Background : Brazil has a substantial population living with HIV (PLWH) who are still unaware of ... more Background : Brazil has a substantial population living with HIV (PLWH) who are still unaware of their serostatus and has recently added HIV self-test (HIVST) into its public health system for key populations such as men who have sex with men (MSM). This study estimates HIVST acceptability among Brazilian MSM and its associated factors among those who had never been tested or had a previous HIV negative result. Methods : Respondent-driven sampling (RDS) was used for behavioral and biological surveillance to recruit 4,176 MSM in 12 Brazilian cities in 2016. Descriptive, bivariate and multivariate analyses were conducted. Overall proportions were weighted with Gile’s estimator in RDS Analyst software and 95% confidence intervals were calculated. The analyses of HIVST acceptability were stratified by prior HIV testing (never or one or more times). Results : We included 3,605 MSM who did not previously know they were PLWH. The acceptability of HIVST was 49.1%, lower among those had neve...
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...
Introducao: Doenca de Parkinson e uma doenca neurodegenerativa e progressiva acometendo o sistema... more Introducao: Doenca de Parkinson e uma doenca neurodegenerativa e progressiva acometendo o sistema nigroestriatal dopaminergico. Jogo patologico pode ser descrito como uma atitude recorrente de apostar em jogos de azar apesar das consequencias negativas decorrentes dessa atividade. Objetivo: Esta revisao tem como objetivo investigar a incidencia do uso de agonistas dopaminergicos e o desenvolvimento de jogo patologico em pacientes com doenca de Parkinson. Materiais e Metodos: Foi realizada uma revisao de literatura a cerca do tema proposto, com seus aspectos medicamentosos e suas respectivas vantagens. Resultados: Os resultados nao permitem associar a incidencia de jogo patologico direta e completamente ao uso de agonistas dopaminergicos. Todavia, uma possivel associacao tem sido cada vez mais frequente e descrita nas literaturas especializadas. Conclusao: Conclui-se que sao necessarios ainda mais estudos para a compreensao dos fatores moleculares e bioquimicos subjacentes as caracte...
The present study aims to identify the prevalence of physical violence against female prisoners i... more The present study aims to identify the prevalence of physical violence against female prisoners in Brazil, as well as related factors. This is a cross-sectional national survey conducted in 15 female prisons in five regions of Brazil selected in multiple stages. The following types of analysis were performed: univariate analysis; stratified analysis relating the outcome (suffer physical violence inside prison) to predictor variables, using the Pearson chi-square test; calculation of the Odds Ratio (O.R.); and multiple logistic regression. The Hosmer-Lemeshow test was used for analysis of goodness of fit and adequacy of the model. The prevalence of physical violence inside female prisons was 37.4%. There was a correlation between physical violence victimization in prison and the following variables: physical victimization prior to arrest (p = 0.013), solitary confinement (p = 0.000), mental suffering (p = 0.003), current or previous abusive intake of alcohol (p = 0.011), current or p...
ABSTRACT: Introduction: This paper details the methods used in the second national Biological and... more ABSTRACT: Introduction: This paper details the methods used in the second national Biological and Behavioral Surveillance Survey (BBSS) of HIV, syphilis, and hepatitis B and C among men who have sex with men in Brazil. Methods: Respondent-driven sampling (RDS) was used in 12 cities in 2016. The targeted sample size was initiated with five to six seeds in each city. HIV, syphilis, and Hepatitis B and C rapid tests were offered to participants. RDS Analyst with Gile’s successive sampling (SS) estimator was used to adjust results as recommended and a weight for each individual was generated for further analysis. Data for the 12 cities were merged and analyzed using Stata 14.0 complex survey data tools with each city treated as its own stratum. Results: Duration of data collection varied from 5.9 to 17.6 weeks. 4,176 men were recruited in the 12 cities. Two sites failed to achieve targeted sample size due to a six-month delay in local IRB approval. No city failed to reach convergence in...
OBJETIVO: A população idosa está aumentando em todo o mundo, assim como a necessidade de cuidados... more OBJETIVO: A população idosa está aumentando em todo o mundo, assim como a necessidade de cuidados intensivos para os idosos. Existem poucos estudos que investiguem os fatores de risco para óbito em pacientes idosos gravemente enfermos. Este estudo teve o objetivo de investigar os fatores associados ao óbito em uma população de pacientes idosos gravemente enfermos admitidos a uma unidade de terapia intensiva no Brasil. MÉTODOS: Estudo retrospectivo de coorte que incluiu todos os pacientes idosos (idade > 60 anos) admitidos a uma unidade de terapia intensiva em Fortaleza, Brasil, de janeiro a dezembro de 2007. Foi realizada uma comparação entre os sobreviventes e os não sobreviventes, e os fatores de risco para óbito foram investigados por meio de análise univariada e multivariada. RESULTADOS: Foi incluído um total de 84 pacientes, com uma média de idade de 73 ± 7,6 anos, sendo 59% do gênero feminino. A mortalidade foi de 62,8%. A principal causa de morte foi disfunção de múltiplos...
