That anthropology was not for us

Special interview - Cadernos de Campo - 25 year

Risk factors for default from tuberculosis treatment in HIV-infected individuals in the state of Pernambuco, Brazil: a prospective cohort study

BACKGROUND: Concomitant treatment of Human Immunodeficiency Virus (HIV) infection and tuberculosis (TB) presents a series of challenges for treatment compliance for both providers and patients. We carried out this study to identify risk factors for default from TB treatment in people living with HIV. METHODS: We conducted a cohort study to monitor HIV/TB co-infected subjects in Pernambuco, Brazil, on a monthly basis, until completion or default of treatment for TB. Logistic regression was used to calculate crude and adjusted odds ratios, 95% confidence intervals and P-values. RESULTS: From a cohort of 2310 HIV subjects, 390 individuals (16.9%) who had started treatment after a diagnosis of TB were selected, and data on 273 individuals who completed or defaulted on treatment for TB were analyzed. The default rate was 21.7% and the following risk factors were identified: male gender, smoking and CD4 T-cell count less than 200 cells/mm3. Age over 29 years, complete or incomplete secondary or university education and the use of highly active antiretroviral therapy (HAART) were identified as protective factors for the outcome. CONCLUSION: The results point to the need for more specific actions, aiming to reduce the default from TB treatment in males, younger adults with low education, smokers and people with CD4 T-cell counts < 200 cells/mm3. Default was less likely to occur in patients under HAART, reinforcing the strategy of early initiation of HAART in individuals with TB

Avaliações macroscópica e histológica do reparo da cartilagem articular equina tratada com microperfurações do osso subcondral associadas ou não à injeção intra-articular de cartogenina

Resumo O objetivo deste estudo foi avaliar o reparo da cartilagem hialina equina, por meio de análises macroscópica (através de videoartroscopia) e histológica (através de fragmentos de biopsia), em defeitos condrais induzidos na tróclea lateral do fêmur tratados pela técnica de microperfurações subcondral associada ou não com administração intra-articular de cartogenina. Foram utilizados seis equinos pesando em média (±DP) 342±1,58 kg, com a idade aproximada de 7,2±1,30 anos e escore corporal de 7,1±0,75, que foram submetidos a videoartroscopia para indução da lesão condral de 1 cm2 na tróclea lateral do fêmur e realização da técnica de microperfuração do osso subcondral de ambos os joelhos. Foram realizadas quatro aplicações semanais com 20 &#956;M de cartogenina intra-articulares em um dos joelhos (grupo tratado) e solução de ringer com lactato na articulação contralateral (grupo controle). Após o período de 60 dias, foram feitas as avaliações macroscópicas, através de videoartroscopias, e histológicas, através de biopsia. Não foram observadas diferenças significativas nos escores macroscópicos e histológicos para reparação condral entre animais dos grupos tratados e não tratados (P>0,05). De modo geral, a porcentagem média de cartilagem hialina no tecido de reparo (17,5%) foi condizente com a literatura internacional usando outros tipos de perfuração condral. Entretanto, não se observaram diferenças estatísticas entre grupos (P>0,05). A terapia com cartogenina, segundo protocolo utilizado, não produziu melhora do processo cicatricial em lesões condrais induzidas e tratadas com microperfurações na tróclea lateral do fêmur em equinos

Empirical treatment for TB in HIV: lessons from a cohort study of people living with HIV treated in Recife, Brazil

Submitted by Kamylla Nascimento ([email protected]) on 2017-11-27T12:21:34Z No. of bitstreams: 1 art. Empirical treatment - albuquerque.pdf: 833721 bytes, checksum: 56754f0ecd79cb233f789eeb4cde6072 (MD5)Approved for entry into archive by Kamylla Nascimento ([email protected]) on 2017-11-27T12:56:42Z (GMT) No. of bitstreams: 1 art. Empirical treatment - albuquerque.pdf: 833721 bytes, checksum: 56754f0ecd79cb233f789eeb4cde6072 (MD5)Made available in DSpace on 2017-11-27T12:56:42Z (GMT). No. of bitstreams: 1 art. Empirical treatment - albuquerque.pdf: 833721 bytes, checksum: 56754f0ecd79cb233f789eeb4cde6072 (MD5) Previous issue date: 2014Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento NESC. Recife, PE, Brasil.Universidade de Pernambuco. Department of Medical Science. Recife, PE, Brazil.Universidade Federal de Pernambuco. Department of Tropical Medicine. Recife, PE, Brazil.Hospital Correia Picanço. Recife, PE, Brazil.Universidade de Pernambuco. Department of Medical Science. Recife, PE, Brazil / Universidade Federal de Pernambuco. Department of Tropical Medicine. Recife, PE, Brazil.Universidade de Pernambuco. Department of Medical Science. Recife, PE, Brazil / Universidade Federal de Pernambuco. Department of Tropical Medicine. Recife, PE, Brazil.Universidade de Pernambuco. Department of Medical Science. Recife, PE, Brazil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento NESC. Recife, PE, Brasil.London School of Hygiene and Tropical Medicine. London, UK.Tuberculosis (TB) is the leading cause of death related to HIV worldwide. This study analyzes the survival of People Living with HIV (PLHIV) reporting cough without bacteriological confirmation of TB and identify factors associated with death

