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Biomedical subjects

F Zicker

Publications and source records attributed to F Zicker.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Seroprevalence and risk factors for hepatitis B virus infection by AgHBs and anti-HBs markers in prisoners and prime blood donors].

Two cross-sectional surveys on hepatitis B virus (HBV) infection were carried out among 1,033 volunteer first-time blood donors in five blood banks (3 private, 2 public) and among 201 prisoners in the Penitentiary Center of Industrial Activity, in Goiania, Central Brazil, between June 1988 and February 1989. Those surveys were part of a major study designed to estimate seroprevalence of HBsAg and anti-HBsAg markers by ELISA test, and to study risk factors associated with seropositivity. The presence of any serum marker was considered as previous exposure to HBV. A standard questionnaire was applied to both populations to evaluate previous blood transfusion, number of sexual partners, homo/bisexual activity, history of sexually transmitted diseases, drug abusers, use of parenteral medicine, acupuncture, tattooing and VDRL seropositivity. Seroprevalence varied from 12.8% to 26.4% in blood donors and prisoners, respectively, (p less than 0.05) and increased with age (X2 trend=14.0 p less than 0.05%). Prisoners had higher percentages of all risk factors investigated than blood donors, with the exception of number of sexual partners. Among all risk factors studied, age, imprisonment and tattooing were statistically associated with seropositivity, even after multivariate analysis controlling for age and reclusion. The paper discusses the methodologic issues related to this epidemiologic investigation.

Adult↗
PubMed1990

Physical activity, opportunity for reinfection, and sibling history of heart disease as risk factors for Chagas' cardiopathy.

A case-control study was conducted to examine whether physical activity, sibling history of heart disease (HHD), and length of residence in an area endemic for Chagas' disease were associated with the risk of developing Chagas' cardiopathy. Two hundred forty-seven cases of Chagas' heart disease and 345 seropositive subjects with normal ECG (controls) were selected in a population survey in Goiânia, Brazil. Prevalence ratios for exposure variables were estimated for cases in relation to controls and for subgroups of seropositives with selected ECG abnormalities in relation to controls. Increasing age and male sex were consistently and significantly related to an increased risk of ECG abnormalities. HHD was significantly associated with ECG alterations in 3 of the 5 comparison subgroups (any ECG alteration, right bundle branch block, and left anterior hemiblock). No association was found between length of residence in an area endemic, physical activity, and ECG abnormalities. A sample of 529 seronegative subjects were also examined and the interaction between exposure variables and seropositivity was tested to assess whether the associations found were specific for seropositives. Males were at greater risk of any ECG alteration and left anterior hemiblock in relation to females if they were seropositive. An increasing risk of ventricular premature beats with age was clearer for seropositive than for seronegative subjects. Subjects with HHD were at an increased risk of ECG abnormalities and this was greater in those with a positive serological test (P less than 0.05). The findings suggest a possible geographical clustering or a familial aggregation of cases of Chagas' heart disease.

Adult↗
PubMed1990

Mass screening for Trypanosoma cruzi infections using the immunofluorescence, ELISA and haemagglutination tests on serum samples and on blood eluates from filter-paper.

Methods used to diagnose Trypanosoma cruzi infection differ in their ability to discriminate between sera from infected and uninfected individuals. We compared the results of an immunofluorescence (IF) test, a haemagglutination (HA) test, and an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of T. cruzi infections in a large population-based survey in central Brazil using blood eluates from filter-paper and venous blood samples. The sensitivities of the tests on eluates, compared with results on serum samples, were low: ELISA (78.1%), IF (69.2%) and HA (64.6%). The level of agreement between the tests on eluates was very poor, with the best co-positivity for IF and ELISA. Both the positive and negative predictive values of the three tests on eluates were similar (around 96%) to those for sera. Higher co-positivity values were obtained for the three tests on sera. The implications of these results are discussed in relation to blood screening, routine medical practice, sero-epidemiological surveys, and the follow-up of patients admitted to therapeutic trials.

Brazil↗
PubMed1989

[Serologic screening of infectious diseases in blood banks as an indicator of morbidity in the population].

