scholarly journals PLATINO, a nine-year follow-up study of COPD in the city of São Paulo, Brazil: the problem of underdiagnosis

2014 ◽  
Vol 40 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Graciane Laender Moreira ◽  
Beatriz Martins Manzano ◽  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Rogelio Perez-Padilla ◽  
...  
Keyword(s):  
Latin American ◽  
Initial Phase ◽  
Severe Disease ◽  
Sao Paulo ◽  
São Paulo ◽  
Chi Square ◽  
Chi Square Test ◽  
Study Population ◽  
The City

OBJECTIVE: To determine the underdiagnosis rate in new COPD cases at the end of a nine-year follow-up period-in the study designated "Projeto Latino-Americano de Investigação em Obstrução Pulmonar" (PLATINO, Latin-American Pulmonary Obstruction Investigation Project)-and compare that with the underdiagnosis rate during the initial phase of the study, as well as to identify the clinical features exhibited by the subjects who were not diagnosed until the end of the follow-up phase. METHODS: The study population comprised the 1,000 residents of the city of São Paulo, Brazil, who took part in the PLATINO study. Of those, 613 participated in the follow-up phase, during which the subjects were assessed with the same instruments and equipment employed in the initial phase of the study. We used the chi-square test or the independent sample t-test to analyze the underdiagnosis rate and to identify the characteristics of the subjects who were not diagnosed until the end of the follow-up phase. RESULTS: The underdiagnosis rate for new COPD cases at the end of the nine-year follow-up period was 70.0%. The underdiagnosis rate during the follow-up phase was 17.5% lower than that reported for the initial phase of the study. The subjects who were not diagnosed until the end of the follow-up phase presented with fewer respiratory symptoms, better pulmonary function, and less severe disease than did those previously diagnosed with COPD. CONCLUSIONS: The underdiagnosis rate for new COPD cases was lower in the follow-up phase of the study than in the initial phase. The subjects who were not diagnosed until the end of the follow-up phase of the PLATINO study presented with the same clinical profile as did those who were not diagnosed in the initial phase. These findings underscore the need for spirometry in order to confirm the diagnosis of COPD and provide early intervention.

scholarly journals Oral Cancer Knowledge Assessment: Newly Graduated versus Senior Dental Clinicians

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Gisele Pavão Spaulonci ◽  
Ricardo Salgado de Souza ◽  
Vanessa Gallego Arias Pecorari ◽  
Luciano Lauria Dib
Keyword(s):  
Oral Cancer ◽  
Sao Paulo ◽  
Knowledge Assessment ◽  
São Paulo ◽  
Cancer Knowledge ◽  
Chi Square ◽  
Chi Square Test ◽  
Level Of Knowledge ◽  
The Subject ◽  
The City

The present study assessed the level of dentists’ knowledge regarding oral cancer in the city of São Paulo, Brazil. A questionnaire was used to compare the level of knowledge among newly graduated and senior clinicians. A total of 20,154 e-mails were correctly delivered to the dentists registered in the database of the Regional Dentistry Council of São Paulo, and 477 (2.36%) responses were received. This sample consisted of 84 newly graduated clinicians and 105 senior clinicians. For the statistical analysis, the chi-square test and the logistic regression analysis were performed withα = 0.05, and the results were described herein. According to their knowledge level, the results were statistically different between the groups, since 19% of the newly graduated clinicians were evaluated with knowledge grade A (excellent) in comparison to 6.7% of the senior clinicians. In spite of the results indicated that newly graduated clinicians’ knowledge regarding oral cancer was 2.1 times higher, 34.5% of the professionals in this group had regular or poor knowledge on the subject, and several questions relating to clinical characteristics and risk factors indicated that there still exist some knowledge gaps, demonstrating that there is a need for further studies and information activities addressing oral cancer.

scholarly journals Tuberculosis fatality rates in the city of Campinas - São Paulo, Brazil, from 2001 to 2009

