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- ItemSomente MetadadadosEffect of race/ethnicity on clinical presentation and risk of gestational trophoblastic neoplasia in patients with complete and partial molar pregnancy at a tertiary care referral center(Mosby-Elsevier, 2016) Gockley, Allison A.; Joseph, Naima T.; Melamed, Alexander; Sun, Sue Yazaki [UNIFESP]; Goodwin, Benjamin; Bernstein, Marilyn; Goldstein, Donald P.; Berkowitz, Ross S.; Horowitz, Neil S.BACKGROUND: The reported incidence of molar pregnancy varies widely among different geographic locations. This variation has been attributed, at least in part, to racial/ethnic differences. While the incidence of molar pregnancies is decreasing, certain ethnic groups such as Hispanics, Asians, and American Indians continue to have an increased risk of developing gestational trophoblastic disease across the globe. OBJECTIVE: We sought to describe the potential effect of ethnicity/race on the presentation and clinical course of complete mole and partial mole. STUDY DESIGN: All patients followed up for complete mole and partial mole at a single institution referral center from 1994 through 2013 were identified. Variables including age, race, gravidity, parity, gestational age, presenting signs/symptoms, serum human chorionic gonadotropin values, and development of gestational trophoblastic neoplasia were extracted from medical records and patient surveys. Patients with complete mole and partial mole were categorized into race/ethnicity groups defined as white, black, Asian, or Hispanic. Due to low numbers of non-white patients with partial mole in each non-white category, patients with partial mole were grouped as white or non-white. Continuous variables were compared using the Kruskal-Wallis test and binary variables were compared using the Fisher exact test. RESULTS: A total of 167 complete mole patients with known race/ethnicity status were included (57.48% white, 14.97% Asian, 14.37% black, 13.17% Hispanic). Hispanics presented at younger age (median 24.5 years) compared to whites (median 32.0 years, P = .04) and Asians median 31.0 years, P = .03). Blacks had higher gravidity than whites (P < .001) and Hispanics (P = .05). There was no significant difference in presenting symptoms, gestational age at diagnosis, and preevacuation serum human chorionic gonadotropin level by race/ethnicity. Hispanics were significantly less likely than whites to develop gestational trophoblastic neoplasia (absolute risk difference, 28.6%
- ItemAcesso aberto (Open Access)Envolvimento religioso e fatores sociodemográficos: resultados de um levantamento nacional no Brasil(Faculdade de Medicina da Universidade de São Paulo, 2010-01-01) Moreira-Almeida, Alexander; Pinsky, Ilana [UNIFESP]; Zaleski, Marcos José Barreto [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Universidade Federal de Juiz de Fora Faculdade de Medicina; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: The relationship between religious involvement and health has been subject to an increasing interest. However, studies investigating religious involvement are scarce outside United States and Europe. OBJECTIVES: This study describes religious involvement in the Brazilian population and its relationship with sociodemographic variables. METHODS: In a Brazilian nationally probabilistic sample (n = 3,007), religious involvement variables and sociodemographic factors were assessed. RESULTS: Five percent of Brazilians reported having no religion, 83% considered religion very important in their lives, and 37% attended religious services at least once a week. The most frequent affiliations were Catholicism (68%), Protestant/Evangelicals (23%), and Kardecist Spiritism (2.5%). Ten percent reported attending more than one religion. In line with studies in other countries, older age and female gender were independently associated with higher levels of subjective and organizational religiousness after controlling for other sociodemographic factors. However, educational level, income and black race were not independently associated with religious involvement variables. DISCUSSION: This study shows high levels of religious involvement among Brazilians and suggests that religiousness may have different associations with other variables across different cultures. To better understand the influence of religion on health, it is necessary to expand this kind of survey to other cultures.
- ItemSomente MetadadadosFetal frontomaxillary facial angle between 11 and 13+6 weeks of gestation in a Brazilian population: influence of different races(Informa Healthcare, 2013-07-01) Nascimento Panigassi, Ana Paula [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Machado Nardozza, Luciano Marcondes [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Silva Pares, David Baptista da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the influence of different races over the measurement of the frontomaxillary facial angle between 11 and 13 + 6 weeks of pregnancy in a Brazilian population.Methods: A cross-sectional study was conducted with 332 healthy pregnant women, with a crown-rump length (CRL) between 47 and 84 mm. Such measurements were taken abdominally, using the mid-sagittal plane, and the angle was measured by tracing a line over the palate and a line from the anterosuperior maxillary angle all the way to the external part of the forehead. As for the reference intervals, a simple linear regression between the frontomaxillary facial angle and the CRL was used, as well as Pearson's correlation coefficient (r). To evaluate the difference between races, a variance analysis was used (ANOVA). To calculate reproducibility, the intraclass correlation coefficient (ICC) was used.Results: the means for the fetal frontomaxillary facial angle in white, black and mixed races were 81.8 +/- 6.6; 82.2 +/- 6.1 and 81.4 +/- 6.2 mm, respectively. There was no statistical difference between races (p = 0.713). A decreasing correlation between the frontomaxillary facial angle and the CRL was observed for the black (r = -0.450) and mixed (r = -0.212) races. Excellent intraobserver reproducibility was observed, as well as a satisfactory interobserver reproducibility, with ICC of 0.858 and 0.605, respectively.Conclusion: There were no significative statistical differences in the measurement of the fetal frontomaxillary facial angle between 11 and 13 + 6 weeks of pregnancy in the different races in a Brazilian population.
