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Biomedical subjects

J Eluf-Neto

Publications and source records attributed to J Eluf-Neto.

11 recordsLinked to original sources
PubMed1996

[Evaluation of the effectiveness of arterial hypertension control in a primary health unit].

The present study is part of a performance evaluation of the Aging Health Care Program carried out at a Primary Health Care Clinic. Activities for Arterial Hypertension (AH), control oriented according to a risk assessment, in conformity with Ministry of Health norms, are included in the Program mentioned. The effectiveness of the reduction of blood pressure (BP) levels in hypertensive individuals subjected to programmatic activities for disease control, in an attempt to identify conditions association with that reduction, is evaluated. Of the 396 patients with AH registered under the Program between 01/01/92 and 06/30/93, 250 cases were included for this evaluation. These patients had, in addition to high blood pressure levels (BP > or = 160/95 mm Hg) on the first attendances at the health center (before registration in the programme), at least two medical consultations during program follow-up. The differences in blood pressure levels between measurements taken during consultations before the beginning of attendance at the program and those taken on the first attendances to the programme were analysed according to initial blood pressure level, age, sex, registering diagnosis and absences during the program follow-up. Reductions of > or = 5 mm Hg diastolic blood pressure (DBP) and/or > or = 10 mm Hg in systolic blood pressure (SBP) were obtained in 197 (78.8%) patients. The mean reduction was 8.8 mm Hg (sd = 11.4) for DBP and 17.7 mm Hg (sd = 18.6) for SBP. Results of several epidemiological studies allow the inference that a decrease in the mortality risk from Cardiovascular Disease can be achieved in a significant proportion of the individuals registered in the program. Blood pressure normalization according to program norms occurred in 111 (44.4%) individuals. Multiple linear regression analysis demonstrated that initial blood pressure and percentages of absenteeism during the follow-up were independently associated with the reductions in SBP and DBP. Age was independently associated only with the reductions in SBP. Participation of age and percentage of absenteeism during follow-up thus reveal that the final result of the programmed work is also a result of the different ways people take care of their own health.

Aged↗
PubMed1996

Pap test coverage in São Paulo municipality and characteristics of the women tested.

Interview data collected in March-September 1987 as part of an international multi-center study were used to assess Pap test coverage in the municipality of São Paulo and determine characteristics that made study subjects more likely or less likely to have been tested. The data analyzed came from interviews with 967 women. Information gathered during the interviews included demographic and socioeconomic data as well as information about use of health service facilities, use of oral contraceptives, breast self-examination, smoking, alcoholism, and prior Pap testing. The results showed that 666 (69%) of the women said they had received a Pap test in the past; 588 (61%) said they had one within three years of the interview; and 399 (41%) said they had one during the past year. Statistically significant relationships were found between Pap testing sometime in the past (and also Pap testing within the preceding three years) and age, education, marital status, use of oral contraceptives, breast self-examination, and consulting with a physician during the year preceding the interview. Adjustment for all the other statistically significant variables through multivariate analysis influenced but did not undo the statistical significance of each of these relationships. Overall, the results of this study point to levels of Pap test coverage exceeding those found by other São Paulo studies. One reason could have been this study's inclusion of Pap tests obtained at medical clinics that were not specifically accredited to give the test; another, which does not exclude the first, could have been a real increase in coverage resulting from increasing dissemination of messages in the 1980s stressing the importance of Pap testing. It is also noteworthy that 40% of the women interviewed said they had not had the test within the preceding three years. Characteristics associated with those not having had the test were youth (being 15-24 years old), being single, having low socioeconomic status, not having consulted a physician for a year, not having used oral contraceptives, and not having performed breast self-examination for a year. Knowing these characteristics could help implement measures to increase Pap test coverage of specific subgroups.

Adolescent↗
PubMed1994

Human papillomavirus and invasive cervical cancer in Brazil.

A hospital-based case-control study was undertaken to examine the role of human papillomavirus (HPV) in the development of invasive cervical cancer in Brazil. The study included 199 histologically confirmed incident cases and 225 age-frequency-matched controls selected from a wide range of diagnostic categories. A polymerase chain reaction technique was used to detect HPV DNA in cervical specimens collected with spatula and brush. HPV DNA was detected in 84% of the cases compared with 17% of controls. Grouping HPV types 16, 18, 31 and 33, 66% of the cases were positive compared with only 6% of the controls. In addition to HPV, number of sexual partners, early age at first intercourse, parity and duration of oral contraceptive use were significantly associated with an increased risk of cervical cancer. A history of previous Papanicolaou smears was significantly associated with a decreased risk. After adjustment, only presence of HPV DNA, parity and history of previous smears remained as independent risk factors. The adjusted odds ratios of cervical cancer associated with HPV 16, 18, 31, and 33 was 69.7 (95% confidence interval 28.7-169.6) and with unidentified types was 12.0 (5.1-28.5). The very high risks found in this study further implicate this virus in the aetiology of cervical cancer.

Adult↗
PubMed1994

Human papillomavirus-related serological markers of invasive cervical carcinoma in Brazil.