Screening tests of 62,814 blood donations carried out between October 85 and October 87 in all five blood banks of Goiânia, Central Brazil, were analysed. The private institutions (3 blood banks) collected 80% of all donations and the remaining were collected by public blood banks. Seroprevalence of HIV, HBsAg, Chagas' disease and syphilis were compared with data obtained in the surveillance system and from previous surveys in an attempt to validate this source of health information. A seroprevalence of 0.07% for AIDS (one ELISA test) was calculated, which may suggest the presence of 1900 infected individuals, in the population of the State of Goiás as a whole. This figure seems reasonably close to the official data obtained by compulsory notification. For Chagas' disease, hepatitis B and syphilis seroprevalence of 3.3%, 1.3% and 4.1% were obtained, respectively. The potential usefulness and the limitations of screening in blood banks as a source of reliable morbidity indicator is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Field trials with oxamniquine in a Schistosomiasis mansoni-endemic area.

In Peri-Peri (Minas Gerais), an area endemic for Schistosoma mansoni, 591 inhabitants were examined. A coprological survey showed a prevalence of infection of 43.7%. After clinical examination 220 patients were distributed into three groups for treatment with oxamniquine; in Group 1, 19 children (2 to 15 years) were treated with a single oral dose of drug suspension around 20 mg/kg body weight; in Group 2, 47 children were treated orally with two 10 mg/kg doses with a 6- to 8-hour interval between them; in Group 3, 154 adults were treated with a single dose of about 15 mg/kg (capsules). The most frequent side effects were dizziness, drowsiness, and headache. No statistical difference in frequency of side effects was observed between Groups 1 and 2. Nevertheless, after treatment 32% of the patients in Group 1 complained of dizziness and 13% of headache, whereas in Group 2 the frequencies of these symptoms were 2% and 0%, respectively. Adults (Group 3) had a higher frequency of side effects, their chief complaints being dizziness and drowsiness. In Groups 1, 2, and 3, respectively, 73.7%, 62.2%, and 82.4% of the patients were cured. Statistical analysis did not show any difference in cure rates between children in Groups 1 and 2; however a significance was found when compared with the cure rate observed in adults, showing the drug to be more active in the latter group. In 61.8% of the 40 patients not cured a decrease of over 90% in the number of S. mansoni eggs/g feces was observed. From the data above oxamniquine seems to be an effective schistosomicidal drug suitable for use in endemic areas, although further studies are still needed.

Adolescent↗
PubMedDate not supplied

Seroprevalence of Trypanosoma cruzi infection among unskilled urban workers in central Brazil.

A cross-sectional survey of the prevalence of Trypanosoma cruzi infection was carried out among urban unskilled workers in an endemic area in central Brazil as part of a study to assess the health impact of Chagas disease and to identify risk factors for the evolution of cardiopathy. Blood samples from 5425 male and female workers, aged 15-61 years, from 5 public institutions, were screened by indirect immunofluorescence, enzyme-linked immunosorbent assay and indirect haemagglutination for antibodies to T. cruzi. Seroprevalence varied from 8.8% to 15.6% in the different institutions and increase with age up to 55 years. More stable jobs were associated with lower seroprevalence. Migrants from São Paulo and Minas Gerais presented higher prevalence and a relative risk associated with seropositivity in relation to workers from Goiás of 2.2 (95% confidence limits, 1.4-3.5) and 1.9 (1.6-2.3), respectively.

Adolescent↗
PubMedDate not supplied

Exercise electrocardiogram tests in manual workers with and without antibodies to Trypanosoma cruzi: a population-based study.

