Comitês de ética e pesquisa : levantamento de 26 hospitais brasileiros

As normas de pesquisa em saúde, sejam nacionais ou internacionais, prevêem que todos os projetos de pesquisa que envolvam serem humanos, antes de serem executados, devem ser submetidos à análise e aprovação de um Comitê de ética em Pesquisa. O objetivo do presente trabalho foi realizar um levantamento do funcionamento dos Comitês de Ética em pesquisa em instituições de saúde no Brasil, de como se está fazendo pesquisa em seres humanos e quais os mecanismos institucionais que estão sendo utilizados para controlá-la. Os dados obtidos demonstram, em primeiro lugar, que é lamentável a forma como vem sendo realizada a pesquisa biomédica no Brasil, em relação aos parâmetros de caráter ético estabelecido por normas nacionais e internacionais. Em segundo lugar, a necessidade de uma ampla divulgação das orientações nacionais e internacionais de pesquisa em saúde e do papel relevante dos Comitês de Ética em Pesquisa

Aspectos clínicos e laboratoriais da toxocaríase visceral na infância

Forty children with a diagnosis of Visceral Toxocariasis were evaluated prospectively from February 1982 to June 1989. Diagnosis was established by clinical, laboratorial and serological (ELISA - ES Toxocara canis antigen) evaluations. A great clinical polymorphism was found in our patients, ranging from unspecific or absent manifestations to an exhuberant symptomatology. The laboratorial findings were: leukocytosis,eosinophilia and elevation of serum gammaglobulin and isohemagglutinin levels. No significant relationship between clinical findings and laboratorial parameters was found. Serology (ELISA) was a method of great diagnostic support but did not show a correlation with clinical and laboratorial findings in this study. There was a significant relationship between pulmonary manifestations and the presence of signs and/or symptoms, when the patients were sent to us. Our findings, especially the high incidence of pulmonary manifestations, suggest that Visceral Toxocariasis has to be included in the differential diagnostic of children with pulmonary manifestations, characteristic epidemiological data and associated eosinophilia.Quarenta crianças portadoras de Toxocaríase Visceral foram avaliadas, prospectivamente, de fevereiro de 1982 a junho de 1989. O diagnóstico foi estabelecido através de avaliações clínicas, laboratoriais e sorológicas (ELISA -Antígeno ES de Toxocara canis). Em nossos pacientes encontramos grande polimorfismo clínico, desde quadros inespecíficos ou assintomáticos até sintomatologia exuberante, sendo as manifestações pulmonares as mais frequentes. Os achados laboratoriais foram: leucocitose, eosinofilia, elevação dos níveis de gamaglobulina e dos títulos de isohemaglutininas séricas. Não encontramos relação significante entre os achados clínicos e os parâmetros laboratoriais, incluindo a sorologia, apesar desta ser um teste de grande auxílio diagnóstico. Nossos achados, especialmente a alta incidência de manifestações pulmonares, sugerem que a Toxocaríase Visceral deve ser incluida no diagnóstico diferencial de crianças que apresentam manifestações pulmonares, dados epidemiológicos característicos e eosinofilia associada

Rubella vaccination of unknowingly pregnant women : the São Paulo experience

Rubella vaccination is contraindicated during pregnancy. During mass immunization of women of childbearing age against rubella, women unknowingly pregnant may be vaccinated. To evaluate the effects of rubella vaccination during pregnancy, the Brazilian state of São Paulo conducted a follow-up study of pregnant women vaccinated during a rubella campaign in 2001. Women vaccinated during pregnancy were reported to a national surveillance system. In the state of São Paulo, follow-up of vaccinated women included household interviews. Serum samples from vaccinated women were tested for antirubella antibodies to classify susceptibility to rubella infection. Children born to susceptible mothers were tested for evidence of congenital rubella infection and evaluated for signs of congenital rubella syndrome. The São Paulo State Health Department received 6473 notifications of women vaccinated during pregnancy. Serology performed for 5580 women identified 811 (15%) that were previously susceptible. Incidence of spontaneous abortion or stillbirth among previously susceptible vaccinated women was similar to women with prior immunity. Twenty-seven (4.7%) of 580 newborns tested had evidence of congenital rubella infection; none had congenital rubella syndrome. Mass rubella vaccination of women of childbearing age was not associated with adverse birth outcomes or congenital rubella syndrome among children born to women vaccinated during pregnancy2042S737S744pregnancyabortion,bornmothersrubellarubella virus vaccineserologic testsvaccinationinfectionssurveillance, medicalcongenital rubella infectionserum specime

