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Navegando por Palavras-chave "incidence"

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Acesso aberto (Open Access)
Amyotrophic lateral sclerosis in Brazil: 1998 national survey
(Academia Brasileira de Neurologia - ABNEURO, 2000-09-01) Dietrich-neto, Flávia; Callegaro, Dagoberto; Dias-Tosta, Elza; Silva, Helga Cristina Almeida da [UNIFESP]; Ferraz, Maria Elizabeth [UNIFESP]; Lima, José Mauro Braz de; Oliveira, Acary Souza Bulle [UNIFESP]; Aventis Pharma; Universidade de São Paulo (USP); Hospital de Base do Distrito Federal Head of Neurology Unit; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro Neurological Institute
OBJECTIVES: To assess the epidemiologic characteristics of amyotrophic lateral sclerosis (ALS) in Brazil in 1998. METHOD: Structured Clinical Report Forms (CRFs) sent to 2,505 Brazilian neurologists from January to September 1998 to be filled with demographic and clinical data regarding any ALS patient seen at any time during that year. RESULTS: Five hundred and forty CRFs were returned by 168 neurologists. Data on 443 patients meeting the criteria of probable or definite ALS according to El Escorial definition were analysed: 63 probable (14.2%) and 380 definite (85.8%). Two hundred and fifty-nine (58.5%) of the patients were male, mean age of onset was 52. Spinal onset occurred in 306 patients (69%); bulbar onset in 82 (18.5%), and both in 52 (11.7%). Twenty-six (5.9%) had a family history of ALS. Two hundred and fifty-nine (58.6%) were seen by private practitioners, and 178 (40.2%) at a hospital clinic. Age-ajusted incidence shows a peak incidence at the 65-74 years old range. CONCLUSIONS: The disease's characteristics are similar to those described in international studies, except for age of onset (Brazilian patients are younger). This difference is not confirmed when figures are age-adjusted.
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Estimating the incidence of systemic lupus erythematosus in a tropical region (Natal, Brazil)
(Arnold, Hodder Headline Plc, 2002-01-01) Vilar, MJP; Sato, E. I.; Univ Fed Rio Grande Norte; Universidade Federal de São Paulo (UNIFESP)
The objective of the study was to evaluate the incidence of Systemic Lupus Erythematosus (SLE) in a tropical urban community (Natal city, Brazil). Only patients living in Natal, a city in the northeastern area of Brazil, older than 15 years, and who fulfilled at least four of the American College of Rheumatology criteria between 1 January 2000 and 31 December 2000, were included. Four sources were used to identify new cases of SLE: (1) the University Hospital; (2) 'health units' and hospitals of the public health network; (3) specialists at private hospitals and outpatient clinics, and (4) three laboratories performing antinuclear antibody (ANA) determination. Census data from 2000 for Brazilian population was used to calculate incidence rate. the standardized mortality ratio (SMR) method and 95% confidence intervals (95% Cl) were calculated.Forty-three patients were diagnosed as new SLE cases in 2000. the calculated incidence was 8.7/100000/year (95% CI 6.3-11.7). Thirty-eight patients were female 14.1/100000/year (95% CI 10.0-19.3) and five were male 2.2/100000/year (95% CI 0.7-5.2). the mean age of new SLE cases was 31.8 years old. (95% CI 27.8-35.8). the mean age for females was 31.4 and for males was 35.0 years old. the median of disease duration (time between onset of the first ACR criterion for SLE and diagnosis) was 10 months (1 - 72 months).This study demonstrated a high incidence of SLE in Natal, apparently higher than reported in other places. the mean age at diagnosis seems lower than referred by other studies. the observed differences may be due to ethnic and/or environmental factors.
