22 research outputs found
Outcomes among HIV-1 Infected Individuals First Starting Antiretroviral Therapy with Concurrent Active TB or Other AIDS-Defining Disease
Background: Tuberculosis (TB) is common among HIV-infected individuals in many resource-limited countries and has been associated with poor survival. We evaluated morbidity and mortality among individuals first starting antiretroviral therapy (ART) with concurrent active TB or other AIDS-defining disease using data from the “Prospective Evaluation of Antiretrovirals in Resource-Limited Settings” (PEARLS) study. Methods: Participants were categorized retrospectively into three groups according to presence of active confirmed or presumptive disease at ART initiation: those with pulmonary and/or extrapulmonary TB (“TB” group), those with other non-TB AIDS-defining disease (“other disease”), or those without concurrent TB or other AIDS-defining disease (“no disease”). Primary outcome was time to the first of virologic failure, HIV disease progression or death. Since the groups differed in characteristics, proportional hazard models were used to compare the hazard of the primary outcome among study groups, adjusting for age, sex, country, screening CD4 count, baseline viral load and ART regimen. Results: 31 of 102 participants (30%) in the “TB” group, 11 of 56 (20%) in the “other disease” group, and 287 of 1413 (20%) in the “no disease” group experienced a primary outcome event (p = 0.042). This difference reflected higher mortality in the TB group: 15 (15%), 0 (0%) and 41 (3%) participants died, respectively (p<0.001). The adjusted hazard ratio comparing the “TB” and “no disease” groups was 1.39 (95% confidence interval: 0.93–2.10; p = 0.11) for the primary outcome and 3.41 (1.72–6.75; p<0.001) for death. Conclusions: Active TB at ART initiation was associated with increased risk of mortality in HIV-1 infected patients
Acceptability of self-conducted home-based HIV testing among men who have sex with men in Brazil: data from an on-line survey
The Brazilian HIV/AIDS epidemic is concentrated among men who have sex with men (MSM), however HIV testing rates among MSM are not commensurate with their risk. Strategies to expand early diagnosis may include use of self-conducted home-based testing kits, which are now available for purchase in the US. In April 2011 we conducted a survey with Brazilian MSM using Facebook to assess HIV testing preferences and acceptability of home-based testing. Among 356 previously tested, HIV-negative MSM, 47% reported a preference for home-based testing, 27% preferred clinic-based testing, and 26% had no preference. Less frequent testers and those who had considered testing but failed to test were more likely to prefer home-based testing. Close to 90% reported that they would use self-test kits; 62% and 54% said they would use home-based testing to make choices about unprotected sex with regular and new partners, respectively. Concerns included difficulty to understand the tests (32%) and receiving results alone (23%). Overall, home-based testing may appeal to MSM and result in increased testing frequency. Research on feasibility and utilization of self-tests in practice is needed
Estimación de la concentración media diaria de material particulado fino en la región del Complejo Industrial y Portuario de Pecém, Ceará, Brasil
A exposição ao material particulado fino (MP2,5) está associada a inúmeros
desfechos à saúde. Desta forma, monitoramento da concentração ambiental
do MP2,5 é importante, especialmente em áreas amplamente industrializadas,
pois abrigam potenciais emissores do MP2,5 e de substâncias com potencial de
aumentar a toxicidade de partículas já suspensas. O objetivo desta pesquisa é estimar a concentração diária do MP2,5 em três áreas de influência do
Complexo Industrial e Portuário do Pecém (CIPP), Ceará, Brasil. Foi aplicado
um modelo de regressão não linear para a estimativa do MP2,5, por meio de
dados de profundidade óptica monitorados por satélite. As estimativas foram
realizadas em três áreas de influência (Ai) do CIPP (São Gonçalo do Amarante – Ai I, Paracuru e Paraipaba – Ai II e Caucaia – Ai III, no período de
2006 a 2017. As médias anuais das concentrações estimadas foram inferiores
ao estabelecido pela legislação nacional em todas as Ai (8µg m-3). Em todas as
Ai, os meses referentes ao período de seca (setembro a fevereiro) apresentaram
as maiores concentrações e uma predominância de ventos leste para oeste. Os
meses que compreendem o período de chuva (março a agosto) apresentaram as
menores concentrações e ventos menos definidos. As condições meteorológicas
podem exercer um papel importante nos processos de remoção, dispersão ou
manutenção das concentrações do material particulado na região. Mesmo com
baixas concentrações estimadas, é importante avaliar a constituição das partículas finas dessa região, bem como sua possível associação a efeitos adversos à
saúde da população local.Exposure to fine particulate matter (PM2.5) is associated with numerous negative health outcomes.
Thus, monitoring the environmental concentration of PM2.5 is important, especially in heavily
industrialized areas, since they harbor potential
emitters of PM2.5 and substances with the potential
to increase the toxicity of already suspended particles. This study aims to estimate daily concentrations of PM2.5 in three areas under the influence of
the Industrial and Port Complex of Pecém (CIPP),
Ceará State, Brazil. A nonlinear regression model
was applied to estimate PM2.5, using satellitemonitored optical depth data. Estimates were
performed in three areas of influence (Ai) of the
CIPP (São Gonçalo do Amarante – AiI, Paracuru
and Paraipaba – AiII, and Caucaia – AiIII), from
2006 to 2017. Estimated mean annual concentrations were lower than established by Brazil’s national legislation in all three Ai (8µg m-³). In all
the Ai, the months of the dry season (September to
February) showed the highest concentrations and
a predominance of east winds, while the months
of the rainy season (March to August) showed
the lowest concentrations and less defined winds
Weather conditions can play an important role in
the removal, dispersal, or maintenance of concentrations of particulate matter in the region. Even
at low estimated concentrations, it is important
to assess the composition of fine participles in this
region and their possible association with adverse
health outcomes in the local population.La exposición al material particulado fino (MP2,5)
está asociada a innumerables problemas de salud.