- ItemSomente MetadadadosII. 'Race', class and affirmative action in Brazil: Reflections from a feminist perspective(Sage Publications Ltd, 2012-05-01) Mountian, Ilana; Calvo-Gonzalez, Elena [UNIFESP]; Manchester Metropolitan Univ; Universidade Federal de São Paulo (UNIFESP)
- ItemSomente MetadadadosThe impact of ethnic miscegenation on tacrolimus clinical pharmacokinetics and therapeutic drug monitoring(Blackwell Munksgaard, 2002-08-01) Felipe, C. R.; Silva, H. T.; Machado, P. G.; Garcia, R.; Moreira, SRD; Pestana, J. O.; Universidade Federal de São Paulo (UNIFESP)The impact of ethnic miscegenation on tacrolimus clinical pharmacokinetics and therapeutic drug monitoring. We sought to determine the influence of ethnic miscegenation on tacrolimus pharmacokinetics and trough concentrations during the first 6 months after transplantation.Methods: Tacrolimus concentrations were measured in blood samples obtained from 22 transplant recipients during the first week of transplant, within pharmacokinetic profiles, and throughout the first 6 months post-transplant, using the Pro Tac II ELISA method. Pharmacokinetic parameters and between- and within-subject blood concentration variability were compared stratifying the total population in two distinct ethnic groups of white (W) and non-white (NW) patients, according to a stringent criterion.Results: Between-subject variability in dose-adjusted concentrations during dosing interval varied from 38.8 to 69.5%. Compared with W patients, NW patients showed higher variability in blood tacrolimus concentrations during dosing interval (37.40 +/- 5.64 vs. 56.95 +/- 11.49, p < 0.001) and lower drug exposures (AUC: 229.4 +/- 55.5 vs. 66.9 +/- 67.1 ng x h/mL, p=0.036). the correlation coefficients (r(2)) between C-0, C-12 or C-max and AUC were 0.83, 0.91 and 0.5, respectively. An equation derived from early time concentrations (C-0, C-1.5 and C-4) accounted for 94% of the variability observed in AUC. Compared with W patients, a higher proportion of tacrolimus blood determinations during the first week were below 10 νg/mL in NW patients (24% vs. 62%, p=0.028). Tacrolimus absorption increased from week 1-4 (1.1 +/- 0.53 vs. 1.73 +/- 0.97 νg/mL/mg, p < 0.0001) but was still showed high between- (41.6-70.4%) and within-subject (18.2-32.5%) variability, regardless of ethnicity, after stabilization.Conclusion: Non-white patients show higher tacrolimus variability and lower drug exposures after transplantation compared with W patients. Therefore, higher initial tacrolimus doses and intensive monitoring are recommended when administering tacrolimus-based immunosupressive therapy to NW patients of this transplant population.
- ItemSomente MetadadadosLoss of control over eating, adiposity, and psychopathology in overweight children(Wiley-Blackwell, 2002-05-01) Morgan, C. M.; Yanovski, S. Z.; Nguyen, T. T.; McDuffie, J.; Sebring, N. G.; Jorge, M. R.; Keil, M.; Yanovski, J. A.; NIH; Universidade Federal de São Paulo (UNIFESP)Objective: To investigate the relationship between loss of control over eating, adiposity, and psychological distress in a nontreatment sample of overweight children. Method: Based on self-reports of eating episodes, 172 overweight children, 6-10 years old, were categorized using the Questionnaire of Eating and Weight Patterns-Adolescent Version into those describing episodes of loss of control over eating (LC), and those with no loss of control (NoLC). Croups were compared on measures of adiposity, dieting, and eating behavior, and associated psychological distress. Results: LC children (33.1%) were heavier and had greater amounts of body fat than NoLC children. They also had higher anxiety, more depressive symptoms, and more body dissatisfaction. 5.3% met questionnaire criteria for BED. Episodes of loss of control occurred infrequently, were often contextual, and involved usual meal foods. Discussion: As in adults, overweight children reporting loss of control over eating have greater severity of obesity and more psychological distress than those with no such symptoms. It remains unknown whether children who endorse loss of control over eating before adolescence will be those who develop the greatest difficulties with binge eating or obesity in adulthood. (C) 2002 by Wiley Periodicals, Inc.