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Historical epidemiology of hepatitis C virus (HCV) in selected countries
(Wiley-Blackwell, 2014-05-01) Bruggmann, P.; Berg, T.; Ovrehus, A. L. H.; Moreno, C.; Brandao Mello, C. E.; Roudot-Thoraval, F.; Marinho, R. T.; Sherman, M.; Ryder, S. D.; Sperl, J.; Akarca, U.; Balik, I.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Buti, M.; Calinas, F.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cornberg, M.; Cramp, M. E.; Dore, G. J.; Doss, W.; Duberg, A. S.; El-Sayed, M. H.; Ergor, G.; Esmat, G.; Estes, C.; Falconer, K.; Felix, J.; Ferraz, Maria Lucia Gomes [UNIFESP]; Ferreira, Paulo Roberto [UNIFESP]; Frankova, S.; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L.; Gower, E.; Gschwantler, M.; Guimaraes Pessoa, M.; Hezode, C.; Hofer, H.; Husa, P.; Idilman, R.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Lazaro, P.; Marotta, P.; Mauss, S.; Mendes Correa, M. C.; Muellhaupt, B.; Myers, R. P.; Negro, F.; Nemecek, V.; Ormeci, N.; Parkes, J.; Peltekian, K. M.; Ramji, A.; Razavi, H.; Reis, N.; Roberts, S. K.; Rosenberg, W. M.; Sarmento-Castro, R.; Sarrazin, C.; Semela, D.; Shiha, G. E.; Sievert, W.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; van Thiel, I.; Van Vlierberghe, H.; Vandijck, D.; Vogel, W.; Waked, I.; Wedemeyer, H.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Van Damme, P.; Aleman, S.; Hindman, S. J.; Arud Ctr Addict Med; Univ Leipzig; Odense Univ Hosp; Univ Libre Brussels; Universidade Federal do Rio de Janeiro (UFRJ); Hop Henri Mondor; Hosp Santa Maria; Univ Toronto; Nottingham Univ Hosp NHS Trust; Biomed Res Unit; Inst Clin & Expt Med; Ege Univ; Ankara Univ; Osped Cantonale; Univ Montreal; Adv Tech Hlth Serv Res TAISS; Hosp Valle de Hebron; Hosp Santo Antonio Capuchos; Hosp Puerta Hierro; Univ Fed Rio Grande do Sul; Region Hosp Hovedstaden; Hannover Med Sch; German Liver Fdn; Univ Plymouth; Univ New S Wales; Cairo Univ; Orebro Univ Hosp; Univ Orebro; Ain Shams Univ; Dokuz Eylul Univ; Ctr Dis Anal CDA; Karolinska Inst; Exigo Consultores; Universidade Federal de São Paulo (UNIFESP); Hosp Carlos III; Univ Copenhagen; Direccao Geral Saude; Universidade Estadual de Campinas (UNICAMP); Wilhelminenspital Stadt Wien; Universidade de São Paulo (USP); Med Univ Vienna; Masaryk Univ; Univ Manitoba; Hlth Sci Ctr; European Liver Patients Assoc; Istanbul Univ; Univ British Columbia; Aalborg Univ Hosp; Katholieke Univ Leuven; Univ Western Ontario; Univ Dusseldorf; Univ Zurich Hosp; Univ Calgary; Univ Hosp; Natl Inst Publ Hlth; Univ Southhampton; Dalhousie Univ; Capital Dist Hlth Author; Assembleia Republ; Alfred Hosp; Monash Univ; UCL; Ctr Hosp Porto; JW Goethe Univ Hosp; Cantonal Hosp St Gallen; Egyptian Liver Res Inst & Hosp ELRIAH; Monash Hlth; Catholic Univ Louvain; Med Univ Graz; St Vincents Hosp; Univ Melbourne; Charles Univ Prague; Cent Mil Hosp; Deutsch Leberhilfe eV; Ghent Univ Hosp; Univ Ghent; Hasselt Univ; Med Univ Innsbruck; Natl Liver Inst; Copenhagen Univ Hosp; Univ Antwerp; Karolinska Univ Hosp
Chronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. for some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. the largest viremic populations were in Egypt, with 6358000 cases in 2008 and Brazil with 2106000 cases in 2007. the age distribution of cases differed between countries. in most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level.
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How Can We Estimate Sepsis Incidence and Mortality?
(Lippincott Williams & Wilkins, 2017) Nunes Gobatto, Andre Luiz; Maccagnan Pinheiro Besen, Bruno Adler; Azevedo, Luciano Cesar Pontes [UNIFESP]
Sepsis is one of the oldest and complex syndromes in medicine that has been in debate for over two millennia. Valid and comparable data on the population burden of sepsis constitute an essential resource for guiding health policy and resource allocation. Despite current epidemiological data suggesting that the global burden of sepsis is huge, the knowledge of its incidence, prevalence, mortality, and case-fatality rates is subject to several flaws. The objective of this narrative review is to assess how sepsis incidence and mortality can be estimated, providing examples on how it has been done so far in medical literature and discussing its possible biases. Results of recent studies suggest that sepsis incidence rates are increasing consistently during the last decades. Although estimates might be biased, this probably reflects a real increase in incidence over time. Nevertheless, case fatality rates have decreased, which is a probable reflex of advances in critical care provision to this very sick population at high risk of death. This conclusion can only be drawn with a reasonable degree of certainty for high-income countries. Conversely, adequately designed studies from middle-and low-income countries are urgently needed. In these countries, sepsis incidence and case-fatality rates could be disproportionally higher due to health care provision constraints and ineffective preventive measures.