Medication noncompliance has a harmful impact on reaching therapeutic goals of delaying the progr... more Medication noncompliance has a harmful impact on reaching therapeutic goals of delaying the progression of chronic kidney disease (CKD). The aim of the present study is to calculate the prevalence of medication noncompliance and to identify medication noncompliance-associated factors in CKD. A cross-sectional study was performed with 130 CKD patients from a university nephrology outpatient clinic, mean age 48.8 +/- 15.8 years, who were continuously self-administering an antihypertensive or immunosuppressive drug, and who were neither on dialysis nor had received a kidney transplant. Noncompliance was measured through self-report (during an interview) and physician assessment. Patients were considered noncompliers if noncompliance had been detected by any of these methods. Sociodemographic, clinical and laboratory and medication characteristics were surveyed, as well as patients' knowledge regarding prescribed medicines and opinions of the quality of the health care service provi...
INTRODUÇÃO: A tuberculose multirresistente é uma ameaça ao controle da tuberculose em todo o mund... more INTRODUÇÃO: A tuberculose multirresistente é uma ameaça ao controle da tuberculose em todo o mundo. Tratamento inadequado é freqüentemente apontado como fator de risco para tuberculose multirresistente. OBJETIVO: Identificar fatores associados ao tratamento inadequado em portadores de tuberculose multirresistente. MÉTODO: Foram levantados e identificados os testes de sensibilidade para tuberculose, realizados no Laboratório Central do Estado do Ceará de 1990 a 1999. Foi realizado um estudo retrospectivo e prospectivo, em grupo de portadores de tuberculose multirresistente, comparando as características dos pacientes com tratamento adequado com as dos com tratamentos inadequados. Foi considerado multirresistente o bacilo resistente a pelo menos rifampicina + isoniazida e utilizado o método das proporções. RESULTADOS: Dos 1.500 testes de sensibilidade realizados, 266 eram multirresistentes. Destes, identificaram-se apenas 153 pacientes, dos quais 19 foram excluídos, restando, no estud...
Background : Brazil has a substantial population living with HIV (PLWH) who are still unaware of ... more Background : Brazil has a substantial population living with HIV (PLWH) who are still unaware of their serostatus and has recently added HIV self-test (HIVST) into its public health system for key populations such as men who have sex with men (MSM). This study estimates HIVST acceptability among Brazilian MSM and its associated factors among those who had never been tested or had a previous HIV negative result. Methods : Respondent-driven sampling (RDS) was used for behavioral and biological surveillance to recruit 4,176 MSM in 12 Brazilian cities in 2016. Descriptive, bivariate and multivariate analyses were conducted. Overall proportions were weighted with Gile’s estimator in RDS Analyst software and 95% confidence intervals were calculated. The analyses of HIVST acceptability were stratified by prior HIV testing (never or one or more times). Results : We included 3,605 MSM who did not previously know they were PLWH. The acceptability of HIVST was 49.1%, lower among those had neve...
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...
Introducao: Doenca de Parkinson e uma doenca neurodegenerativa e progressiva acometendo o sistema... more Introducao: Doenca de Parkinson e uma doenca neurodegenerativa e progressiva acometendo o sistema nigroestriatal dopaminergico. Jogo patologico pode ser descrito como uma atitude recorrente de apostar em jogos de azar apesar das consequencias negativas decorrentes dessa atividade. Objetivo: Esta revisao tem como objetivo investigar a incidencia do uso de agonistas dopaminergicos e o desenvolvimento de jogo patologico em pacientes com doenca de Parkinson. Materiais e Metodos: Foi realizada uma revisao de literatura a cerca do tema proposto, com seus aspectos medicamentosos e suas respectivas vantagens. Resultados: Os resultados nao permitem associar a incidencia de jogo patologico direta e completamente ao uso de agonistas dopaminergicos. Todavia, uma possivel associacao tem sido cada vez mais frequente e descrita nas literaturas especializadas. Conclusao: Conclui-se que sao necessarios ainda mais estudos para a compreensao dos fatores moleculares e bioquimicos subjacentes as caracte...
The present study aims to identify the prevalence of physical violence against female prisoners i... more The present study aims to identify the prevalence of physical violence against female prisoners in Brazil, as well as related factors. This is a cross-sectional national survey conducted in 15 female prisons in five regions of Brazil selected in multiple stages. The following types of analysis were performed: univariate analysis; stratified analysis relating the outcome (suffer physical violence inside prison) to predictor variables, using the Pearson chi-square test; calculation of the Odds Ratio (O.R.); and multiple logistic regression. The Hosmer-Lemeshow test was used for analysis of goodness of fit and adequacy of the model. The prevalence of physical violence inside female prisons was 37.4%. There was a correlation between physical violence victimization in prison and the following variables: physical victimization prior to arrest (p = 0.013), solitary confinement (p = 0.000), mental suffering (p = 0.003), current or previous abusive intake of alcohol (p = 0.011), current or p...
