Priscyla Waleska Simões

Prevalence of human papillomavirus in breast cancer: a systematic review.

Objective We performed a systematic review and meta-analyses to estimate the prevalence of human papillomavirus (HPV) in breast carcinoma and to explore the reasons for the ongoing controversies about this issue. Materials and Methods A comprehensive search of the Cochrane Library, MEDLINE, CANCERLIT, LILACS, and EMBASE databases was performed for papers published from January 1990 to January 2011. The medical subject heading terms were searched for the following: breast neoplasm, breast lesions, breast cancer, and HPV or human papillomavirus. Statistical analysis was performed using REVMAN 5.0. Results Twenty-nine primary studies, including 2211 samples, were analyzed. Overall, HPV prevalence in patients with breast cancer was 23.0% (95% CI, 21.2%–24.8%). The prevalence of HPV ranged from 13.4% (95% CI, 10.2%–16%) in Europe to 42.9% (95% CI, 36.4%–49.4%) in North America and Australia. The prevalence of HPV in controls was 12.9%. Combinations of 9 case-control studies showed that breast cancer was associated with HPV (odds ratio, 5.9; 95% CI, 3.26–10.67). Conclusion We found a high prevalence of HPV DNA in breast cancer. There is strong evidence to suggest that HPV has an important role in the development of breast cancer.

Perfil epidemiológico dos pacientes com hanseníase no extremo sul de Santa Catarina, no período de 2001 a 2007

INTRODUCTIONnLeprosy is one of the oldest diseases of humanity and persists as a serious public health problem. Brazil has the highest incidence and second highest prevalence. In the Americas, it accounts for 93% of the cases, according to World Health Organization data from 2008. The objective of this study was to ascertain the profile of leprosy patients in the municipalities of the Association of Municipalities of the Carboniferous Region (AMREC), over the period from January 1, 2001, to December 31, 2007.nnnMETHODSnThis was a retrospective cross-sectional study carried out in the AMREC region in Santa Catarina, Brazil. The sample was of census type, in which all the patients notified were analyzed.nnnRESULTSn54 patients were analyzed, among whom 57% were female and 42.6% were male. The most prevalent age group was from 30 to 39 years old (31.5%) and 79.6% had white skin color. The occupation was unknown in 51 cases, as was bacilloscopy in 98%. The tuberculoid and Virchowian forms each presented a frequency of 27.8%. The coefficient of detection observed in the municipalities ranged from low to very high.nnnCONCLUSIONSnNeither multibacillary nor paucibacillary forms predominated in the analysis, nor any specific clinical form. Nevertheless, it is known that cases are being diagnosed late because of the low percentage of indeterminate cases, with predominance among females. Added to this, the information on the notification forms is sparse, which makes it impossible to show the realities of the study population.

Epidemiologic and clinical characteristics of pregnant women living with HIV/AIDS in a region of Southern Brazil where the subtype C of HIV-1 infection predominates

UNLABELLEDnSouthern Brazil has the highest prevalence rate of AIDS in the country and is the only region in the Americas where HIV-1 subtype C prevails.nnnOBJECTIVEnWe evaluated the epidemiologic and clinical characteristics of pregnant women living with HIV/AIDS in the South region of Santa Catarina, Brazil.nnnMETHODSnAll pregnant women with HIV infection attending the obstetric outpatient clinic of Criciúma, State of Santa Catarina, in 2007 (n = 46) were invited to participate. Data of 36 eligible participants were obtained through a standardized questionnaire.nnnRESULTSnThe great majority were young, with a steady partner, low family income, low education level and referring early first sexual intercourse. Many reported use of illicit non-injecting drugs (55.5%) and unprotected sex with partners that were HIV-positive (57.7%), injecting drug user (22.2%), male inmate (19.4%), truck driver (13.8%), with history of sexually transmitted disease (11.1%) or men who have sex with men (MSM) (2.8%). Most (66.7%) of the participants had their HIV diagnosis done during the pregnancy, 7 (19.4%) had a previous history of HIV mother-to-child transmission. Therapy based on highly active antiretroviral therapy (94%) was initiated at 19.3 weeks on average and 33% showed irregular antiretroviral adherence.nnnCONCLUSIONnThese results confirm previous data on HIV epidemiology in Brazil and suggest that the women partners sexual behavior and unprotected sexual intercourse are important aspects of HIV epidemic. Additional efforts in education, prophylaxis and medication adherence are needed.