Blood pressure, heart rate and electrocardiographic responses to exercise were compared in a group of 125 subjects with antibodies to Trypanosoma cruzi and in 153 seronegative subjects, randomly selected from persons with no evidence of heart disease in a resting electrocardiogram during a cross-sectional survey among apparently healthy manual workers. The mean heart rates and diastolic and systolic blood pressures of those in each group did not differ statistically at different phases of the exercise test and there was no evidence of a difference in physical fitness between those in the 2 groups. An abnormal test was recorded in 26.2% of seropositive, and in 16.1% of seronegative, subjects (odds ratio adjusted for age, sex and body mass index [OR] = 2.0, 95% confidence interval [95% CI] = 1.1-3.8). No significant difference was observed between the 2 groups in the occurrence of hypertensive response to exercise (6.4% among seropositives and 5.9% among seronegatives), ST depression greater than 1 mm (0.8% and 2.0%), supraventricular premature beats (4.8% and 2.6%) or conduction defects (0.8% and 1.3%). Complex ventricular premature beats were recorded more often in seropositive subjects (12.8% and 3.9%; OR = 3.7, 95% CI = 1.4-9.8, P less than 0.01). The risk of an abnormal test increased with age in both groups. A history of cardiovascular symptoms, gender and body mass was not associated with the risk of an abnormal response in the test. The findings suggest that exercise testing might be a routine procedure when subjects with antibodies to T. cruzi are being assessed for participation in potentially high risk activities, such as heavy manual work.

Adult↗
PubMedDate not supplied

[Seroprevalence and risk factors for syphilis in prisoners in Goiás, Brazil].

A cross-sectional survey was carried-out among 299 prisoners in the Penitentiary Center of Industrial Activity of Goiás (CEPAIGO), to determine the seroprevalence to T. pallidum and to identify risk factors associated to seropositivity. The seropositivity criterion was a positive VDRL test at any titer. A questionnaire was applied to evaluate the following risk factors: time of imprisonment, clinical evidence of sexually transmitted diseases (STD), history of syphilis or others STD, homo/bisexuality and number of sexual partners. The positive (PPV) and negative (NPV) predictive values of the history of syphilis were calculated. Seroprevalence of 18.4% was found and no difference was detected in the different age groups. The PPV of history of syphilis was 26% indicating that 74% of the individuals who have reported syphilis in the past presented a negative VDRL test. Among all the risk factors studied, homo/bisexuality was the only one with statistically significant association with seropositivity (relative risks 5.7-95% CL1.2-26, p = 0.03). The paper discusses the methodological problems related with the investigation.

Adolescent↗
PubMedDate not supplied

[Bacteriologic study of abscesses caused by bites of snakes of the genus Bothrops].

The bacterial flora of 99 cases of abscesses following Bothrops snakebite were analysed. They corresponded to 61.1% of all snakebite abscesses observed in 1030 patients attending the Hospital de Doenças Tropicais de Goiánia in Goiás, Brazil, from January 1984 to April 1988. An exsudate sample of each abscess was examined by Gram stain, culture and susceptibility tests. The Gram negative bacillis, Morganella morganii, Escherichia coli and Providencia sp were the most frequent bacterias isolated. They were identified in 44.4%, 20.2% and 13.1% of the samples respectively. This flora was similar to those described in snake mouth and venom by other researchers. Based on the results of the susceptibility tests the authors suggested the use of chloramphenicol for the treatment of those abscesses which do not respond to simple drainage.

Abscess↗
PubMedDate not supplied

Trends of T. cruzi infection based on data from blood bank screening.

Between October 1988 and April 1989 a cross-sectional survey was carried out in six out of eight blood banks of Goiánia, Central Brazil. Subjects attending for first-time blood donation in the mornings of the study period (n = 1358) were interviewed and screened for T. cruzi infection as a part of a major study among blood donors. Tests to anti-T. cruzi antibodies were performed, simultaneously, by indirect hemagglutination test (IHA) and complement fixation test (CFT). A subject was considered seropositive when any one of the two tests showed a positive result. Information on age, sex, place of birth, migration and socio-economic level was recorded. Results from this survey were compared with seroprevalence rates obtained in previous studies in an attempt to analyse trend of T. cruzi infection in an endemic urban area. The overall seroprevalence of T. cruzi infection among first-time donors was found to be 3.5% (95% confidence interval 2.5%-4.5%). The seroprevalence rate increased with age up to 45 years and then decreased. Migrants from rural areas had higher seroprevalence rates than subjects from urban counties (1.8%-16.2% vs. 0%-3.6%). A four fold decrease in prevalence rates was observed when these rates were compared with those of fifteen years ago. Two possible hypotheses to explain this difference were suggested: 1. a cohort effect related with the decrease of transmission in rural areas and/or 2. a differential proportion of people of rural origin among blood donors between the two periods. The potential usefulness of blood banks as a source of epidemiological information to monitor trends of T. cruzi infection in an urban adult population was stressed.