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Incidence and Main Risk Factors for Severe Retinopathy of Prematurity in Infants Weighing Less Than 1000 Grams in Brazil
(Oxford Univ Press, 2013-12-01) Fortes Filho, Joao Borges; Borges Fortes, Barbara Gastal; Tartarella, Marcia Beatriz [UNIFESP]; Procianoy, Renato Soibelmann; Univ Fed Rio Grande do Sul; Universidade Federal de São Paulo (UNIFESP)
Objectives: This study evaluated the incidence and risk factors for severe retinopathy of prematurity (ROP) in babies <1000 g at Porto Alegre, Brazil.Methods: Prospective cohort study including premature children with birth weight <= 1000 g was conducted. Main outcome was the occurrence of severe ROP needing treatment.Results: A total of 157 infants were included. Severe ROP occurred in 20 infants (12.7%). Nineteen patients were treated by laser photocoagulation. Main risk factors for severe ROP were gestational age (P=0.029), infant's weight measured at sixth week of life (P<0.001) and number of days of oxygen therapy under mechanical ventilation (P<0.001). After logistic regression, infant's weight at sixth week of life and number of days in mechanical ventilation were associated to severe ROP.Conclusions: We reported the incidence of 12.7% of severe ROP among babies born <= 1000 g in our institution. Laser photocoagulation was effective to stabilize the disease among 19 treated patients.
Acesso aberto (Open Access)
Incidência de lúpus eritematoso sistêmico em Natal, RN - Brasil
(Sociedade Brasileira de Reumatologia, 2003-12-01) Vilar, Maria José Pereira; Rodrigues, Juliana Martins; Sato, Emilia Inoue [UNIFESP]; Universidade Federal do Rio Grande do Norte Departamento de Medicina Clínica; UFRN Hospital Universitário Onofre Lopes; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To study the incidence of Systemic Lupus Erythematosus (SLE) in the city of Natal, Brazil. METHODS: Only patients living in the city of Natal, older than 15 years old, who fulfilled at least 4 of ACR criteria between January 1st, 2000 and December 31st, 2000, were included. Four sources were used to identify new cases of SLE: 1) the University Hospital; 2) health units and hospitals of the public health network; 3) specialists at private hospitals and outpatient clinics; 4) three laboratories performing antinuclear antibody (ANA) determination. Physicians were contacted by mail, receiving explanations about the study and directions on how to collaborate. Brazilian population census data (2000) was used to calculate incidence rate. The Standardized Mortality Ratio (SMR) was used to compare the incidence rates. The 95% confidence intervals (95% CI) were calculated and a P value < 0.05 was considered statistically significant. RESULTS: Forty three patients were diagnosed as SLE new cases in 2000. The calculated incidence was 8.7/100 000/year (95% CI 6.3-11.7). Thirty eight patients were female 14.1/100.000/year (95% CI 10.0-19.3) and 5 were male 2.2/100.000/year (95% CI 0.7-5.2). The mean age of SLE new cases was 31.8 years old (95% CI 27.8-35.8). The mean age for women was 31.4 years old and for men it was 35.0 years old. The median of disease duration (time between onset of the first ACR criterion for SLE and diagnosis) was 10 months (1-72 months). CONCLUSIONS: The incidence of SLE in Natal is apparently higher than those reported in other regions of the world. The observed differences may be due to ethnical and/or environmental factors.
Acesso aberto (Open Access)
Incidência de pneumonia associada à ventilação mecânica em pacientes submetidos à aspiração endotraqueal pelos sistemas aberto e fechado: estudo prospectivo - dados preliminares
(Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2001-01-01) Zeitoun, Sandra Salloum [UNIFESP]; Barros, Alba Lucia Bottura Leite de [UNIFESP]; Diccini, Solange [UNIFESP]; Juliano, Yara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital do Sepaco
This a randomized clinical trial in which 20 patients were prospectively evaluated for the incidence of ventilator-associated pneumonia (VAP), of whom 12 received endotracheal suctioning by an open-suction method and 8 by a closed-suction method. Differences in the incidence of VAP was not significantly different (p = 0.4) between closed and open suctioning. Differences in Acute Physiology and Chronic Health Evaluation II, duration of entubation, and the use of steroids were all not significant. All patients in the study used H2 antagonist and a nasogastric tube. Proceeding with the study will involve a sample increase with a possible change in the results.
