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Biomedical subjects

A P Brandão

Publications and source records attributed to A P Brandão.

At least 19 recordsLinked to original sources
PubMed2005

Immunogenicity of a 23-valent pneumococcal polysaccharide vaccine in Brazilian elderly.

Serum antibodies specific for the capsular polysaccharides of Streptococcus pneumoniae provide protection against invasive pneumococcal infection. In Brazil, this vaccine has been used for people over 65 years with clinical risk to develop pneumococcal infection since 1999. We evaluated the immune response of 102 elderly subjects (75.5% females and 24.5% males) with a mean age of 71 years, and 19 young healthy adults (63.2% females and 36.8% males) with a mean age of 27 years. The elderly study group consisted of outpatients who received follow-up care in the Geriatric Department of General Hospital, Faculty of Medicine, University of São Paulo. None had acute illness at the time of vaccination. Both groups were immunized with one intra-deltoid injection with 0.5 ml of a 23-valent pneumococcal polysaccharide vaccine. The total IgG specific antibody concentrations to capsular polysaccharides 1, 3, 5, 6B, 8, and 14 were determined against pre- and 1-month post-vaccination sera. All samples were analyzed according to the second-generation pneumococcal polysaccharide ELISA protocol. We observed that the pneumococcal polysaccharide vaccine evoked consistent antibody increase for serotypes 1, 5, 6B, 8, and 14 (geometric mean concentration increase of 2.46 in the elderly and 2.84 in the young adults). Otherwise, we observed no increase in antibody concentration for serotype 3 in both groups.

Adult↗
PubMed1998

Early blood pressure level as a mark of familial aggregation of metabolic cardiovascular risk factors--the Rio de Janeiro Study.

OBJECTIVE: To investigate the familial aggregation of metabolic risk factors (RF) according to blood pressure (BP) percentile of children and adolescents. DESIGN AND METHODS: Normal BP was established in 3906 children and adolescents in 1987. From this population two groups of target individuals were separated: group A (n = 327) with systolic and/or diastolic BP percentile > 95 and group B (n = 327) with systolic and diastolic BP percentile < or = 50. Ten years later, familial aggregation of metabolic RF was evaluated using clinical and laboratorial data from 785 individuals, divided into two groups: group 1 with 135 target individuals (BP percentile > 95), 181 parents, 100 siblings and 16 grandparents; and group 2: 106 target individuals (BP percentile < or = 50), 145 parents, 84 siblings and 18 grandparents. RESULTS: (1) The longitudinal study 10 years later (tracking effect) showed that 34.8% of target individuals of group 1 and 90.5% of group 2 remained at the same BP percentile. (2) Comparing the two groups of target individuals, group 1 had higher weight and body mass index (BMI), systolic BP (SBP), diastolic BP (DBP), and heart rate (HR) (P < 0.001) and lower HDL (P < 0.003). (3) Comparing target individuals' and their relatives' measurements together, group 1 had higher BMI, HR, SBP, DBP (P < 0.03) and lower HDL (P < 0.001). (4) SBP and DBP showed significant correlation with all metabolic variables even when BMI was controlled in a multiple regression analysis (P < 0.04). CONCLUSION: BP level in children and adolescents was a good marker for familial aggregation of metabolic RF, suggesting an interaction of genetic and environmental factors. Primary intervention should be carried out in early stages of life.

Adolescent↗
PubMed1998

Macroscopic agglutination test for rapid diagnosis of human leptospirosis.

A commercially available slide agglutination test (SAT) for the diagnosis of human leptospirosis was evaluated by comparing it to an immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) and to the microscopic agglutination test (MAT). For all 108 patients, leptospirosis was diagnosed on the basis of a fourfold or greater increase in titer by MAT (seroconversion), and all but 1 of 245 controls were MAT negative (titers, <1:100). Both SAT and the IgM ELISA failed to detect one case of infection (sensitivity, 99%). Only 3 of 145 blood donors and none of the 100 patients with other illnesses were SAT positive (specificity, 99%). The overall results were similar for the three tests; however, SAT and ELISA were statistically more sensitive as initial screening tests. For 22% of the patients, the diagnosis of leptospirosis was made earlier by SAT than by MAT. SAT detected 27 (44%) of 62 MAT-negative patients with the first serum sample. ELISA and SAT had very similar results. Follow-up of patients for 1 year after the onset of symptoms showed a decreasing rate of positivity by SAT from the third month on. The rate of positivity by ELISA decreased more slowly, to about 67% by the end of the study. By MAT all patients were persistently reactive. SAT and ELISA seem to be convenient methods for the rapid and early screening for leptospirosis and could replace the less sensitive MAT. ELISA gives less subjective results than SAT and provides information on IgM kinetics, but it can be performed only by the more sophisticated laboratories. SAT is inexpensive, can be performed more quickly and more easily than ELISA, and could be used by the less well equipped laboratories.