Hepatotoxicity during TB treatment in people with HIV/AIDS related to NAT2 polymorphisms in Pernambuco, Northeast Brazil

Introduction and objective: Hepatotoxicity during tuberculosis (TB) treatment is frequent and may be related to the Arylamine N-Acetyltransferase (NAT2) acetylator profile, in which allele frequencies differ according to the population. The aim of this study was to investigate functional polymorphisms in NAT2 associated with the development of hepatotoxicity after initiating treatment for TB in people living with HIV/AIDS (PLWHA) in Pernambuco, Northeast Brazil. Material and methods: This was a prospective cohort study that investigated seven single nucleotide polymorphisms located in the NAT2 coding region in 173 PLWHA undergoing TB treatment. Hepatotoxicity was defined as elevated aminotransferase levels and identified as being three times higher than it was before initiating TB treatment, with associated symptoms of hepatitis. A further 80 healthy subjects, without HIV infection or TB were used as a control group. All individuals were genotyped by direct sequencing. Results: The NAT2*13A and NAT2*6B variant alleles were significantly associated with the development of hepatotoxicity during TB treatment in PLWHA (p < 0.05). Individual comparisons between the wild type and each variant genotype revealed that PLWHA with signatures NAT2*13A/NAT2*13A (OR 4.4; CI95% 1.1–18.8; p 0.037) and NAT2*13A/NAT2*6B (OR 4.4; CI95% 1.5–12.7; p 0.005) significantly increased the risk of hepatotoxicity. Conclusion: This study suggests that NAT2*13A and NAT2*6B variant alleles are risk factors for developing hepatotoxicity, and PLWHA with genotypes NAT2*13A/NAT2*13A and NAT2*13A/NAT2*6B should be targeted for specific care to reduce the risk of hepatotoxicity during treatment for tuberculosis

A saúde da mulher em situação de violência: representações e decisões de gestores/as municipais do Sistema Único de Saúde Women's health in violent situations: municipal administrative roles and decision-making in the Brazilian public health system

Este estudo tem como objetivo investigar as representações de gestores/as sobre a saúde da mulher em situação de violência e a influência dessas representações nas decisões por ações de saúde para essas mulheres. Trata-se de um estudo qualitativo e descritivo, do qual participaram 18 gestores/as de três municípios em Gestão Plena do SUS da Região Metropolitana do Recife (Pernambuco, Brasil). Esses gestores/as foram acomodados em três grupos distintos, com base na semelhança de suas falas sobre a mulher em situação de violência e as ações em saúde para essas mulheres. Entretanto, esses três grupos convergem no que se refere às representações que determinam as decisões por ações em saúde para essas mulheres: o compromisso da gestão com o movimento feminista. Este compromisso aparece como o fator mais relevante e argumentos comuns entre gestores/as da saúde como: problema de saúde pública e qualidade de vida, ou mais tecnicamente, a questão de custo-benefício, não são destacados.<br>The aim of this study was to investigate the role of health management staff concerning the health of women facing violent situations and the impact these roles have on decisions concerning health measures targeting these women. The study employed a qualitative, descriptive methodology including 18 health management staff members from three municipalities classified as having fully autonomous municipal management systems under the Unified National Health System (SUS) in Greater Metropolitan Recife, Pernambuco State, Brazil. Staff members were divided into three distinct groups according to their opinions on women in violent situations and women's health interventions. However, the three groups were convergent with respect to their roles in determining decisions on health actions for these women. The health management staff's commitment to the feminist movement proved to be the most relevant factor. Common issues among staff members, such as the problem of public health and quality of living, or more technically, the cost-benefit issue, did appear as key arguments