2019 ◽  
Vol 22 ◽  
Author(s):  
Helenice Bosco de Oliveira ◽  
Letícia Marin-Léon ◽  
Nanci Michele Saita ◽  
Jonathan Eric Golub
Keyword(s):  
Statistical Significance ◽  
Case Fatality ◽  
Sao Paulo ◽  
São Paulo ◽  
Chi Square ◽  
Delay In Diagnosis ◽  
Hiv Coinfection ◽  
Chi Square Test ◽  
The University ◽  
The City

ABSTRACT: Introduction: The mortality rate among tuberculosis patients (TB fatality) has been attributed to irregular chemotherapy, delay in diagnosis, multidrug resistance, and HIV coinfection. Objective: To analyze TB fatality rates by sex, clinical presentation and HIV coinfection in Campinas, São Paulo, Brazil. Methods: Cohorts of residents in the city of Campinas who either died during treatment for tuberculosis or had the disease confirmed after death were divided into three intervals: 2001-2003, 2004-2006, and 2007-2009. Data were obtained from the database of the Tuberculosis Surveillance System of the University of Campinas, and notifications were gathered through TB-WEB Health São Paulo Secretary. Statistical significance was determined using a chi-square test, considering p < 0.05. Results: Between 2001 and 2009, 3,416 TB patients were diagnosed: 2,827 (82.8%) were new TB cases and 589 (17.2%) were retreatments. Between the first and second triennium, the number of new patients decreased by 18%, and 23% among retreatments. Between the second and third intervals, the reduction was 5% and 21%, respectively. General case fatality rate declined from 11.4% to 9.9% across intervals, and was most significant among patients that had previously abandoned treatment (17.3% to 5.1%). Fatality rates among patients coinfected with TB-AIDS were 2-3 times that of patients not infected with TB-AIDS throughout the intervals. Fatality between the first and third triennium among TB-AIDS co-infected patients declined (24.8% to 19.5%), while increasing slightly among non-AIDS TB patients (7.3% to 8%) during this period. Conclusion: Though mortality among TB-AIDS patients declined from 2001-2009, rates among non-AIDS TB remained stagnant. Improved TB diagnosis and treatment is needed to further decrease TB mortality in Campinas.

scholarly journals A catequese nos primórdios da cidade de São Paulo Piratininga revisitado por ocasião dos 450 anos de sua fundação

2019 ◽  
Vol 64 (256) ◽  
pp. 903
Author(s):  
Paulo Suess
Keyword(s):  
Latin American ◽  
Historical Context ◽  
Sao Paulo ◽  
São Paulo ◽  
Linguistic Context ◽  
Cultural Survival ◽  
The Face ◽  
History Of ◽  
Brazilian History ◽  
The City

A história da cidade de São Paulo e do Brasil é uma história de desaparecimentos e esquecimentos, de resistências e lutas pela sobrevivência física e cultural, de transformações e adaptações. Arar a memória dos destinatários e dos agentes da primeira evangelização, por ocasião dos 450 anos da “conversão do Brasil”, é uma tarefa instigante, sobretudo no contexto histórico de hoje, onde a pergunta sobre a possibilidade de um outro mundo é ao mesmo tempo uma pergunta sobre a relevância da evangelização. A comemoração da fundação da “Casa de Piratininga”, um pobre colégio que se tornou megalópole, tem a tarefa de religar o conhecimento histórico ao reconhecimento contemporâneo do outro. O Autor, missiólogo e historiador, por muitos anos ligado à causa indígena no país e no continente latino-americano, conduz o leitor pela cristandade do Brasil e pela diversidade étnica da Província de São Vicente. Dois eixos da evangelização ganham destaque: a questão da comunicação num contexto lingüístico plural e a questão da violência e da força diante da proposta evangélica de gratuidade e paz.Abstract: The history of the city of São Paulo and Brazilian history, in general, are full of disappearances and omissions, of resistance and struggles for physical and cultural survival, of transformations and adaptations. On the occasion of the 450th anniversary of the “conversion of Brazil”, to trace the memories of both addressees and agents of the first evangelization is a stimulating task, particularly in today’s historical context, where the question about the possibility of another world is, at the same time, a question about the relevance of evangelization. The celebration of the foundation of the “Casa de Piratininga”, an ordinary school that became a megalopolis, seeks to reconnect historical knowledge to the contemporary recognition of the Other. The Author – a missiologist and historian that, for many years, has been connected with the Indian cause in this country and in the Latin-American continent – guides the reader through the Christendom in Brazil and through the ethnical diversity in the Province of São Vicente. He focuses, in particular, on two axles of the evangelization: the issue of communication in a plural linguistic context and the issue of violence and coercion in the face of the evangelical proposal of graciousness and peace.