Masked sera from 194 cases and 217 controls participating in a case-control study of cervical cancer in Brazil were examined for antibodies to human papillomavirus (HPV) 16 E6 and E7 by radioimmunoprecipitation assay. Radiolabeled full-length E6 and E7 proteins expressed by in vitro transcription and translation in rabbit reticulocyte lysate were used as antigens. The antibody prevalences in cases and controls were: 54.1% versus 6% for E6; 30.4% versus 4.6% for E7; 63.4% versus 10.1% for either E6 or E7; and 21.1% versus 0.5% for both E6 and E7. The corresponding odds ratios were 35 ([95% confidence interval (CI)], 15-83), 10 (95% CI, 4-25), 28 (95% CI, 13-61) and 87 (95% CI, 10-736). The most marked contrast between cases and controls was observed for sera with high antibody titers (cpm > 6000) with an odds ratio of 239 (95% CI, 29-1946) for E6 or E7. Seroreactivity in cases was partially type specific; women who had HPV-16 DNA in the genital tract had higher antibody prevalence rates than those who were negative for HPV DNA. Reactivity to the E6 protein was associated with the stage of disease; the antibody prevalence was 62.7% in cases with stages II-IV and 31.0% in cases with stage I (P < 0.005). HPV-16 serology and HPV polymerase chain reaction were compared as markers for invasive cervical cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Risk of exposure to Chagas' disease among seroreactive Brazilian blood donors.

BACKGROUND: Screening of blood donors for Chagas' disease by using currently available serologic tests is complicated by the lack of adequate sensitivity, discordant results between tests, and the absence of a gold standard. STUDY DESIGN AND METHODS: The study was designed to evaluate the serologic tests by using epidemiologic data relating to the risk of exposure to Trypanosoma cruzi in the urban centers of Brazil. The serologic results obtained from screening 411,617 voluntary blood donations in São Paulo during 1993 and 1994 were reviewed, as well as follow-up results on 1,267 donors who initially were repeatably reactive in at least one of three screening tests. Epidemiologic data were obtained from 321 individuals who on follow-up remained reactive in at least one test and who returned for medical counseling. Controls included 119 screen-negative blood donors and 45 blood donors who were repeatably reactive in at least one screening test but were negative on follow-up. RESULTS: Of the individuals who reacted in three screening tests, 94.6 percent remained reactive on follow-up. Of the individuals who were repeatably reactive in only one screening test, 70.8 percent were negative in all three tests on follow-up. Most individuals who reacted in two or three tests on follow-up had epidemiologic evidence of a risk of exposure to Chagas' disease. A significant proportion (29.1%) of those who were reactive in only one test on follow-up had epidemiologic evidence of exposure to the Chagas' disease vector as compared to 14.6 percent of controls (p = 0.007). This suggests that some of these individuals truly were infected. CONCLUSION: No single test for Chagas' disease is sufficiently sensitive to prevent transfusion transmission of the disease in the urban centers of Brazil.

Animals↗
PubMedDate not supplied

Risk factors for HPV DNA detection in middle-aged women.

BACKGROUND AND OBJECTIVES: Strong epidemiologic evidence indicates that human papillomavirus (HPV) is the main etiologic factor of cervical cancer. A few cohort studies suggest that most HPV infections are transient in young women and that persistent HPV infections are more common in older women. Little is known about the determinants of persistent HPV infections. The present study was aimed at increasing our knowledge about these determinants. GOALS: To identify risk factors for genital HPV DNA detection among cytologically normal middle-aged women. STUDY DESIGN: Eight hundred ten women who participated as control subjects in three case-control studies on cervical cancer in Spain, Colombia, and Brazil were included in this study. After an interview, women underwent a gynecologic examination with collection of exfoliated cells for a Papanicolaou smear and HPV DNA detection. Human papilloma virus DNA was detected by polymerase chain reaction (PCR)-based hybridization techniques. RESULTS: The HPV positivity rate was 10.5% in the whole population, but was higher in the areas with high incidence of cervical cancer (17% in Brazil and 13% in Colombia) than in Spain (4.9%), which is a low-risk area for cervical cancer. Age was related to the prevalence of HPV DNA in Brazil, but not in Spain and Colombia. In univariate analyses in all three countries, the prevalence of HPV DNA was positively associated with the number of lifetime sexual partners and inversely associated with the levels of family income and with age at first sexual intercourse. There was four times increase in the odds ratio (OR) of HPV infection in women who had six or more lifetime sexual partners compared with those with one or less. The use of any kind of contraceptive tended to decrease the OR for HPV detection. Their ORs ranged from 0.44 (barrier methods) to 0.48 (oral contraceptives). In Spain and Colombia, antibodies against Chlamydia trachomatis were positively associated with the prevalence of HPV DNA. In a final multivariate model, the positive associations with lifetime number of sexual partners, socioeconomic status, and C. trachomatis persisted. CONCLUSIONS: These results support the sexual transmission of HPV and suggest that socioeconomic status and antibodies to C. trachomatis are independent predictors of HPV detection in middle-aged cytologically normal women.

Adult↗