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A populational-based survey on the prevalence, incidence, and risk factors of urinary incontinence in older adults-results from the "SABE STUDY"
(Wiley, 2018) Nunes Tamanini, Jose Tadeu [UNIFESP]; Pallone, Leticia Valerio; Ferreira Sartori, Marair Gracio [UNIFESP]; Batista Castello Girao, Manoel Joao [UNIFESP]; Ferreira dos Santos, Jair Licio; de Oliveira Duarte, Yeda Aparecida; van Kerrebroeck, Philip E. V. A.
AimsTo estimate the prevalence and incidence of urinary incontinence (UI) and identify the associated risk factors in a cohort of elderly individuals in Brazil. MethodsIn 2006, individuals aged 60 years were selected from the SABE Study (Health, Well-being, and Aging). The dependent variable was reported UI in 2009. UI was assessed using the International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form (ICIQ-UI SF). Incidence was measured in units of 1000 person-years, and Cox regression was applied for data analysis. Multivariate analysis was used to assess risk factors for UI. Incidence risk ratio (IRR) was used for comparison. ResultsThis is the first study to examine the incidence of UI in Brazilian elderly individuals. In total, 1413 individuals were included; the mean age was 74.5 years, and 864 (61.8%) participants were female. The risk of UI was greater among women with cancer (other than skin) and among those with diabetes. In men, the risk of UI was greater for those in Instrumental Activities of Daily Living (IADL) category 5-8 and those who self-reported a fair health status. The prevalence of UI was 14.2% and 28.2% for men and women, respectively. The incidence rate of UI was 25.6 and 39.3 (x1000 person-years) for men and women, respectively. ConclusionsThe incidence rate of UI among older adults in the Brazilian community was high for elderly individuals. The identified risk factors were diabetes and IADL category 5-8 (women) as well as cancer (other than skin) and self-reported health status (male).
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The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm
(Wiley-Blackwell, 2014-05-01) Razavi, H.; Waked, I.; Sarrazin, C.; Myers, R. P.; Idilman, R.; Calinas, F.; Vogel, W.; Mendes Correa, M. C.; Hezode, C.; Lazaro, P.; Akarca, U.; Aleman, S.; Balik, I.; Berg, T.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Brandao Mello, C. E.; Bruggmann, P.; Buti, M.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cramp, M. E.; Dore, G. J.; Doss, W.; Duberg, A. S.; El-Sayed, M. H.; Ergor, G.; Esmat, G.; Falconer, K.; Felix, J.; Ferraz, Maria Lucia Gomes [UNIFESP]; Ferreira, Paulo Roberto [UNIFESP]; Frankova, S.; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L.; Gower, E.; Gschwantler, M.; Guimaraes Pessoa, M.; Hindman, S. J.; Hofer, H.; Husa, P.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Marinho, R. T.; Marotta, P.; Mauss, S.; Moreno, C.; Murphy, K.; Negro, F.; Nemecek, V.; Ormeci, N.; Ovrehus, A. L. H.; Parkes, J.; Pasini, K.; Peltekian, K. M.; Ramji, A.; Reis, N.; Roberts, S. K.; Rosenberg, W. M.; Roudot-Thoraval, F.; Ryder, S. D.; Sarmento-Castro, R.; Semela, D.; Sherman, M.; Shiha, G. E.; Sievert, W.; Sperl, J.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; Van Damme, P.; van Thiel, I.; Van Vlierberghe, H.; Vandijck, D.; Wedemeyer, H.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Cornberg, M.; Muellhaupt, B.; Estes, C.; Ctr Dis Anal; Natl Liver Inst; JW Goethe Univ Hosp; Univ Calgary; Ankara Univ; Hosp Santo Antonio Capuchos; Med Univ Innsbruck; Universidade de São Paulo (USP); Hop Henri Mondor; Adv Tech Hlth Serv Res TAISS; Ege Univ; Karolinska Inst; Karolinska Univ Hosp; Univ Leipzig; Osped Cantonale; Univ Montreal; Fed Univ State Rio de Janeiro; Arud Ctr Addict Med; Hosp Valle de Hebron; Hosp Puerta Hierro; Univ Fed Rio Grande do Sul; Odense Univ Hosp; Reg Hosp Hovedstaden; Universidade Federal do Rio de Janeiro (UFRJ); Univ Plymouth; Univ New S Wales; Cairo Univ; Orebro Univ Hosp; Univ Orebro; Ain Shams Univ; Dokuz Eylul Univ; Exigo Consultores; Universidade Federal