scholarly journals Clinical, Laboratory, and Genetic Features of Erdheim-Chester Disease Patients from Two Reference Centers in a Developing Country

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 22-23
Author(s):  
Antonio Adolfo Guerra Soares Brandão ◽  
Giancarlo Fatobene ◽  
Andre Abdo ◽  
Luis Alberto de Padua Covas Lage ◽  
Israel Bendit ◽  
...  
Keyword(s):  
Median Time ◽  
Latin American ◽  
Braf Mutation ◽  
Sao Paulo ◽  
São Paulo ◽  
First Line ◽  
Erdheim Chester Disease ◽  
Erdheim Chester ◽  
Chester Disease

INTRODUCTION: Erdheim-Chester Disease (ECD) is a rare histiocytic neoplasm with a heterogenous clinical course with asymptomatic localized course or systemic compromise involving multiples organs causing significant morbidity and mortality. There are few cohorts published however mainly from North America and Europe. Given the scarcity of data on ECD in Latin America, we have established a local registry in the city of São Paulo to collect clinical and biological material of ECD patients. METHODS: We retrospectively collected clinical data on biopsy-proven ECD patients diagnosed and treated at two reference centers for histiocytic disorders (Hospital das Clínicas da Universidade de São Paulo e Hospital Sírio-Libanês, Brazil) from January 2006 to February 2020. RESULTS: Sixteen patients with confirmed diagnosis of ECD were included with median age of 53 years. 75% were males and a median follow-up time of 50 months (7-163). Median time from onset of symptoms to diagnosis was 13 months (0.1-142). Immunohistochemistry (IHC) findings showed positivity for CD68 in 15/16 (94%) and for S100 in 3/16 (19%) patients, no case had CD1a positivity. The most frequent organs involved were: bone (75%), skin (44%), central nervous system (CNS) (44%), lymph nodes (31%), lung (13%), liver (6%), spleen (6%), and gastrointestinal tract (6%) of cases. CNS lesions involvement occurred mostly in the pituitary gland (86%). Twelve of 16 (75%) patients presented disease in more than one organ. Xanthelasma and xanthoma were the most common skin lesions (44%). The most frequent histiocytosis-related clinical manifestations were bone pain (44%) and diabetes insipidus (38%). The most frequent radiologic findings were osteosclerosis in 12/16 (75%) patients, retroperitoneal fibrosis around the kidneys in 6/16 (38%), the coated aorta sign and orbital infiltration were found in 4/16 (25%) of cases. 18FDG/PET-CT was performed in all patients, of whom 13 (81%) had hypermetabolic lesions. BRAF status at diagnosis was available in 13/16 patients using the technique of Sanger in 5/13, pyrosequencing in 3/13, IHC in 3/13 and polymerase chain reaction (PCR) in 2/13. Mutations were detected in only 3/16 (19%) cases. All patients received treatment due to symptomatic disease with a median of two lines of therapy (1-7). Median time between diagnosis and the first treatment was one month. First-line treatments were interferon in 12/16 patients, steroids in 5/16, and each one of thalidomide, vemurafenib and tumoral resection in one patient. Beyond first-line therapy, the most conventional chemotherapy regimens used were cladribine (4/16 patients) and LCH-like etoposide-containing vinblastine, methotrexate and mercaptopurine (2/16 patients). Other treatments included radiotherapy (4/16 patients) and a single patient used cobimetinib, imatinib and infliximab. Median progression free survival (PFS) after the first line treatment was 7.5 months (95% CI 5-10), and median overall survival (OS) was not reached to this date. Time to next treatment was 9 months in patients who did not achieved at least partial response after first line, and 15 months in those who attained it. PFS at 2 years was 45% (95% CI 0.17-0.71), and OS at 2 years was 100%. One patient died due to infection complication after the first cycle of cladribine after 50 months of follow-up. CONCLUSION: To our knowledge, despite the low number of patients, this is the largest Latin American cohort of patients with ECD reported to date. Our findings resemble demographic characteristics, sites of involvement and treatment choices reported by other groups. However, it is noteworthy that the proportion of ECD patients bearing a BRAF mutation (18.8%) was pretty lower than previously reported (approximately 50%). This needs to be taken cautiously due to the small number of subjects and due to technical issues, since all samples analyzed by PCR or Sanger were negative for BRAF mutation. A national registry of histiocytosis is needed to confirm these preliminary data. Disclosures No relevant conflicts of interest to declare.

