The Portuguese version of the schedule of racist events

Objective There is a lack of research tools in Portuguese to evaluate racial discrimination. The purpose of this study was to psychometrically assess the Portuguese version of the Schedule of Racist Events (SRE) in a sample of individuals enrolled in a research trial with antiretroviral medications in southern Brazil. Methods Sample of 147 individuals living with HIV and/or AIDS. Research participants completed the Schedule of Racist Events and the WHOQOL-HIV BREF questionnaires. Results The SRE scores of non-white participants were significantly higher than the scores of white-participants. The Crombach’s alpha coefficients, for the three subscales of the Portuguese version of the SRE, were high and significant. There were significant correlations between all subscales of the SRE and relevant domains of the WHOQOL-HIV BREF. Conclusion The original English version of the SRE was successfully adapted to Portuguese. The Portuguese version of SRE constitutes a valid research instrument for evaluating racial discrimination

Is chemotherapy necessary for patients with molar pregnancy and human chorionic gonadotropin serum levels raised but falling at 6 months after uterine evacuation?

Objective. To compare the outcomes of Brazilian patients with molar pregnancy who continue human chorionic gonadotropin (hCG) surveillance with those treated with chemotherapy when hCG was still positive, but falling at 6 months after uterine evacuation. Methods. Retrospective chart review of 12,526 patients with hydatidiform mole treated at one of nine Brazilian reference centers from January 1990 to May 2016. Results. At 6 months from uterine evacuation', 96 (0.8%) patients had hCG levels raised but falling. In 15/96 (15.6%) patients, chemotherapy was initiated immediately per FIGO 2000 criteria, while 81/96 (84.4%) patients were managed expectantly. Among the latter, 65/81 (80.2%) achieved spontaneous remission and 16 (19.8%) developed postmolar gestational trophoblastic neoplasia (GTN). Patients who received chemotherapy following expectant management required more time for remission (11 versus 8 monthsp = 0.001), had a greater interval between uterine evacuation and initiating chemotherapy (8 versus 6 monthsp < 0.001), and presented with a median WHO/FIGO risk score higher than women treated according to FIGO 2000 criteria (4 versus 2, p = 0.04), but there were no significant differences in the need for multiagent treatment regimens (1/15 versus 3/16 patients, p = 0.60). None of the women relapsed, and no deaths occurred in either group. Conclusion. In order to avoid unnecessary exposure of women to chemotherapy, we no longer follow the FIGO 2000 recommendation to treat all patients with molar pregnancy and hCG raised but falling at 6 months after evacuation. Instead, we pursue close hormonal and radiological surveillance as the best strategy for these patients. (C) 2016 Elsevier Inc. All rights reserved.Carlos Chagas Filho Foundation under the Brazilian Ministry of Science and TechnologyDonald P. Goldstein MD Trophoblastic Tumor Registry EndowmentDyett Family Trophoblastic Disease Research and Registry EndowmentUniv Fed Fluminense, Rio de Janeiro Trophoblast Dis Ctr, Antonio Pedro Univ Hosp, Matern Sch,Matern Ward Santa Casa Misericordia Ri, Rio De Janeiro, RJ, BrazilUniv Fed Fluminense, Postgrad Program Med Sci, Niteroi, RJ, BrazilUniv Fed Rio de Janeiro, Matern Sch, Postgrad Program Perinatal Hlth, Fac Med, Rio De Janeiro, RJ, BrazilSao Paulo State Univ, Trophoblast Dis Ctr, Clin Hosp, Botucatu Med Sch,Dept Gynecol & Obstet, Botucatu, SP, BrazilUniv Fed Sao Paulo, Paulista Sch Med, Sao Paulo Hosp, Trophoblast Dis Ctr, Sao Paulo, SP, BrazilUniv Sao Paulo, Sao Paulo Clin Hosp, Trophoblast Dis Ctr, Sao Paulo, SP, BrazilCaxias Do Sul Univ, Caxias Do Sul Trophoblast Dis Ctr, Gen Hosp Caxias Do Sul, Sch Med,Ctr Biol & Hlth Sci, Caxias Do Sul, MS USAIrmandade Santa Casa Misericordia Hosp, Porto Alegre Trophoblast Dis Ctr, Mario Totta Matern Ward, Porto Alegre, RS, BrazilGoias Fed Univ, Goias Trophoblast Dis Ctr, Clin Hosp Goias, Goiania, Go, BrazilHarvard Med Sch, Brigham & Womens Hosp, New England Trophoblast Dis Ctr, Div Gynecol Oncol,Dept Obstet & Gynecol & Reprod, Boston, MA USASão Paulo Hospital Trophoblastic Disease Center, Paulista School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, São Paulo, BrazilWeb of Scienc