de São Paulo (UNIFESP); Inst Clin & Expt Med; Hosp Carlos III; Univ Copenhagen; Direccao Geral Saude; Universidade Estadual de Campinas (UNICAMP); Wilhelminenspital Stadt Wien; Med Univ Vienna; Masaryk Univ; Univ Manitoba; Hlth Sci Ctr; European Liver Patients Assoc; Istanbul Univ; Univ British Columbia; Aalborg Univ Hosp; Katholieke Univ Leuven; Hosp Santa Maria; Univ Western Ontario; Univ Dusseldorf; Univ Libre Brussels; Univ Hosp; Natl Inst Publ Hlth; Univ Southhampton; Dalhousie Univ & Hepatol Serv; Assembleia Republ; Alfred Hosp; Monash Univ; UCL; Nottingham Univ Hosp NHS Trust; Biomed Res Unit; Ctr Hosp Porto; Cantonal Hosp St Gallen; Univ Toronto; Egyptian Liver Res Inst & Hosp; Monash Hlth; Catholic Univ Louvain; Med Univ Graz; St Vincents Hosp; Univ Melbourne; Charles Univ Prague; Cent Mil Hosp; Univ Antwerp; Deutsch Leberhilfe eV; Ghent Univ Hosp; Univ Ghent; Hannover Med Sch; Copenhagen Univ Hosp; Univ Zurich Hosp
The disease burden of hepatitis C virus (HCV) is expected to increase as the infected population ages. A modelling approach was used to estimate the total number of viremic infections, diagnosed, treated and new infections in 2013. in addition, the model was used to estimate the change in the total number of HCV infections, the disease progression and mortality in 2013-2030. Finally, expert panel consensus was used to capture current treatment practices in each country. Using today's treatment paradigm, the total number of HCV infections is projected to decline or remain flat in all countries studied. However, in the same time period, the number of individuals with late-stage liver disease is projected to increase. This study concluded that the current treatment rate and efficacy are not sufficient to manage the disease burden of HCV. Thus, alternative strategies are required to keep the number of HCV individuals with advanced liver disease and liver-related deaths from increasing.
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Prevalence and 7-year incidence of Type II diabetes mellitus in a Japanese-Brazilian population: an alarming public health problem
(Springer, 2002-12-01) Gimeno, Sueli Godoy Agostinho [UNIFESP]; Ferreira, Sandra Roberta Gouvea [UNIFESP]; Franco, Laercio Joel [UNIFESP]; Hirai, Amelia Toyomi [UNIFESP]; Matsumura, Luiza Kimiko [UNIFESP]; Moises, R. S.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
Aims/hypothesis. in 1993, the prevalence of glucose intolerance was studied in a sample of 647 first-generation and second-generation Japanese-Brazilians. Their cohort was followed until 2000, when a second survey was conducted, this included the first and second generations, aged 30 or more years. the aims were to estimate the prevalence of glucose intolerance and 7-yr incidence of Type 11 (non-insulin-dependent) diabetes mellitus in this population.Methods. Prevalence rates were obtained for 1330 subjects examined in 2000. the incidence of diabetes mellitus was calculated for those classified as normal glucose tolerant in 1993 (n=253). A Student's t test and the Cox proportional hazard model were used in data analysis.Results. in the year 2000, higher proportions of subjects were observed in all categories of glucose intolerance than those found in 1993. the overall incidence of diabetes was 30.9 per 1000 per year. A worse profile was observed among incident cases. of diabetes, characterized by higher baseline values of anthropometric and metabolic variables as compared to those who had not developed diabetes. Analysis considering the simultaneous effects of demographic, nutritional and metabolic variables and physical activity levels for the development of diabetes showed that age, sex, waist circumference, fasting and 2-h plasma glucose concentrations were independent predictors.Conclusion/interpretation. Our data point towards a worsening of glucose tolerance status among Japanese-Brazilians, who show one of the highest prevalence rates of diabetes mellitus worldwide. This could reflect their strong genetic susceptibility associated with unfavourable environmental conditions.