Adolescent↗
PubMed1997

Hyperglycemia, hyperinsulinemia, overweight, and high blood pressure in young adults: the Rio de Janeiro Study.

Children and adolescents (n=3906, 10-15 years old) have been participating in a screening program for high blood pressure. Sixty-four individuals (17-23 years old) from this population were followed up for 8 years and four consecutive screenings and were stratified into three groups according to blood pressure: group 1 (n=23), > or = 95th percentile for at least three of four evaluations; group 2 (n=28), < 50th percentile for at least three of four screenings; and group 3 (n=13), with unstable blood pressure percentiles. All 64 individuals underwent an oral glucose tolerance test after a 12-hour fast. Blood samples were collected at 0, 30, 60, 90, and 120 minutes for insulin and glucose measurements. Group 1 had a greater body mass index and higher systolic and diastolic blood pressures, basal glucose and insulin levels, and peak values of insulin and glucose levels than the other groups (P<.05). Group 1 also had a higher prevalence of overweight and abnormal values of basal insulin than the other groups (P<.05) and a higher proportion of glucose-intolerant individuals when compared with group 2 (P<.05). Systolic and diastolic blood pressures were positively related to body mass index (P<.05) and insulin variables (P<.05); however, when body mass index was controlled for, only systolic blood pressure demonstrated a significant correlation with insulin variables (P<.05). The association of overweight, hyperinsulinemia, glucose intolerance, and high blood pressure can be detected early, but the significance of these findings would be better explained by longitudinal studies.

Adolescent↗
PubMed1996

Evaluation of diagnostic tests for human leptospirosis.

The IgM-PK-ELISA, an enzyme-linked immunosorbent assay for immunoglobulin M employing a proteinase K-treated antigen, and the "Leptoteste-S" macroagglutination test were evaluated for use in a rapid serodiagnosis of human leptospirosis. The microscopic agglutination test (MAT) was used as reference. The three serological tests were applied to serum samples from patients with leptospirosis (N = 89), typhoid fever (N = 8), malaria (N = 19), syphilis (N = 20), hepatitis (N = 16) and from clinically healthy donors (N = 92). The overall results of the IgM-PK-ELISA and the "Leptoteste-S" are comparable to those of the MAT. However, both tests differed statistically from MAT in terms of the positivity of the acute-phase sera, with approximately 38% of the patients with leptospirosis being identified earlier than when MAT was used. The IgM-PK-ELISA, with 89.9% sensitivity and 97.4% specificity, could be the test of choice for those laboratories which are equipped to perform ELISA. The "Leptoteste-S", with 89.9% sensitivity and 94.8% specificity, seems to be easier to perform and the most accessible to peripheral laboratories for rapid screening of human sera. Both techniques present the important characteristic of detecting early antibodies against leptospires, thus providing a diagnosis during the early stages of the disease.

Agglutination Tests↗
PubMed1995

Role of anthropometric indexes and blood pressure as determinants of left ventricular mass and geometry in adolescents. The Rio de Janeiro Study.

To evaluate left ventricular structural changes and their relationship to blood pressure and anthropometric indexes, we examined by echocardiography 108 adolescents aged 13 to 19 years. Subjects were divided into three groups according to blood pressure tracking during three moments of observation: group 1 (n = 27), > or = 95th percentile; group 2 (n = 37), < or = 50th percentile; and group 3 (n = 44), blood pressure not stable in the original percentile. Left ventricular mass index and the prevalence of altered left ventricular geometry were greater in group 1 (P < .05 and P < .02, respectively). Of all the anthropometric indexes, body surface area showed the best correlation with left ventricular mass (P < .00001). Left ventricular mass also correlated with systolic and diastolic pressures (P < .00001 and P < .003, respectively). Ventricular septal and posterior wall thicknesses and left ventricular diastolic diameter showed good correlations with body surface area (P < .00001). These variables also correlated with systolic pressure (P < .001). In a multiple regression model when body surface area was controlled, systolic pressure did not correlate significantly with left ventricular mass. In a similar model systolic pressure maintained a significant correlation with ventricular septal and posterior wall (P < .00001) thicknesses but not with left ventricular diastolic diameter (P > .05). We conclude that left ventricular structural changes can occur early after initial abnormalities of blood pressure. Considering that body surface area and systolic pressure were the best predictors of left ventricular alterations in adolescents, the usual way of correcting left ventricular mass by body surface area should be reviewed.

