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São Paulo, Brazil

Sampaio P.B.,Federal University of Espirito Santo | Madeira E.S.,Curso de Medicina | Diniz L.,Federal University of Espirito Santo | Noia E.L.,Federal University of Espirito Santo | Zandonade E.,Federal University of Espirito Santo
Revista da Sociedade Brasileira de Medicina Tropical | Year: 2013

Introduction: Leprosy remains a relevant public health issue in Brazil. The objective of this study was to analyze the spatial distribution of new cases of leprosy and to detect areas with higher risks of disease in the City of Vitória. Methods: The study was ecologically based on the spatial distribution of leprosy in the City of Vitória, State of Espirito Santo between 2005 and 2009. The data sources used came from the available records of the State Health Secretary of Espirito Santo. A global and local empirical Bayesian method was used in the spatial analysis to produce a leprosy risk estimation, and the fluctuation effect was smoothed from the detection coefficients. Results: The study used thematic maps to illustrate that leprosy is distributed heterogeneously between the neighborhoods and that it is possible to identify areas with high risk of disease. The Pearson correlation coefficient of 0.926 (p = 0.001) for the Local Method indicated highly correlated coefficients. The Moran index was calculated to evaluate correlations between the incidences of adjoining districts. Conclusions: We identified the spatial contexts in which there were the highest incidence rates of leprosy in Vitória during the studied period. The results contribute to the knowledge of the spatial distribution of leprosy in the City of Vitória, which can help establish more cost-effective control strategies because they indicate specific regions and priority planning activities that can interfere with the transmission chain.


Parreira J.G.,Santa Casa de Misericordia de Sao Paulo | Vianna A.M.F.,Santa Casa de Misericordia de Sao Paulo | Cardoso G.S.,Santa Casa de Misericordia de Sao Paulo | Karakhanian W.Z.,Santa Casa de Misericordia de Sao Paulo | And 4 more authors.
Revista da Associacao Medica Brasileira | Year: 2010

Objective. Assess characteristics of trauma patients who sustained falls from their own height, more specifically focusing on presence of severe injuries, diagnosis and treatment. Methods. Retrospective study including all adult blunt trauma patients admitted in the emergency room in a period of 9 months. Lesions with AIS (Abbreviated Injury Scale)>3 were considered "severe". Variables were compared between victims of fall from their own height (group I) and other blunt trauma mechanisms (group II). Student's t, chi square and Fisher exact tests were used for statistical analysis, considering p<0.05 as significant. Results. Of the 1993 trauma patients included, 305 (15%) were victims of falls from their own height. In group I, mean age was 52.2 ± 20.8 years and 64.8% were male. Injuries in the head segment were the most frequently observed (62.2%), followed by injuries in the extremities (22.3%), thorax (1.3%) and abdomen (0.7%). Severe injuries (AIS≥3) were more frequent in the head (8.9%), followed by extremities (4,9%). In group I, craniotomies were needed in 2.3%. By comparing groups, we observed that victims of falls from their own height had significantly higher mean age, highermean systolic blood pressure, and higher head AIS mean, as well as lower ISS mean, thorax AIS mean, abdomen AIS mean and extremities AIS mean. Conclusion. Importance of the trauma mechanism in victims of falls from own height should be emphasized due to a considerable possibility of occult severe injuries, mainly in the cephalic segment.


Rosa R.S.,Curso de Medicina | Martinelli A.L.C.,University of Sao Paulo | Passos A.D.C.,University of Sao Paulo
Revista da Sociedade Brasileira de Medicina Tropical | Year: 2014

Introduction: Hepatitis C virus (HCV) is primarily transmitted via contact with the blood of infected patients, although the form of contact has not been identified for a significant percentage of carriers. The present study evaluated possible risk factors for HCV transmission in a medium-sized town located in the northwest region of the State of São Paulo. Methods: This was a case-control study, with the case group consisting of 190 chronic HCV carriers older than 18 years residing in the municipality of Catanduva. The control group also consisted of 190 individuals with HCV-negative serology. The groups were paired (1:1) for gender, age range (± five years), and place of residence. The same structured questionnaire was applied to all subjects, who gave written informed consent to participate in the study. The data were statistically analyzed using crude and adjusted logistic regression, and the results were expressed as odds ratios with a 95% confidence interval. Results: The demographic profiles of the groups indicated a predominance of males (68.9%) and mean ages of 47.1 years (case group) and 47.3 years (control group). After adjusting for conditional regression, the following factors were found to represent risks for HCV: history of sexually transmitted disease (STD) and blood transfusion; accidents with syringes and/or needles; tattoos; and the use of non-injectable drugs and injectable medications. Conclusions: The transmission of HCV via the blood route has been well characterized. Other forms of contact with human blood and/or secretions are likely to transmit the virus, although with a lower frequency of occurrence.


Pranchevicius M.C.,Curso de Medicina
Bioengineered | Year: 2013

Cancer is one of the most important health problems because many cases are difficult to prevent. Cancer still has unknown mechanisms of pathogenesis, and its capacity to produce temporary or permanent damage, besides death, is very high. Although many anticancer therapies are available, finding a cure for cancer continues to be a difficult task. Thus, many efforts have been made to develop more effective treatments, such as immunotherapy based on a new class of tumor-specific products that are produced using recombinant DNA technology. These recombinant products are used with the main objectives of killing the tumor and stimulating immune cells to respond to the cancer cells. The principal recombinant products in anticancer therapy are immunostimulants, vaccines, antibodies, immunotoxins and fusion proteins. This review focuses on the general aspects of these genetically engineered products, their clinical performance, current advances and future prospects for this type of anticancer therapy.


Ferreira L.C.B.,Lutheran University of Brazil | Regner A.,Lutheran University of Brazil | Miotto K.D.L.,Curso de Medicina | Moura S.D.,Curso de Medicina | And 4 more authors.
Brain Injury | Year: 2014

Background: Despite the involvement of cytokine production in neurotrauma, there is still controversy regarding cytokines levels and clinical outcome following severe traumatic brain injury (TBI). Objective: The present study was designed to investigate whether cytokine levels (of IL-1β, IL-6, IL-8, IL-10, IL-12p70 and TNF-α) are associated with primary outcome (death or survival) after severe TBI. Methods: This prospective study enrolled 24 male patients, victims of severe TBI. Venous blood samples were taken in the Intensive Care Unit (ICU) (study entry), 24 and 48 hours later. Plasma cytokine levels were assayed by flow cytometry. Results: Severe TBI was associated with a 42% mortality rate. TBI patients had a significant increase in the levels of all cytokines measured, except for IL-1β, compared to controls. Statistically significant increases in the IL-10, -8 and -6 levels were observed in the non-survivors TBI patients compared to the survivors sub-group measured in the first sample (study entry) and in the subsequent sample (24 hours later). There were no significant differences in IL-1β, TNF-α and IL-12p70 levels between survivors and non-survivors in any time sampled. Conclusions: The findings indicate that increased IL-10, -8 and -6 levels may constitute an early predictor of unfavourable outcome in severe TBI patients. © 2014 Informa UK Ltd.

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