Recent immunization against measles does not interfere with the sero-response to yellow fever vaccine

Secretaria de Estado de Saúde de São Paulo. Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac. São Paulo, SP, Brasil.Secretaria de Estado de Saúde de São Paulo. Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac. São Paulo, SP, Brasil.Universidade de São Paulo. Faculdade de Medicina. Instituto de Medicina Tropical de São Paulo. Departamento de Doenças Infecciosas e Parasitárias. São Paulo, SP, Brasil.Secretaria de Estado de Saúde de São Paulo. Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos. Rio de Janeiro, RJ, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Secretaria de Estado de Saúde de São Paulo. Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac. São Paulo, SP, Brasil.Secretaria de Estado de Saúde de São Paulo. Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac. São Paulo, SP, Brasil.Secretaria de Estado de Saúde de São Paulo. Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac. São Paulo, SP, Brasil.Secretaria de Estado de Saúde de São Paulo. Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac. São Paulo, SP, Brasil.Universidade de São Paulo. Faculdade de Medicina. Instituto de Medicina Tropical de São Paulo. Departamento de Doenças Infecciosas e Parasitárias. São Paulo, SP, Brasil.In order to determine whether previous measles vaccination interferes with the sero-response to yellow fever vaccine, 294 children at nine months of age were randomly assigned to immunization with yellow fever vaccine at di erent time intervals after measles vaccination. The seroconversion rate (SCR) and the log10 geometric mean titer (GMT) for 17 DD yellow fever vaccine at di erent intervals after Schwarz measles vaccination were: 1±6 days: SCR= 44/57= 77%; GMT= 4.57; 7±13 days: SCR= 36/53= 68%; GMT= 4.46; 14±21 days: SCR= 55/65= 85%; GMT= 4.46; 22±27 days: SCR= 41/54= 76%; GMT= 4.41 and >28 days: SCR= 52/65= 80%; GMT= 4.24 ( p> 0.05). We conclude that recent immunization against measles does not interfere with the sero-response to yellow fever vaccine

Rubella Vaccination of Unknowingly Pregnant Women: The Sao Paulo Experience, 2001

Background. Rubella vaccination is contraindicated during pregnancy. During mass immunization of women of childbearing age against rubella, women unknowingly pregnant may be vaccinated. To evaluate the effects of rubella vaccination during pregnancy, the Brazilian state of Sao Paulo conducted a follow-up study of pregnant women vaccinated during a rubella campaign in 2001.Methods. Women vaccinated during pregnancy were reported to a national surveillance system. In the state of Sao Paulo, follow-up of vaccinated women included household interviews. Serum samples from vaccinated women were tested for antirubella antibodies to classify susceptibility to rubella infection. Children born to susceptible mothers were tested for evidence of congenital rubella infection and evaluated for signs of congenital rubella syndrome.Results. The Sao Paulo State Health Department received 6473 notifications of women vaccinated during pregnancy. Serology performed for 5580 women identified 811 (15%) that were previously susceptible. Incidence of spontaneous abortion or stillbirth among previously susceptible vaccinated women was similar to women with prior immunity. Twenty-seven (4.7%) of 580 newborns tested had evidence of congenital rubella infection; none had congenital rubella syndrome.Conclusions. Mass rubella vaccination of women of childbearing age was not associated with adverse birth outcomes or congenital rubella syndrome among children born to women vaccinated during pregnancy