Use of rhu-GM-CSF in pulmonary tuberculosis patients: results of a randomized clinical trial

It has been postulated that deficient or incomplete clinical and/or microbiological response to tuberculosis treatment is associated with cell-mediated immunological dysfunction involving monocytes and macrophages. A phase 2 safety trial was conducted by treating patients with either recombinant human granulocyte-macrophage colony-stimulating factor (rhu-GM-CSF) or a placebo, both in combination with anti-tuberculosis chemotherapy. Thirty-one patients with documented pulmonary tuberculosis were treated with rifampin/isoniazid for six months, plus pyrazinamide for the first two months. At the beginning of treatment, rhu-GM-CSF (125µg/M²) was randomly assigned to 16 patients and injected subcutaneously twice weekly for four weeks; the other 15 patients received a placebo. The patients were accompanied in the hospital for two weeks, then monthly on an out patient basis, for 12 months. Clinical outcomes were similar in both groups, with no difference in acid-fast bacilli (AFB) clearance in sputum at the end of the fourth week of treatment. Nevertheless, a trend to faster conversion to negative was observed in the rhu-GM-CSF group until the eighth week of treatment (p=0.07), after which all patients converted to AFB negative. Adverse events in the rhu-GM-CSF group were local skin inflammation and an increase in the leukocyte count after each injection, returning to normal 72 hours after rhu-GM-CSF injection. Three patients developed SGOP and SGPT > 2.5 times the normal values. All patients included in the GM-CSF group were culture negative at six months, except one who had primary TB resistance. None of the patients had to discontinue the treatment in either group. We conclude that rhu-GM-CSF adjuvant immunotherapy could be safely explored in a phase 3 trial with patients who have active tuberculosis

Prevalence and risk of blood-borne and sexually transmitted viral infections in incarcerated youth in Salvador, Brazil: opportunity and obligation for intervention

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2015-06-03T14:08:57Z No. of bitstreams: 1 Fialho M Prevalence and Risk of Blood....pdf: 201517 bytes, checksum: 25fa3d4b37bf635e1d217c15d75f1729 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2015-06-03T14:23:47Z (GMT) No. of bitstreams: 1 Fialho M Prevalence and Risk of Blood....pdf: 201517 bytes, checksum: 25fa3d4b37bf635e1d217c15d75f1729 (MD5)Made available in DSpace on 2015-06-03T14:23:47Z (GMT). No. of bitstreams: 1 Fialho M Prevalence and Risk of Blood....pdf: 201517 bytes, checksum: 25fa3d4b37bf635e1d217c15d75f1729 (MD5) Previous issue date: 2008Centro de Referência do Estado da Bahia para AIDS. CREAIDS. Salvador, BA, Brasil.Centro de Referência do Estado da Bahia para AIDS. CREAIDS. Salvador, BA, Brasil,University of California San Francisco. Center for AIDS Prevention Studies. San Francisco, CA, USA,Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil,Centro de Referência do Estado da Bahia para AIDS. CREAIDS. Salvador, BA, Brasil,Universidade Federal da Bahia. Infectious Diseases Service. Salvador, BA, Brasil,Centro de Estudos em AIDS do Rio Grande do Sul . CEARGS. Porto Alegre, RS, Brasil,Universidade Federal da Bahia. Infectious Diseases Service. Salvador, BA, Brasil,To determine the prevalence of sexually transmitted and blood-borne infections among incarcerated adolescents in Salvador, Brazil, we interviewed 300 incarcerated youth aged 11-18 years to participate in a physical examination and to provide a blood sample to test for HIV-1, hepatitis B and C viruses exposure, human T-cells lymphotrophic virus, and syphilis. Overall prevalence was anti-HIV, 0.34%; anti-HBc, 11.1%; HBsAg, 2.4%; anti-HCV, 6.4%; HTLV, 1.09%; and syphilis, 3.4%. The majority (86.3%) reported a history of sexual activity; 27% had never used condoms. Girls also reported previous pregnancy (35%), abortion (26%) and sexual abuse (74%). Many youth reported a family history of alcohol abuse (56%), illicit drug use (24.7%), or legal problems (38%). Serological results show that youth in Salvador are at high risk for blood-borne and sexually transmitted infections. Policies to reduce the risk and impact of these infections should be a requisite part of health care for incarcerated youth

Rates of and Reasons for Failure of Commercial Human Immunodeficiency Virus Type 1 Viral Load Assays in Brazil▿