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Program for the epidemiological evaluation of stroke in Tandil, Argentina (PREVISTA) study: rationale and design
(Wiley-Blackwell, 2013-10-01) Sposato, Luciano A.; Coppola, Mariano L.; Altamirano, Juan; Guerrero, Brenda Borrego; Casanova, Jorge; De Martino, Maximiliano; Diaz, Alejandro; Feigin, Valery L.; Funaro, Fernando; Gradillone, Maria E.; Lewin, Maria L.; Lopes, Renato D. [UNIFESP]; Lopez, Daniel H.; Louge, Mariel; Maccarone, Patricia; Martens, Cecilia; Miguel, Marcelo; Rabinstein, Alejandro; Morasso, Hernan; Riccio, Patricia M.; Saposnik, Gustavo; Silva, Damian; Suasnabar, Ramon; Truelsen, Thomas; Uzcudun, Araceli; Viviani, Carlos A.; Bahit, M. Cecilia; INECO Fdn; Univ Western Ontario; Hosp Ramon Santamarina; Nueva Clin Chacabuco; Sanatorio Tandil; AUT Univ; Universidade Federal de São Paulo (UNIFESP); Duke Clin Res Inst; BCRI; Mayo Clin; Univ Toronto; Copenhagen Univ Hosp; Circulo Med Tandil; Resonancia Ctr
The availability of population-based epidemiological data on the incident risk of stroke is very scarce in Argentina and other Latin American countries. in response to the priorities established by the World Health Organization and the United Nations, PREVISTA was envisaged as a population-based program to determine the risk of first-ever and recurrent stroke and transient ischemic attack incidence and mortality in Tandil, Buenos Aires, Argentina.The study will be conducted according to Standardized Tools for Stroke Surveillance (STEPS Stroke) methodology and will enroll all new (incident) and recurrent consecutive cases of stroke and transient ischemic attack in the City of Tandil between May 1st, 2013 and April 30, 2015. the study will include patients with ischemic stroke, non-traumatic primary intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack. To ensure the inclusion of every cerebrovascular event during an observation period of two years, we will instrument an 'intensive screening program', consisting of a comprehensive daily tracking of every potential event of stroke or transient ischemic attack using multiple overlapping sources. Mortality would be determined during follow-up for every enrolled patient. Also, fatal community events would be screened daily through revision of death certificates at funeral homes and local offices of vital statistics. All causes of death will be adjudicated by an ad-hoc committee.The close population of Tandil is representative of a large proportion of Latin-American countries with low- and middle-income economies. the findings and conclusions of PREVISTA may provide data that could support future health policy decision-making in the region.
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Prospective study of hepatitis C virus infection in hemodialysis patients by monthly analysis of HCV RNA and antibodies
(Natl Research Council Canada, 2003-08-01) Moreira, Regina; Pinho, Joao Renato Ribeiro; Fares, Jorge; Oba, Isabel Takano; Cardoso, Maria Regina; Saraceni, Claudia Patara; Granato, Celso [UNIFESP]; Inst Adolfo Lutz Registro; Unidades Dialise & Tratamento Nefrol; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
The aims of this study were to (i) evaluate the prevalence and the incidence of hepatitis C virus (HCV) infection in hemodialysis patients in two different centers in São Paulo (Brazil), (ii) determine the time required to detect HCV infection among these patients by serology or PCR, (iii) establish the importance of alanine aminotransferase determination as a marker of HCV infection, and (iv) identify the HCV genotypes in this population. Serum samples were collected monthly for 1 year from 281 patients admitted to hospital for hemodialysis. Out of 281 patients, 41 patients (14.6%) were HCV positive; six patients seroconverted during this study (incidence=3.1/1000 person-month). in 1.8% (5/281) of cases, RNA was detected before the appearance of antibodies (up to 5 months), and in 1.1% (3/281) of cases, RNA was the unique marker of HCV infection. the genotypes found were 1a, 1b, 3a, and 4a. the presence of genotype 4a is noteworthy, since it is a rare genotype in Brazil. These data pointed out the high prevalence and incidence of HCV infection at hemodialysis centers in Brazil and showed that routine PCR is fundamental for improving the detection of HCV carriers among patients undergoing hemodialysis.