Adolescent↗
PubMed1995

Behaviour of specific IgM, IgG and IgA class antibodies in human leptospirosis during the acute phase of the disease and during convalescence.

The behaviour of specific IgM, IgG and IgA class antibodies in human leptospirosis was studied by ELISA. Two groups of patients were followed up, 57 of them in the acute phase and 10 during convalescence, the latter with a mean follow-up of 10.5 months. IgM class antibodies were detected starting on the 2nd day of symptoms and were observed in 100% of patients up to the 5th month, in 66.7% up to the 7th month and in 50% up to the 12th month after the onset of symptoms. IgG class antibodies were first detected on the 7th day of symptoms in 9.1% of patients, with maximum reactivity (87.5%) between the 2nd and 3rd month, and were not detected at all in one patient. IgA class antibodies were detected starting on the 5th day of symptoms in 7.7% of patients, and in all patients on the 15th day, persisting in 100% of cases up to the 9th follow-up month. During the 12th month, they were observed in 83.3% of patients. The results indicate that an anti IgA ELISA could be of great value in seroprevalence studies on human leptospirosis.

Adolescent↗
PubMed1995

[Multicenter National Study for the evaluation of the efficacy and tolerance of nifedipine oral release osmotic system in mild to moderate hypertension].

PURPOSE: Evaluation of the efficacy and tolerability of nifedipine oros in patients with mild to moderate essential hypertension without major target organ damage and the anti-hypertensive effect along the 24 hours. METHODS: Two hundred and three patients were studied. After two weeks placebo running period single dose of nifedipine oros (30 mg/day) was administered for 8 weeks. At the end of the 4th week, the non-responders (diastolic blood pressure > 90 mmHg or reduction in diastolic pressure < 10 mmHg), had the dosage increased to 60 mg/day. Laboratory tests and 24h blood pressure monitoring (60 patients) were performed at the beginning and at the end of the study. RESULTS: One hundred and ninety one patients completed the study. Fifty nine percent were considered responders at the end of the 4th week with nifedipine oros 30 mg/day and 41% needed dosage increment to 60 mg/day. At the end of the 8th week, all patients were considered responders to nifedipine oros. The blood pressure control extended throughout the 24h of the day. The most common adverse events were edema (14.6%) and headache (12.4%). Good and very good tolerability were informed by 85% of the patients. CONCLUSION: Nifedipine oros was able to control blood pressure efficaciously along the 24h period without important side effects. The possibility of once day dosage, increases the patient adherence to anti-hypertensive therapy.

Administration, Oral↗
PubMed1992

Familial aggregation of arterial blood pressure and possible genetic influence.

The aggregation of arterial blood pressure, weight, and height were compared between family members of children and adolescents with blood pressure percentiles at or above 95 (group 1) and at or below 50 (group 2). Weight, height, and systolic and diastolic blood pressures were significantly higher in siblings and target individuals of group 1 (p less than 0.001). Weight and systolic and diastolic blood pressures were significantly higher in mothers of group 1 (p less than 0.001). Covariant analysis comparing the average systolic and diastolic blood pressures of both groups controlled by age, age and weight, and age and Quetelet index revealed that the arterial blood pressure of mothers, siblings, and target individuals remained higher in group 1 (p less than 0.05 to p less than 0.001). These observations show a strong familial aggregation of arterial blood pressure not dependent only on physical development and also raise the question of a genetic basis as a possible mechanism of systemic arterial hypertension.

Age Factors↗
PubMed1989

The significance of physical development on the blood pressure curve of children between 6 and 9 years of age and its relationship with familial aggregation.

Arterial blood pressure values of 3109 children between 6 and 9 years of age in the city of Rio de Janeiro were analysed according to low, medium and high socio-economic levels. At medium and high socio-economic levels, arterial pressures, weight and height were higher than those observed in children of a lower socio-economic level. Blood pressure was best correlated to body weight. The aggregation of arterial pressure, weight and height was compared between family members of children with percentiles below 50 and above 90. Systolic blood pressure and weight were significantly lower in family members with a percentile below 50. We conclude that there is a need for a long-term follow-up of these children and their families, in order to improve our knowledge of the mechanisms involved in the origin of arterial hypertension.

Blood Pressure↗