scholarly journals Prevalence of lip and perioral Ephelides in beach workers

2013 ◽  
Vol 88 (1) ◽  
pp. 56-63
Author(s):  
Eudes Euler de Souza Lucena ◽  
Ana Claudia de Queiroz Castro ◽  
Danielle Bezerra de Farias ◽  
Pérola Teixeira de Lima ◽  
Éricka Janine Dantas da Silveira ◽  
...  
Keyword(s):  
General Health ◽  
Rio Grande ◽  
Clinical Tests ◽  
Melanin Production ◽  
Chi Square ◽  
Sociodemographic Variables ◽  
Significance Level ◽  
Chi Square Test ◽  
Study Population ◽  
The City

BACKGROUND: Ephelides are small hyperpigmented macules common in the skin, presenting as areas with increased melanin production. Ephelides are observed in genetically predisposed individuals, particularly fair-skinned people highly susceptible to sunburn. OBJECTIVES: This study aimed to determine the prevalence of lip and perioral ephelides in 362 beach workers in the city of Natal (Rio Grande do Norte) and to investigate potential associations with sociodemographic, occupational and general health. METHODS: For this purpose clinical tests were performed by calibrated examiners in the epidemiological area around the lips and the area bounded laterally by the nasolabial groove and at the bottom by the chin. A questionnaire was completed and assessed. The possible associations between sociodemographic variables, occupational and general health with the presence of lip and perioral ephelides were evaluated by chi-square test for a significance level of 5%. RESULTS: Approximately one third of the workers were affected by perioral ephelides (33.7%) and around a quarter of them by lip ephelides (24.0%). Gender was the only variable significantly associated with the presence of perioral ephelides (p = 0.002), unlike lip ephelides which proved to be significantly associated with habits (p = 0.036) and alcoholism (0.030). CONCLUSIONS: The prevalence of ephelides in lip and perioral region was high in the study population, with gender and certain habits associated with its occurrence.

scholarly journals Management and Clinical Characteristics in Children with SARS-CoV-2 Infection: Experience in a highly complex public hospital in the city of São Paulo

2020 ◽  
Author(s):  
Rafael Santos Rodrigues Vieira ◽  
Erisson Linhares de Aguiar ◽  
Nara Michelle de Araújo Evangelista ◽  
Sergio Antonio Bastos Sarrubbo ◽  
Helmar Abreu Rocha Verlangieri ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Sao Paulo ◽  
World Health ◽  
São Paulo ◽  
Pediatric Hospital ◽  
Multiprofessional Team ◽  
The City

