Short-term triple therapy with azithromycin for Helicobacter pylori eradication: Low cost, high compliance, but low efficacy

<p>Abstract</p> <p>Background</p> <p>The Brazilian consensus recommends a short-term treatment course with clarithromycin, amoxicillin and proton-pump inhibitor for the eradication of <it>Helicobacter pylori </it>(<it>H. pylori)</it>. This treatment course has good efficacy, but cannot be afforded by a large part of the population. Azithromycin, amoxicillin and omeprazole are subsidized, for several aims, by the Brazilian federal government. Therefore, a short-term treatment course that uses these drugs is a low-cost one, but its efficacy regarding the bacterium eradication is yet to be demonstrated. The study's purpose was to verify the efficacy of <it>H. pylori </it>eradication in infected patients who presented peptic ulcer disease, using the association of azithromycin, amoxicillin and omeprazole.</p> <p>Methods</p> <p>Sixty patients with peptic ulcer diagnosed by upper digestive endoscopy and <it>H. pylori </it>infection documented by rapid urease test, histological analysis and urea breath test were treated for six days with a combination of azithromycin 500 mg and omeprazole 20 mg, in a single daily dose, associated with amoxicillin 500 mg 3 times a day. The eradication control was carried out 12 weeks after the treatment by means of the same diagnostic tests. The eradication rates were calculated with 95% confidence interval.</p> <p>Results</p> <p>The eradication rate was 38% per intention to treat and 41% per protocol. Few adverse effects were observed and treatment compliance was high.</p> <p>Conclusion</p> <p>Despite its low cost and high compliance, the low eradication rate does not allow the recommendation of the triple therapy with azithromycin as an adequate treatment for <it>H. pylori </it>infection.</p

Oral health-related quality of life of children with oral clefts and their families

Abstract Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being. Objective: To compare oral health-related quality of life (OHRQoL) of children with and without oral clefts and their families. Materials and Methods: 121 children aged from 2 to 6 years, from both sexes, enrolled in the treatment routine of the Pediatric Dentistry Clinics of a Dental School and a Hospital for Cleft Treatment were divided into two groups: Group 1 - children with cleft lip and palate; Group 2 - children without cleft lip and palate. The OHRQoL was assessed using the validated Portuguese version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The questionnaire was answered individually, only once, at a private place. Mann-Whitney U test was used to verify differences between groups. Spearman's Rho test was used to associate sex and age with quality of life. The level of significance was set at 5% (p<0.05). Results: According to the parents’ perception on the OHRQoL of children with and without cleft lip and palate, oral health of children with oral clefts (Group 1) had a statistically significant impact on OHRQoL. The correlation of sex with impact on OHRQoL did not show statistically significant differences. On the other hand, the higher the age the higher the impact on QoL. Conclusions: The group comparison revealed that the cleft lip and palate negatively impacted on OHRQoL of 2 to 6-year-old children and their parents

Exame Papanicolaou: sentimentos relatados por profissionais de enfermagem ao se submeterem a esse exame Pap smear screening: sensations reported by nursing professionals when submitted to this test

Objetivou-se conhecer os sentimentos de auxiliares e técnicas de enfermagem ao se submeterem ao exame Papanicolaou. Trata-se de um estudo descritivo com abordagem qualitativa realizado nos meses de setembro a outubro de 2006, com 35 servidoras de uma instituição governamental referência em ginecologia na cidade de Fortaleza (CE). Os dados foram coletados através de entrevista semiestruturada, contendo uma questão norteadora gravada e analisada de acordo com referencial teórico metodológico da fenomenologia social. Os relatos foram agrupados em três temáticas: um exame que causa incômodo, medo e vergonha; um exame que gera ansiedade quanto aos resultados; e um exame que "me deixa calma e tranquila". Apesar de as entrevistadas pertencerem a uma instituição que cuida de mulheres na prevenção do câncer cérvico-uterino, elas não deixaram de emitir sentimentos negativos relacionados ao exame. Concluiu-se a importância de realizar projetos educativos, enfatizando a importância do empoderamento das usuárias a fim de minimizar essas questões.<br>This work sought to record the impressions of nursing assistants and technicians after submitting to Pap smear screening. This is a descriptive study using a qualitative approach conducted in September and October of 2006 with 35 employees of a public institution, which is a benchmark in gynecology in Fortaleza in the State of Ceará (Brazil). The data was collected through semi-structured interviews containing a recorded leading question and analyzed according to the methodological-theoretical reference of social phenomenology. The testimonials were separated in three groups: an exam that causes discomfort, fear and shame; an exam that causes anxiety about the results; and an exam that "makes me calm and relaxed". Despite the interviewees being part of an institution that cares for the prevention of cervical-uterine cancer in women, negative feelings about the Pap smear test were nonetheless reported. The conclusion reached is that it is important to stage educational campaigns emphasizing the importance of empowerment of patients in order to minimize these aspects

Field and classroom initiatives for portable sequence-based monitoring of dengue virus in Brazil.

Brazil experienced a large dengue virus (DENV) epidemic in 2019, highlighting a continuous struggle with effective control and public health preparedness. Using Oxford Nanopore sequencing, we led field and classroom initiatives for the monitoring of DENV in Brazil, generating 227 novel genome sequences of DENV1-2 from 85 municipalities (2015-2019). This equated to an over 50% increase in the number of DENV genomes from Brazil available in public databases. Using both phylogenetic and epidemiological models we retrospectively reconstructed the recent transmission history of DENV1-2. Phylogenetic analysis revealed complex patterns of transmission, with both lineage co-circulation and replacement. We identified two lineages within the DENV2 BR-4 clade, for which we estimated the effective reproduction number and pattern of seasonality. Overall, the surveillance outputs and training initiative described here serve as a proof-of-concept for the utility of real-time portable sequencing for research and local capacity building in the genomic surveillance of emerging viruses