Por ello, la supervisión de la concentración ambiental del MP2,5 es importante, especialmente en
áreas ampliamente industrializadas, puesto que
albergan potenciales emisores de MP2,5 y de sustancias con potencial de aumentar la toxicidad
de partículas ya suspendidas. El objetivo de esta
investigación es estimar la concentración diaria
del MP2,5 en tres áreas de influencia del Complejo Industrial y Portuario de Pecém (CIPP), Ceará,
Brasil. Se aplicó un modelo de regresión no lineal
para la estimación del MP2,5, mediante datos de
profundidad óptica supervisados por satélite. Las
estimaciones fueron realizadas en tres áreas de influencia (Ai) del CIPP (São Gonçalo do Amarante
– Ai I, Paracuru y Paraipaba – Ai II y Caucaia
– Ai III en el período de 2006 a 2017. Las medias
anuales de las concentraciones estimadas fueron
inferiores a lo establecido por la legislación nacional en todas las Ai (8µg m-³). En todas las Ai, los
meses referentes al período de sequía (de setiembre
a febrero) presentaron las mayores concentraciones y una predominancia de vientos este a oeste,
los meses que comprenden el período de lluvia
(marzo a agosto) presentaron las menores concentraciones y vientos menos definidos. Las condiciones meteorológicas pueden ejercer un papel importante en los procesos de eliminación, dispersión o
mantenimiento de las concentraciones del material
particulado en la región. Incluso con bajas concentraciones estimadas es importante que se evalúe la
constitución de las partículas finas de esta región,
así como su posible asociación con efectos adversos
para la salud de la población local
Acceptability of self-conducted home-based HIV testing among men who have sex with men in Brazil: data from an on-line survey
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Previous issue date: 2014Center for AIDS Prevention Studies, University of California, San Francisco, U.S.AFundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, BrasilFundação Oswaldo Cruz, Instituto de Pesquisa Clinica Evandro Chagas, Rio de Janeiro, BrasilRollins School of Public Health, Emory University, Atlanta, U.S.ABridge HIV, San Francisco Department of Public Health, San Francisco, U.S.ARollins School of Public Health, Emory University, Atlanta, U.S.AFundação Oswaldo Cruz, Instituto de Pesquisa Clinica Evandro Chagas, Rio de Janeiro, BrasilThe Brazilian HIV/AIDS epidemic is concentrated among men who have sex with men (MSM), however HIV testing rates among MSM are not commensurate with their risk. Strategies to expand early diagnosis may include use of self-conducted home-based testing kits, which are now available for purchase in the US. In April 2011 we conducted a survey with Brazilian MSM using Facebook to assess HIV testing preferences and acceptability of home-based testing. Among 356 previously tested, HIV-negative MSM, 47% reported a preference for home-based testing, 27% preferred clinic-based testing, and 26% had no preference. Less frequent testers and those who had considered testing but failed to test were more likely to prefer home-based testing. Close to 90% reported that they would use self-test kits; 62% and 54% said they would use home-based testing to make choices about unprotected sex with regular and new partners, respectively. Concerns included difficulty to understand the tests (32%) and receiving results alone (23%). Overall, home-based testing may appeal to MSM and result in increased testing frequency. Research on feasibility and utilization of self-tests in practice is needed
Incidência de episódios hipotônicos-hiporresponsivos associados à vacina combinada DTP/Hib usada no Programa Nacional de Imunizações
OBJETIVO: Avaliar a segurança da vacina combinada de difteria-tétano-coqueluche de células inteiras e Haemophilus influenzae tipo b usada no Programa Nacional de Imunizações, e em especial a incidência de episódios hipotônicos-hiporresponsivos. MÉTODO: Acompanhamento de uma coorte de 21.064 lactentes (20.925 ou 99,7% aderiram ao protocolo de estudo), nas 48 horas após a aplicação da vacina de difteria, tétano, coqueluche de células inteiras e Haemophilus influenzae tipo b em centros de saúde na cidade do Rio de Janeiro, para determinar e investigar eventos adversos graves, espontâneos e solicitados. Cada criança foi monitorada durante somente uma dose. RESULTADOS: A incidência de episódios hipotônicos-hiporresponsivos foi de 1:1.744 doses (casos confirmados) e de 1:1.495 doses (casos confirmados mais casos suspeitos). A taxa de incidência de convulsões foi de 1:5.231 doses. Não foram detectados casos de apnéia. Esses resultados são comparáveis àqueles relatados na literatura para a vacina contra difteria-tétano-coqueluche de células inteiras. CONCLUSÃO: A vacina contra difteria, tétano, coqueluche de células inteiras e Haemophilus influenzae tipo b em estudo pode ser usada com segurança no Programa Nacional de Imunizações, de acordo com as precauções e contra-indicações correntes