli.
Background: There is a significant shortage of official records that enable estimating the real p... more Background: There is a significant shortage of official records that enable estimating the real prevalence of nontuberculous mycobacteria (NTM) infections in Brazil. The study aims to investigate the clinical, laboratory, and epidemiological aspects of patients with NTM isolation at an infectious diseases reference hospital, and to identify factors associated with mortality. Methods: This was an observational study in which clinical, epidemiological, and laboratory aspects were evaluated in patients with NTM isolated at care in Hospital São José, located in Northeastern Brazil, from 2005 to 2016. The records of the reference laboratory for NTM isolates were searched from the culture results of patients. Afterward, the medical records of the patients were reviewed. The analytical assessment was conducted by the Mann–Whitney and Fisher's exact test. The adopted level of significance was 5%. Results: A total of 69 patients were described, with a predominance of males (73.9%). The m...
To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors assoc... more To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among ...
DOAJ (DOAJ: Directory of Open Access Journals), Aug 1, 2014
Background: This study was conducted to investigate factors associated with thrombocytopenia in a... more Background: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. Patients and Methods: This is a retrospective study including 374 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil. All patients had diagnosis of leptospirosis, and acute kidney injury (AKI) was defined according to the RIFLE criteria. Thrombocytopenia was defined as platelets count lower than 100,000/mm3. Results: A total of 374 patients were included, with a mean age of 36.1±15.5 years, and 83.4% were male. Thrombocytopenia was present at hospital admission in 200 cases (53.5%) and developed during hospital stay in 150 cases (40.3%). Patients with thrombocytopenia had a higher frequency of dehydration (53% vs. 35.3%, p=0.001), epistaxis (5.7% vs. 0.8%, p=0.033), hematemesis (13% vs. 4.6%, p=0.006), myalgia (91.5% vs. 84.5%, p=0.038), hematuria (54.8% vs. 37.6%, p=0.011), metabolic acidosis (18% vs. 9.2%, p=0.016) and hypoalbuminemia (17.8% vs. 7.5%, p=0.005). Independent risk factors associated with thrombocytopenia during hospital stay were length of disease (OR: 1.2, p=0.001) and AKI (OR: 6.6, p=0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p=1.000) or during hospital stay (12.6% vs. 11.3%, p=0.748). Conclusions: Thrombocytopenia is a frequent complication in leptospirosis, which was present in more than half of patients at hospital admission. The length of disease and AKI are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality. Advanced age and oliguria were independent risk factors for death.
To estimate hypertension prevalence and associated factors among female correctional officers (FC... more To estimate hypertension prevalence and associated factors among female correctional officers (FCO) in female Brazilian prisons.
Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco asso... more Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto...
The majority of the women in prisons comes from the poorest strata of society with limited access... more The majority of the women in prisons comes from the poorest strata of society with limited access to education, income and health services. This contributes to the fact that female prisoners have a higher burden of adverse health events than both male prisoners and women in general population We objectived to estimate the prevalence of different morbidities and risk factors among female prisoners in Brazil. A total of 1,327 women were recruited in this cross-sectional study. Data were collected using a using audio computer-assisted self-interviewing questionnaire, rapid antibody tests and physical examination. The higher prevalences was of syphilis, infection sexually disease, arterial hypertense, asthma, common mental disorders and severe physical violence. Regarding risk factors, 36.3% have good knowledge about HIV, 55.8% were smokers, 72.3% had ever used any illicit drug, 92.1% are sedentary and 92.1% maintained an unhealthy diet. Female prisoners are disproportionately affected ...
Journal of the Association of Nurses in AIDS Care, 2020
Brazil has the third largest prison population in the world and is also experiencing a high and r... more Brazil has the third largest prison population in the world and is also experiencing a high and rising rate of syphilis infection. To establish the gaps in syphilis testing, we examined data from a nationally representative sample of incarcerated women in Brazil. Data originated from a cross-sectional survey designed to represent all regions of Brazil (N = 1,327). Data were collected by Audio Computer-Assisted Self-Interview, including variables in several blocks or domains. 49.2% had a lifetime history of being tested for syphilis. Increased likelihood of syphilis testing was significantly associated with completed elementary education (odds ratio ajustado [AOR] 1.75, 95% confidence interval [CI] 1.28–2.40), completed high school or more (AOR 2.04, 95% CI 1.36–3.06), income below minimum wage (AOR 1.46, 95% CI 1.10–1.94), homelessness (AOR 1.83, 95% CI 1.21–2.76), having heard of the female condom (AOR 1.92, 95% CI 1.25–2.95), received a condom in prison (AOR 1.56, 95% CI 1.11–2.21...