Adult↗
PubMedDate not supplied

A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil.

This clinical trial compared parasitological efficacy, levels of in vivo resistance and side effects of oral chloroquine 25 mg/Kg and 50 mg/Kg in 3 days treatment in Plasmodium falciparum malaria with an extended followed-up of 30 days. The study enrolled 58 patients in the 25 mg/Kg group and 66 in the 50 mg/Kg group. All eligible subjects were over 14 years of age and came from Amazon Basin and Central Brazil during the period of August 1989 to April 1991. The cure rate in the 50 mg/Kg group was 89.4% on day 7 and 71.2% on day 14 compared to 44.8% and 24.1% in the 25 mg/Kg group. 74.1% of the patients in the 25 mg/Kg group and 48.4% of the patients in the 50 mg/Kg group had detectable parasitaemia at the day 30. However, there was a decrease of the geometric mean parasite density in both groups specially in the 50 mg/Kg group. There was 24.1% of RIII and 13.8% of RII in the 25 mg/Kg group. Side effects were found to be minimum in both groups. The present data support that there was a high level resistance to chloroquine in both groups, and the high dose regimen only delayed the development of resistance and its administration should not be recommended as first choice in malaria P. falciparum therapy in Brazil.

Adult↗
PubMedDate not supplied

Risk factors for Trypanosoma cruzi infection among blood donors in central Brazil.

Characteristics and possible risk factors associated with Trypanosoma cruzi infection among blood donors were assessed within a routine screening programme in blood banks in an endemic area of Chagas disease. 6,172 voluntary blood donors were interviewed and tested for anti-T. cruzi antibodies by Haemagglutination and Complement Fixation tests in six blood banks in Goiânia-Central Brazil from October 1988 to April 1989. An overall prevalence of 2.3% for T. cruzi infection was obtained, being 3.3% for first-time blood donors and 1.9% for regular ones (p < 0.01). Considering this seropositivity among regular blood donors, selection of candidates relying only on the history of previous donation was found to be inadequate. The risk of infection increased inversely with the degrees of education and monthly income. There was a 9.2 risk of infection (95% CI 3.8-22.6) for those who had lived more than 21 years in an endemic area compared to subjects who had never lived in rural settings, after multivariate analysis. These informations may help to review the criteria of selection of donors in order to improve quality of blood products in endemic areas.

Adolescent↗
PubMedDate not supplied

Risk for transfusion-transmitted infectious diseases in Central and South America.

We report the potential risk for an infectious disease through tainted transfusion in 10 countries of South and Central America in 1993 and in two countries of South America in 1994, as well as the cost of reagents as partial estimation of screening costs. Of the 12 countries included in the study, nine screened all donors for HIV; three screened all donors for hepatitis B virus (HBV); two screened all donors for Trypanosoma cruzi; none screened all donors for hepatitis C virus (HCV); and six screened some donors for syphilis. Estimates of the risk of acquiring HIV through blood transfusion were much lower than for acquiring HBV, HCV, or T. cruzi because of significantly higher screening and lower prevalence.rates for HIV. An index of infectious disease spread through blood transfusion was calculated for each country. The highest value was obtained for Bolivia (233 infections per 10,000 transfusions); in five other countries, it was 68 to 103 infections per 10,000. The risks were lower in Honduras (nine per 10,000), Ecuador (16 per 10,000), and Paraguay (19 per 10,000). While the real number of potentially infected units or infected persons is probably lower than our estimates because of false positives and already infected recipients, the data reinforce the need for an information system to assess the level of screening for infectious diseases in the blood supply. Since this information was collected, Chile, Colombia, Costa Rica, and Venezuela have made HCV screening mandatory; serologic testing for HCV has increased in those countries, as well as in El Salvador and Honduras. T. cruzi screening is now mandatory in Colombia, and the percentage of screened donors increased not only in Colombia, but also in Ecuador, El Salvador, and Paraguay. Laws to regulate blood transfusion practices have been enacted in Bolivia, Guatemala, and Peru. However, donor screening still needs to improve for one or more diseases in most countries.

Central America↗