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Sepsis: A Threat That Needs a Global Solution
(Lippincott Williams & Wilkins, 2018) Machado, Flavia Ribeiro [UNIFESP]; Pontes Azevedo, Luciano Cesar
Acesso aberto (Open Access)
Síndrome metabólica na população Khisêdjê, residente no Parque Indígena do Xingu - Brasil Central: mudanças no período de 1999-2000 a 2010-2011
(Universidade Federal de São Paulo (UNIFESP), 2014-09-16) Mazzucchetti, Lalucha [UNIFESP]; Gimeno, Suely Godoy Agostinho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective: To identify the changes in the morbidities profile related to metabolic syndrome (MS) among the Khisêdjê indigenous adults and elderly residents in the Xingu Indigenous Park, over the period 1999-2000 to 2010-2011. Methods: This is an epidemiological study, with a serial cross-sectional design (conducted in 1999-2000 and 2010-2011), which allowed the calculation of the measure of cumulative incidence. Both were carried in the Ngôjwêre village. We invited to participate in the study all the subjects of both sexes with ages ?20 years of ethnicity Khisêdjê or residents in the villages of the area covered by the Wawi Indigenous Post Surveillance - Special Health District Xingu Indigenous (Mato Grosso/Brazil). While in the years of 1999-2000 86 individuals were evaluated, in the years of 2010-2011 179 were evaluated; 78 subjects were evaluated in both moments. We used a standard form for data collection. The collection of anthropometric measurements followed the procedures recommended by the World Health Organization in 1995. For the measurement of the body composition a tetrapolar bioelectrical impedance device model was used. For identification of MS and its components the criteria diagnostic proposed by Alberti and colleagues in 2009 were used. The MS was defined by the concomitant presence of at least three metabolic abnormalities: abdominal obesity, glucose intolerance, hypertension, hypertriglyceridemia and low HDL cholesterol. The Stata software was used for all analysis steps. Results: The evaluation conducted in 2010-2011 enabled the identification of a population that is in high metabolic and cardiovascular risk, since 30.7% of SM was found. The comparison the 1999-2000 data with those of 2010-2011 showed deterioration in the morbidities profile related to MS. The main damages were increasing prevalence of overweight of 37.2% to 48.0%; of hypertension of 3.6% to 25.1%; of diabetes mellitus 1.3% to 3.9%; and of hyperuricemia of 5.2% to 15.1%. In terms of body composition, the data suggest that the presence of excessive weight is associated with increased muscle mass. The concomitant evaluation of some individuals made possible the identification, in 10 years of follow-up, the cumulative incidence of 37.5% of SM; of 47.4% of hypertriglyceridemia; of 38.9% of arterial hypertension (AH); of 32.0% of central obesity; of 30.4% of overweight; of 29.1% of hypercholesterolemia; of 25.0% of low HDL-C; of 10.4% of high LDLc; and of 2.9% of diabetes mellitus (DM). The age proved to be a risk factor for the incidence of hypertension, DM and high LDLc, regardless of sex; being male was a protective factor for the incidence of central obesity, independent of age. Conclusions: Deteriorations of most health indicators evaluated were identified, the Khisêdjê are exposed to high cardiometabolic risk. This result may be related to changes in traditional lifestyle.
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Strategies to manage hepatitis C virus (HCV) disease burden
(Wiley-Blackwell, 2014-05-01) Wedemeyer, H.; Duberg, A. S.; Buti, M.; Rosenberg, W. M.; Frankova, S.; Esmat, G.; Ormeci, N.; Van Vlierberghe, H.; Gschwantler, M.; Akarca, U.; Aleman, S.; Balik, I.; Berg, T.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Brandao Mello, C. E.; Bruggmann, P.; Calinas, F.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cornberg, M.; Cramp, M. E.; Dore, G. J.; Doss, W.; El-Sayed, M. H.; Ergor, G.; Estes, C.; Falconer, K.; Felix, J.; Ferraz, Maria Lucia Gomes [UNIFESP]; Ferreira, Paulo Roberto [UNIFESP]; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L.; Guimaraes Pessoa, M.; Hezode, C.; Hindman, S. J.; Hofer, H.; Husa, P.; Idilman, R.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Lazaro, P.; Marinho, R. T.; Marotta, P.; Mauss, S.; Mendes Correa, M. C.; Moreno, C.; Muellhaupt, B.; Myers, R. P.; Nemecek, V.; Ovrehus, A. L. H.; Parkes, J.; Peltekian, K. M.; Ramji, A.; Razavi, H.; Reis, N.; Roberts, S. K.; Roudot-Thoraval, F.; Ryder, S. D.; Sarmento-Castro, R.; Sarrazin, C.; Semela, D.; Sherman, M.; Shiha, G. E.; Sperl, J.