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2021
Background Mycobacterium leprae was the first microorganism directly associated with a disease, h... more Background Mycobacterium leprae was the first microorganism directly associated with a disease, however, there are still important gaps in our understanding of transmission. Although household contacts are prioritized, there is evidence of the importance of extrahousehold contacts. The goal of this article is to contribute to our understanding of the transmission of leprosy ex-household. Methods We compare co-location data of 397 leprosy cases and 211 controls drawn from the Centro de Dermatologia Sanitária D. Libânia in Fortaleza, Brazil. We collected lifetime geolocation data related to residence, school attendance and workplace and developed novel methods to establish a critical distance (Rc) for exposure and evaluated the potential for transmission for residence, school and workplace. Results Our methods provide different threshold values of distance for residence, school and workplace. Residence networks demonstrate an Rc of about 500 m. Cases cluster in workplaces as well. Sch...
Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, incr... more Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM). Objectives: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO). Methods: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile’s Successive Sampling estimator. Results: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), mor...
The Pediatric infectious disease journal, Jan 22, 2017
Malnutrition results in serious consequences for growth and cognitive development in children. We... more Malnutrition results in serious consequences for growth and cognitive development in children. We studied select child and maternal biological factors, socio-economic factors, enteric pathogenic burden, and gut function biomarkers in 402 children 6-24 months of age in North-eastern Brazil. In this prospective case-control study, not being fed colostrum (odds ratio [OR] = 3.29, 95% confidence interval [CI] 1.73-6.26), maternal age ≥18 years (OR = 1.88, 95% CI 1.10-3.22), and no electrical fan (OR = 2.46, 95% CI 1.22-4.96) or bicycle (OR = 1.80, 95% CI 1.10-2.95) in the household were positively associated, and higher birth weight (OR = 0.27, 95% CI 0.19-0.38), larger head circumference (OR = 0.74, 95% CI 0.66-0.82), and shortness of breath in the last two weeks (OR = 0.49, 95% CI 0.27-0.90) were negatively associated with malnutrition. Subclinical enteric pathogen infections were common, and enteroaggregative Escherichia coli infections were more prevalent in malnourished children (p...
The objectives of this study is to compare ductus venosus (DV) and cerebral transverse sinus (CTS... more The objectives of this study is to compare ductus venosus (DV) and cerebral transverse sinus (CTS) Doppler velocimetry for predicting acidemia at birth in pregnancies complicated by placental insufficiency. A prospective cross-sectional study involving 69 cases. Doppler assessment of the DV and CTS was carried out in the last 24 hours prior to delivery. The sensitivity, specificity, positive and negative predictive values, and the accuracy and false-positive and false-negative rates were calculated for those parameters considered to be good predictors of acidemia. The McNemar test was used to compare the various parameters. The DV pulsatility index(PI), S/A, and (S - A)/S ratios as well as the CTS PI and the (S - A)/S ratio were good predictors of acidemia. The comparison between DV and CTS showed that for pulsatility index for veins, the sensitivity was 52.4% versus 66.7%, p = 0.508; the specificity was 81.2% versus 77.1%, p = 0.774; and the accuracy was 72.5% versus 73.9%, p = 1.0...
Background Despite the preventive policies adopted, reduction in sexually transmitted infections ... more Background Despite the preventive policies adopted, reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of hepatitis C virus (HCV) infection has increased among the most vulnerable population groups, including MSM. The aim of this study was to estimate the prevalence of HCV infection and to assess risky practices among MSM from 12 Brazilian cities. Methods This study was carried out from June to December 2016 using respondent driven sampling (RDS). Participants completed a self-administered questionnaire to collect behavioral, socioeconomic, and demographic variables. In addition, the rapid diagnostic test (RDT) for HCV was offered. Positive results were sent to Instituto Adolfo Lutz for confirmation. Results A total of 4,176 participants were recruited and 23 samples were sent for confirmation. Of these, 16 were confirmed, resulting in a prevalence of 0.7% (95% CI: 0.3%—1.7%). The Southeast region showed a prevalence ...