AbstractIn February 2020, the World Health Organization designated the disease COVID-19, which means Coronavirus disease 2019. The virus that causes COVID-19 is designated as severe acute respiratory syndrome by Coronavirus 2 (SARS-CoV-2). The virus tends to determine clinical manifestations more frequently in adults and, especially, in the elderly, with high mortality in the population with chronic diseases. Most studies confirm the trend towards less severe disease in pediatric patients, and few studies describe the behavior of the virus in children. In late February 2020, a public pediatric hospital in the city of São Paulo, in the face of the announced epidemic, through its multiprofessional team, prepared itself to the care of patients with SARS-CoV-2 infection, determing certain clinical protocols defining the flow of care and therapeutic procedures to patients. This study intends to present the clinical characteristics and evolution of the disease by SARS-CoV-2 in pediatric patients seen in a public pediatric hospital of high complexity, evaluating the effectiveness and acceptance of the measures adopted. As a result, a good evolution of the disease was observed in the affected children, even in those with comorbidities. There was a trend towards a greater number of days of hospitalization and the need for ICU in patients with comorbidities and progression with clinical worsening after initial improvement. The protocols adopted and the flow instituted allowed good adherence by the multidisciplinary team.

scholarly journals Anthropometric status of individuals with COPD in the city of São Paulo, Brazil, over time - analysis of a population-based study

2019 ◽  
Vol 45 (6) ◽  
Author(s):  
Josiane Marchioro ◽  
Mariana Rodrigues Gazzotti ◽  
Graciane Laender Moreira ◽  
Beatriz Martins Manzano ◽  
Ana Maria Baptista Menezes ◽  
...  
Keyword(s):  
Population Based ◽  
Sao Paulo ◽  
São Paulo ◽  
Anthropometric Data ◽  
Baseline Phase ◽  
Population Based Study ◽  
Two Phases ◽  
The City ◽  
Severe Copd

ABSTRACT Objective: To evaluate the anthropometric data obtained for residents of the city of São Paulo, Brazil, in a study of Latin America conducted in two phases (baseline, in 2003, and follow-up, in 2012). Methods: This was an analysis of data obtained for São Paulo residents in a two-phase population-based study evaluating the prevalence of COPD and its relationship with certain risk factors among individuals ≥ 40 years of age. The anthropometric data included values for weight, height, body mass index (BMI), and waist circumference. In the follow-up phase of that study, the same variables were evaluated in the same population sample as that of the baseline phase. Results: Of the 1,000 São Paulo residents enrolled in the baseline phase of that study, 587 participated in the follow-up phase, and 80 (13.6%) of those 587 subjects had COPD. Comparing the baseline and follow-up phases, we found increases in all anthropometric measures in both groups (COPD and non-COPD), although the differences were significant only in the non-COPD group. The subjects with mild COPD showed increases in weight and BMI (Δweight = 1.6 ± 5.7 and ΔBMI = 0.7 ± 2.2), whereas those with moderate or severe COPD showed reductions (Δweight = −1.7 ± 8.1 and ΔBMI = −0.4 ± 3.0), as did those with severe or very severe COPD (Δweight = −0.5 ± 5.4 and ΔBMI = −0.8 ± 3.3). Conclusions: Between the two phases of the study, the subjects with mild COPD showed increases in weight and BMI, whereas those with a more severe form of the disease showed reductions.

Factors associated with high-risk pregnancy: role of environmental contaminants, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Martins ◽  
J Fernandes ◽  
Y Pamplona ◽  
C Barbieri ◽  
J Vaz ◽  
...  
Keyword(s):  
High Risk ◽  
Environmental Contaminants ◽  
Sao Paulo ◽  
The State ◽  
High Risk Pregnancy ◽  
São Paulo ◽  
Multiple Logistic Regression ◽  
Chi Square ◽  
Risk Pregnancy ◽  
Chi Square Test