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; Van Damme, P.; van Thiel, I.; Vandijck, D.; Vogel, W.; Waked, I.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Negro, F.; Sievert, W.; Gower, E.; Hannover Med Sch; German Liver Fdn; Orebro Univ Hosp; Univ Orebro; Hosp Valle de Hebron; UCL; Inst Clin & Expt Med; Cairo Univ; Ankara Univ; Ghent Univ Hosp; Wilhelminenspital Stadt Wien; Ege Univ; Karolinska Inst; Karolinska Univ Hosp; Univ Leipzig; Osped Cantonale; Univ Montreal; Adv Tech Hlth Serv Res TAISS; Fed Univ State Rio de Janeiro; Arud Ctr Addict Med; Hosp Santo Antonio Capuchos; Hosp Puerta Hierro; Univ Fed Rio Grande do Sul; Odense Univ Hosp; Region Hosp Hovedstaden; Universidade Federal do Rio de Janeiro (UFRJ); Univ Plymouth; Univ New S Wales; Ain Shams Univ; Dokuz Eylul Univ; Ctr Dis Anal CDA; Exigo Consultores; Universidade Federal de São Paulo (UNIFESP); Hosp Carlos III; Univ Copenhagen; Direccao Geral Saude; Universidade Estadual de Campinas (UNICAMP); Universidade de São Paulo (USP); Hop Henri Mondor; Med Univ Vienna; Masaryk Univ; Univ Manitoba; Hlth Sci Ctr; European Liver Patients Assoc; Istanbul Univ; Univ British Columbia; Aalborg Univ Hosp; Katholieke Univ Leuven; Univ Western Ontario; Univ Dusseldorf; Univ Libre Brussels; Univ Zurich Hosp; Univ Calgary; Natl Inst Publ Hlth; Univ Southhampton; Dalhousie Univ & Hepatol Serv; Assembleia Republ; Alfred Hosp; Monash Univ; Nottingham Univ Hosp NHS Trust; Biomed Res Unit; Ctr Hosp Porto; JW Goethe Univ Hosp; Cantonal Hosp St Gallen; Univ Toronto; Egyptian Liver Res Inst & Hosp ELRIAH; Catholic Univ Louvain; Med Univ Graz; St Vincents Hosp; Univ Melbourne; Charles Univ Prague; Cent Mil Hosp; Univ Antwerp; Deutsch Leberhilfe eV; Univ Ghent; Hasselt Univ; Med Univ Innsbruck; Natl Liver Inst; Copenhagen Univ Hosp; Univ Hosp; Monash Hlth
The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. the largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical.
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Trends in Incidence of Primary Cutaneous Malignancies in Children, Adolescents, and Young Adults: A Population-Based Study
(Wiley-Blackwell, 2014-02-01) Senerchia, Andreza A. [UNIFESP]; Ribeiro, Karina B.; Rodriguez-Galindo, Carlos; Universidade Federal de São Paulo (UNIFESP); Santa Casa São Paulo; Harvard Univ
BackgroundSkin cancer incidence among young adults is rising; however, the epidemiological characteristics of primary cutaneous lymphomas and cutaneous soft tissue sarcomas (CSTS) in individuals <30 years old has not been investigated. We analyzed the incidence and time-trends of primary cutaneous malignancies in children and adolescents/young adults (AYA).ProcedureSEER-17 and -13 data were used to assess the descriptive epidemiology and time-trends in incidence of primary cutaneous malignancies in children and AYA. SEERStat and Joinpoint softwares were utilized to estimate annual percent changes (APC) in incidence.ResultsIn total, 7,814 cases (ASR=25.66/1,000,000 habitants) of primary skin cancers in <30 years old were diagnosed in 2000-2008. Females had a higher incidence of melanoma (risk ratio (RR)=1.95; P<0.001) and a lower risk of developing CSTS (RR=0.64, P<0.001). Compared to whites, blacks have a lower incidence of melanoma (RR=0.03, P<0.001), and higher risk of CSTS (RR=2.28, P<0.001). Melanoma increased in females over a 15-year period (1992-2006) (APC=2.5, 95%CI=1.8; 3.2), and the incidence of cutaneous T-cell lymphomas increased over the period 1992-2008 (APC=9.5, 95% CI=6.7; 12.4). CSTS incidence decreased among males over the period 1992-1999 (APC=-21.4, 95% CI -27.2; -15.1), particularly due to a decrease in Kaposi sarcoma incidence (AAPC 1992-2008=-13.6, 95% CI=-22.4;-3.8), although with a notable racial disparity (whites, AAPC=-15.2, 95% CI=-23.2;-6.4; blacks, AAPC=-10.6, 95% CI=-13.2;-7.9).ConclusionsNon-melanoma skin cancer is very rare in children and AYA. We have shown variation in time-trends in incidence as well as in incidence patterns by race, sex, age, and histologic type, highlighting the importance of descriptive epidemiology to better understand the characteristics of these malignancies. Pediatr Blood Cancer 2014;61:211-216. (c) 2013 Wiley Periodicals, Inc.

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