Epidemiological Report on the Treatment of Patients with Gestational Trophoblastic Disease in 10 Brazilian Referral Centers Results After 12 Years Since International FIGO 2000 Consensus

OBJECTIVE: To evaluate treatment of Brazilian patients with gestational trophoblastic disease (GTD).STUDY DESIGN: A retrospective cohort study with analysis of medical reports performed in 10 Brazilian referral centers from January 2000 to December 2011.RESULTS: Of 5,250 patients 3 died (0.06%) at the time of uterine evacuation. Spontaneous remission of GTD (group G1) was observed in 4,103 cases, and 1,144 (21.8%) progressed to gestational trophoblastic neoplasia (GTN) (G2). In G1 2,716 (66.2%) had complete hydatidiform mole (HM) and 1,210, partial HM (29.5%); 3,772 patients (92.7%) recovered as noted in December 2012. In G2, of 1,118 patients treated, initial histopathological results of previous gestation were complete HM (77.5% [n = 886]), partial HM (8.8% [n = 100]), and choriocarcinoma (8.0% [n = 92]); 930 (81.3%) were low-risk, 200 (17.5%) were high-risk GTN, and 14 had placental site trophoblastic tumor (PSTT) (1.2%); cure was achieved in 1,078 cases (96.4%), but 26 patients (2.3%) died (4 low-risk [0.4%], 19 high-risk [9.5%], and 3 PSTT [21.4%]).CONCLUSION: The highest death rates were due to high-risk GTN and PSTT. Patients with molar pregnancy should be referred to a referral center for an early diagnosis and prompt treatment of GTN in order to reduce the morbidity and mortality found in advanced stages.Univ Fed Rio de Janeiro, Laranjeiras Matern Sch, Fluminense Fed Univ, Antonio Pedro Univ Hosp,Santa Casa Misericordia R, BR-21941 Rio De Janeiro, BrazilIrmandade Santa Casa Misericordia Porto Alegre Ma, Porto Alegre, RS, BrazilGoias Fed Univ, Clin Hosp, Goiania, Go, BrazilUniv Fed Sao Paulo, Sao Paulo Univ Hosp, Sao Paulo, BrazilParana Univ Hosp, Clin Hosp, Curitiba, Parana, BrazilUniv Sao Paulo, Clin Hosp Ribeirao Preto, BR-05508 Sao Paulo, BrazilCaxias do Sul Univ, Gen Hosp Caxias do Sul, Petropolis, RS, BrazilSao Paulo State Univ, Botucatu Med Sch, Botucatu, SP, BrazilGuilherme Alvaro Hosp Santos, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Univ Hosp, Sao Paulo, BrazilWeb of Scienc

G6P[8] Rotavirus a Possessing a Wa-like VP3 Gene from a Child with Acute Gastroenteritis Living in the Northwest Amazon Region

The introduction of rotavirus A (RVA) vaccines has considerably reduced the RVA-associated mortality among children under 5 years of age worldwide. The ability of RVA to reassort gives rise to different combinations of surface proteins G (glycoprotein, VP7) and P (protease sensitive, VP4) RVA types infecting children. During the epidemiological surveillance of RVA in the Northwest Amazon region, an unusual rotavirus genotype G6P[8] was detected in feces of a 2-year-old child with acute gastroenteritis (AGE) that had been vaccinated with one dose of Rotarix(&amp; REG;) (RV1). The G6P[8] sample had a DS-1-like constellation with a Wa-like VP3 gene mono-reassortment similar to equine-like G3P[8] that has been frequently detected in Brazil previously. The results presented here reinforce the evolutionary dynamics of RVA and the importance of constant molecular surveillance