Abstract Introduction The Região Metropolitana da Baixada Santista (RMBS) is considered as a region with the worst maternal and child mortality rates in the state of São Paulo, Brazil. Besides this, RMBS has the worst rates of environmental contamination. High-Risk Pregnancy is one of the factors that lead to a higher chance of morbidity and mortality of the mother and fetus binomial. Objective Evaluate the relationship between exposure to environmental contaminants and high-risk pregnancy. Methodology Case-control study, using a probabilistic sample composed of 402 pregnant women divided into with and without high-risk pregnancy. The instrument used was a self-administered questionnaire and secondary data on contaminated areas obtained from the Environmental Company of the State of São Paulo. Descriptive analysis, Chi-square test, univariate and multiple logistic regression analysis were performed. The participants were also georeferenced by place of residence. Results It was observed an association, by chi-square test between high-risk pregnancy and age over 35 years (p &lt; 0.05), use of insecticide (p &lt; 0.001), consumption of foods packed in plastics (p = 0.050) and manipulation with oil paint (p = 0.002). The final multiple logistic regression model demonstrated that those who live in contaminated areas are 2 times more likely to have a risk pregnancy (OR = 1.993; 95%CI: 1.02; 3.90), as well as identified as jointly important risk factors for pregnancy: working in health services (OR = 3.97 (95%CI: 1.00; 16.09)), use of insecticide (OR = 3.45 (95%CI: 1.66; 7.16)) and use of oil paint (OR = 6.96 (95%CI: 1.38; 35.09)). Conclusions Environmental contaminants play an important role in pregnancy, and mitigating measures are needed to improve the environment and reduce high-risk pregnancy in RMBS. Key messages Exposure to the environmental contaminants is an important rik factor in the pregnancy. The Região Metropolitana da Baixada Santista (RMBS) is considered as a region with the worst maternal and child mortality rates in the state of São Paulo, Brazil.

scholarly journals Anti-hepatitis A virus frequency in adolescents at an outpatient clinic in São Paulo, Brazil

2006 ◽  
Vol 48 (1) ◽  
pp. 43-44 ◽  
Author(s):  
Maria Isabel Saraiva Dinelli ◽  
Mauro Fisberg ◽  
Maria Isabel de Moraes-Pinto
Keyword(s):  
At Risk ◽  
Outpatient Clinic ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Age Groups ◽  
Sao Paulo ◽  
São Paulo ◽  
Chi Square ◽  
Chi Square Test ◽  
Two Age Groups

The prevalence of hepatitis A virus (HAV) antibodies was assessed in adolescents (age ranging from 10.4 to 19.9 years) at an Adolescent Outpatient Clinic in São Paulo, Brazil. Anti-HAV was detected in 137 (54.2%) out of 253 individuals. When separated into two age groups, anti-HAV frequency was higher in the 15 to 19 year-old group (64%) in comparison to the 10 to 14 year-old group (46%) (Chi-square test: p = 0.004). These results suggest that adolescents in São Paulo are at risk of hepatitis A infection and are probably contracting HAV infection during this age period.

scholarly journals FAKTOR-FAKTOR KEAKTIFAN KADER DALAM KEGIATAN POSYANDU DI WILAYAH KERJA PUSKESMAS BETUNGAN KOTA BENGKULU

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Ida Royani
Keyword(s):  
Health Center ◽  
Sampling Technique ◽  
Community Based ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Associated ◽  
Chi Square Test ◽  
Study Population ◽  
Almost All ◽  
The City

IHC is a community service post, which is one of the community-based health effort managed and organized from, by, for and with the community, the decline becomes inactive cadres in IHC activities may lead to the ineffectiveness of service. The purpose of this study was to determine the factors associated with the activeness of cadres in the IHC of Betungan Health Center in the city of Bengkulu in 2017. The design study used was an observational analytic cross sectional approach, this study was conducted in Betungan health center in Bengkulu on March 11 to June 11, 2017. The study population were all cadres in Betungan health center Bengkulu, with the samples of 49 people taken by using a total sampling technique. The collection of data was done directly using the check list sheet, and analyzed using the chi-square test for the education and exacted fisher test used in the variable age and occupation. The results showed nearly all (87.8) aged 25-54, the majority (73.5) were less educated, almost all (87.8) did not work and almost all (87.8) were active cadres. The results of chi-square value of age (p = 0.01), education (p = 0.00) and work (p = 1.000). with the rate of 95%, if p <0.05 means that there was a relationship between age and education, and if this study p> 0.05 means that there was no relationship between the work with the cadres activeness in Betungan health center in Bengkulu.This study is expected to provide information about the factors associated with the activeness of the cadres in IHC activities to institutions of the clinic, cadres and researchers.

Sign in / Sign up

Export Citation Format

Share Document