ABSTRACT: Introduction: This paper details the methods used in the second national Biological and... more ABSTRACT: Introduction: This paper details the methods used in the second national Biological and Behavioral Surveillance Survey (BBSS) of HIV, syphilis, and hepatitis B and C among men who have sex with men in Brazil. Methods: Respondent-driven sampling (RDS) was used in 12 cities in 2016. The targeted sample size was initiated with five to six seeds in each city. HIV, syphilis, and Hepatitis B and C rapid tests were offered to participants. RDS Analyst with Gile’s successive sampling (SS) estimator was used to adjust results as recommended and a weight for each individual was generated for further analysis. Data for the 12 cities were merged and analyzed using Stata 14.0 complex survey data tools with each city treated as its own stratum. Results: Duration of data collection varied from 5.9 to 17.6 weeks. 4,176 men were recruited in the 12 cities. Two sites failed to achieve targeted sample size due to a six-month delay in local IRB approval. No city failed to reach convergence in...
OBJETIVO: A população idosa está aumentando em todo o mundo, assim como a necessidade de cuidados... more OBJETIVO: A população idosa está aumentando em todo o mundo, assim como a necessidade de cuidados intensivos para os idosos. Existem poucos estudos que investiguem os fatores de risco para óbito em pacientes idosos gravemente enfermos. Este estudo teve o objetivo de investigar os fatores associados ao óbito em uma população de pacientes idosos gravemente enfermos admitidos a uma unidade de terapia intensiva no Brasil. MÉTODOS: Estudo retrospectivo de coorte que incluiu todos os pacientes idosos (idade > 60 anos) admitidos a uma unidade de terapia intensiva em Fortaleza, Brasil, de janeiro a dezembro de 2007. Foi realizada uma comparação entre os sobreviventes e os não sobreviventes, e os fatores de risco para óbito foram investigados por meio de análise univariada e multivariada. RESULTADOS: Foi incluído um total de 84 pacientes, com uma média de idade de 73 ± 7,6 anos, sendo 59% do gênero feminino. A mortalidade foi de 62,8%. A principal causa de morte foi disfunção de múltiplos...
Medication noncompliance has a harmful impact on reaching therapeutic goals of delaying the progr... more Medication noncompliance has a harmful impact on reaching therapeutic goals of delaying the progression of chronic kidney disease (CKD). The aim of the present study is to calculate the prevalence of medication noncompliance and to identify medication noncompliance-associated factors in CKD. A cross-sectional study was performed with 130 CKD patients from a university nephrology outpatient clinic, mean age 48.8 +/- 15.8 years, who were continuously self-administering an antihypertensive or immunosuppressive drug, and who were neither on dialysis nor had received a kidney transplant. Noncompliance was measured through self-report (during an interview) and physician assessment. Patients were considered noncompliers if noncompliance had been detected by any of these methods. Sociodemographic, clinical and laboratory and medication characteristics were surveyed, as well as patients' knowledge regarding prescribed medicines and opinions of the quality of the health care service provi...
INTRODUÇÃO: A tuberculose multirresistente é uma ameaça ao controle da tuberculose em todo o mund... more INTRODUÇÃO: A tuberculose multirresistente é uma ameaça ao controle da tuberculose em todo o mundo. Tratamento inadequado é freqüentemente apontado como fator de risco para tuberculose multirresistente. OBJETIVO: Identificar fatores associados ao tratamento inadequado em portadores de tuberculose multirresistente. MÉTODO: Foram levantados e identificados os testes de sensibilidade para tuberculose, realizados no Laboratório Central do Estado do Ceará de 1990 a 1999. Foi realizado um estudo retrospectivo e prospectivo, em grupo de portadores de tuberculose multirresistente, comparando as características dos pacientes com tratamento adequado com as dos com tratamentos inadequados. Foi considerado multirresistente o bacilo resistente a pelo menos rifampicina + isoniazida e utilizado o método das proporções. RESULTADOS: Dos 1.500 testes de sensibilidade realizados, 266 eram multirresistentes. Destes, identificaram-se apenas 153 pacientes, dos quais 19 foram excluídos, restando, no estud...
Background. Disseminated histoplasmosis is common in AIDS patients with advanced immunosuppressio... more Background. Disseminated histoplasmosis is common in AIDS patients with advanced immunosuppression in Ceará, Northeastern Brazil. The goal of this study was to determine the prevalence of Histoplasma infection in patients with HIV/AIDS living in Fortaleza, the capital of Ceará. Methods. Intradermal tests with histoplasmin (mycelial phase) were performed in 161 HIV patients with CD4 ≥ 350 cells/mm3. Evidence of recent illness was evaluated with immunodiffusion (ID) tests in 76 of these individuals. Results. A total of 11.8% of patients reacted to histoplasmin and 2.63% had ID test positive to Histoplasma. The presence of mango trees (Mangifera indica) in the patient neighborhood (OR = 2.870; 95% CI = 1.081-7.617; p = 0.040) and past activity involving soil (OR = 2.834; 95% CI = 1.045-7.687; p = 0.045) or visits to a farm (OR = 3.869; 95% CI = 1.189-12.591; p = 0.033) were significantly associated with Histoplasma infection. Conclusions. Patients with HIV living in Fortaleza have an expressive prevalence of infection with Histoplasma.
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