We examined failures of commercial human immunodeficiency virus type 1 (HIV-1) viral load assays of 1,195 plasma samples from Brazilian patients. Assay failure was assumed for samples in which the virus was undetectable by commercial assay but which tested positive by real-time reverse transcription-PCR of the HIV-1 long terminal repeat (LTR) region or if the viral load differed by >2 log10 from that determined by LTR assay. Failure rates for Bayer Versant bDNA 3.0, Roche Amplicor Monitor v1.5, and bioMerieux NucliSens QT were 0.68, 0.47, and 4.33%, respectively. NucliSens may be inadequate for use in Brazil

An infant with Down syndrome and fever of unknown origin.

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T19:02:55Z No. of bitstreams: 1 Mello CD An infant....pdf: 228899 bytes, checksum: 3edc988ed78534f6f1f99835a737de90 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T19:03:05Z (GMT) No. of bitstreams: 1 Mello CD An infant....pdf: 228899 bytes, checksum: 3edc988ed78534f6f1f99835a737de90 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T19:14:00Z (GMT) No. of bitstreams: 1 Mello CD An infant....pdf: 228899 bytes, checksum: 3edc988ed78534f6f1f99835a737de90 (MD5)Made available in DSpace on 2014-12-22T19:14:00Z (GMT). No. of bitstreams: 1 Mello CD An infant....pdf: 228899 bytes, checksum: 3edc988ed78534f6f1f99835a737de90 (MD5) Previous issue date: 2010Universidade Federal da Bahia. Escola de Medicina. Departamento de Pediatria. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Escola de Medicina. Departamento de Patologia. Salvador, BA, BrasilFederal University of Bahia. University Hospital Diseases Unit. Salvador, BA, BrasilUniversidade Federal da Bahia. Escola de Medicina. Departamento de Patologia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Escola de Medicina. Departamento de Patologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Escola de Medicina. Departamento de Pediatria. Salvador, BA, Brasi

Studies on control of visceral leishmaniasis: impact of dog control on canine and human visceral leishmaniasis in Jacobina, Bahia, Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-04-18T14:01:02Z No. of bitstreams: 1 Ashford DA Studies on control of visceral....pdf: 61022 bytes, checksum: 0df2500bcc0325682ee498de7182435b (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-04-18T14:14:11Z (GMT) No. of bitstreams: 1 Ashford DA Studies on control of visceral....pdf: 61022 bytes, checksum: 0df2500bcc0325682ee498de7182435b (MD5)Made available in DSpace on 2016-04-18T14:14:11Z (GMT). No. of bitstreams: 1 Ashford DA Studies on control of visceral....pdf: 61022 bytes, checksum: 0df2500bcc0325682ee498de7182435b (MD5) Previous issue date: 1998Centers for Disease Control and Prevention. Atlanta, GASchool of Public Health. Department of Tropical Public Health. Harvard Boston, MAUniversidade Federal da Bahia. Salvador, BA, BrasilSchool of Public Health. Department of Tropical Public Health. Harvard Boston, MAFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Salvador, BA, BrasilUniversidade Federal da Bahia. Salvador, BA, BrasilUniversidade Federal da Bahia. Salvador, BA, BrasilTo assess the effect of removing leishmania-infected dogs on the incidence of visceral leishmaniasis, a controlled intervention study was performed in northeast Brazil. The attempted elimination of seropositive dogs resulted in an initial significant decrease in the annual incidence of seroconversion among dogs from 36% to 6% over the first two years. In the following two years, the incidence increased to 11% and 14%, respectively. In a control area in which dogs were surveyed but seropositive dogs were not removed, the cumulative incidence did not vary significantly from year to year, ranging from 16% to 27%. In the intervention area, the prevalence of dog seropositivity decreased from 36% before the intervention to 10% and remained stable. These findings suggest that attempting to remove seropositive dogs is insufficient as a measure for eradicating visceral leishmaniasis in dogs. However, the force of transmission of infection among dogs can be reduced by such programs. Also, when the number of human cases before and after the start of the intervention was calculated, a significant decrease in incidence of disease in the intervention area was observed among children less than 15 years of age (P , 0.01). The results of this intervention study suggest that the elimination of the majority of seropositive dogs may affect the cumulative incidence of seroconversion in dogs temporarily and may also diminish the incidence of human cases of visceral leishmaniasis