Introduction: Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive ... more Introduction: Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neoplasms. However, controversy remains as to whether preoperative staging with breast MRI impacts surgical outcomes and local recurrence. Materials and Methods: BREAST-MRI is a randomized, open-label trial including female breast cancer patients older than 18 years old, with stage 0-III disease, eligible for BCS. We performed a 1:1 stratified randomization by breast density according to ACR-BIRADS to divide patients into two groups; one in which preoperative MRI was used and the control group where the MRI was not used. The primary outcome was local relapse-free survival (LR). Secondary outcomes were overall survival (OS), repeat operation, and the proportion of patients whose surgical management was modified to mastectomy. Results: 524 were randomized, 257 included in the MRI group, and 267 in the control group. The baseline characteristics were similar between groups, except for chemo...
Background Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neo... more Background Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neoplasms. Controversy remains about its impact on the preoperative staging of breast cancer surgery. This study evaluated survival and surgical outcomes of preoperative MRI in conservative breast cancer surgery. Methods A phase III, randomized, open-label, single-center trial including female breast cancer participants, stage 0–III disease, and eligible for breast-conserving surgery. We compared the role of including MRI in preoperative evaluation versus radiologic exam routine with mammography and ultrasound in breast cancer conservative candidates. The primary outcome was local relapse-free survival (LRFS), and secondary outcomes were overall survival (OS), mastectomy rate, and reoperation rate. Results 524 were randomized to preoperative MRI group (n = 257) or control group (n = 267). The survival analysis showed a 5.9-years LRFS of 99.2% in MRI group versus 98.9% in control group (HR =...
This study compares the strains of genotypes of M. leprae from nasal secretions (NS) and skin bio... more This study compares the strains of genotypes of M. leprae from nasal secretions (NS) and skin biopsy (SB) in the same patient, supplementing conventional epidemiology to gain insight into the infection of leprosy in Fortaleza, Brazil. The sample consisted of 38 newly diagnosed leprosy patients attending the National Reference Center of Dermatology Dona Libania (CDERM), in Fortaleza, who tested positive for M. leprae by PCR in DNA extracts of nasal secretions. DNA was also extracted from skin biopsy (SB) scrapings of each patient and used for multiplex PCR amplification of M. leprae VNTR loci. The number of repeats at 15 loci were determined by the fragment length analysis method. Locus VNTR genotypes were achieved in 38 NS, and in 38 SB specimens. M. leprae strains differed in their genotypes in paired specimens in all but two of 38 patients. The genotype similarity in the remainder ranged from 53% to 87%. M. leprae 15 VNTR loci genotypes of paired nasal and biopsy skin samples from five patients were identical, while as many as seven loci differed in the 33 other patients. When the NS and biopsy genotypes were pooled and compared, it was found that there was a great variability among different VNTR markers. It is important to investigate other molecular markers suitable for typing genetic variations of the bacilli.
Background: There is a significant shortage of official records that enable estimating the real p... more Background: There is a significant shortage of official records that enable estimating the real prevalence of nontuberculous mycobacteria (NTM) infections in Brazil. The study aims to investigate the clinical, laboratory, and epidemiological aspects of patients with NTM isolation at an infectious diseases reference hospital, and to identify factors associated with mortality. Methods: This was an observational study in which clinical, epidemiological, and laboratory aspects were evaluated in patients with NTM isolated at care in Hospital São José, located in Northeastern Brazil, from 2005 to 2016. The records of the reference laboratory for NTM isolates were searched from the culture results of patients. Afterward, the medical records of the patients were reviewed. The analytical assessment was conducted by the Mann–Whitney and Fisher's exact test. The adopted level of significance was 5%. Results: A total of 69 patients were described, with a predominance of males (73.9%). The m...
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