Accuracy of telomerase in estimating breast cancer risk: A systematic review and meta-analysis

OBJECTIVEnTo determine the accuracy of telomerase activity in predicting a higher risk for breast cancer.nnnSTUDY DESIGNnA quantitative systematic review was performed. Studies that detected telomerase activities in breast tissue were included.nnnRESULTSnTwenty-five primary studies were analyzed, which included 2395 breast lesions. The proportion of breast cancer was 60.8%. Eighty-two percent (1193/1455) of breast cancer cases and 18% (169/940) of benign lesions cases were positive for telomerase activity. For breast cancer vs benign or normal breast tissue, the pooled likelihood ratio for the presence of telomerase activity was 4.5 (95% confidence interval [CI], 3.1-6.5) and the post-test probability was 88% (95% CI, 83-91). For breast cancer vs benign or normal tissue, the area under the summary receiver operating characteristic (SROC) curve was 0.89 with the Q* point value of 0.82.nnnCONCLUSIONnOur systematic review showed that telomerase activity was significantly present in breast cancer when compared with normal breast tissue or benign breast lesions.

Incidence of congenital syphilis in the South Region of Brazil

INTRODUCTIONnThe aim of this study was to establish the incidence rates of congenital syphilis in the South Region of Brazil from 2001 to 2009.nnnMETHODSnTemporal ecological and descriptive study based on the cases recorded by the System of Information of Notifiable Diseases.nnnRESULTSnThe incidence of congenital syphilis has been increasing in the South Region of Brazil since 2004; the highest incidence rates were in women who received prenatal care (113.5 new cases per 100,000 births, p<0.001), who were diagnosed with syphilis at pregnancy (69.8 new cases per 100,000 births, p=0.001), and whose partner did not undergo treatment for syphilis (53.1 new cases per 100,000 births, p=0.001).nnnCONCLUSIONSnThe population of the present study mostly consisted of adult black women with low educational levels who attended prenatal care, who were diagnosed with syphilis during pregnancy, and whose partners were not treated for syphilis. Based on these results, actions are recommended to reduce the incidence of this disease, which is preventable by early diagnosis and appropriate treatment. The present was merely an ecological study; therefore, further investigations are necessary to elucidate the causes of these findings.

Sobrecarga no cuidado, estresse e impacto na qualidade de vida de cuidadores domiciliares assistidos na atenção básica

This is a descriptive, cross-sectional study with quantitative approach and population census configured. The instruments used for the implementation of this research were the Inventory of Symptoms of Stress for adults of Lipp, the Functional Independence Measure, the Brazilian version of the quality of life questionnaire SF-36, and the Questionnaire for Assessing the Informal Caregiver Overload. Most caregivers were female (90.9%) with an average age of 51.7 (± 11.0) years; in relation to the degree of relatedness, 45.5% were the subjects’ children, and the Overall Functional Independence Measure of the subjects to whom the care was dedicated was 70.2 (± 40.1). Most caregivers showed stress (81.8%) and reported high overload. A moderate positive correlation (rs = 0.571) between the Functional Independence Measure and Pain (SF-36) was also observed, which was considered to be statistically significant (p = 0.001). To direct the attention to caregivers and understand the physical, social and emotional barriers involved in the action of caring, becomes indispensable in the context of public health not only to provide greater quality of life and lower overload on caregivers, but also on who is being cared.

Incidence of hepatitis C in Brazil

INTRODUCTIONnHepatitis C is a public health problem of global dimensions, affecting approximately 200 million people worldwide. The main objective of this study was to estimate the incidence rate of hepatitis C in Brazil during the period between 2001 and 2012.nnnMETHODSnAn epidemiological, temporal, and descriptive study was performed using data from the Information System for Reportable Diseases.nnnRESULTSnBetween 2001 and 2012, a total of 151,056 hepatitis C cases were recorded, accounting for 30.3% of all hepatitis notifications in Brazil. The average gross coefficient for the analysis period was 6.7 new cases per 100,000 inhabitants. The regions with the highest rates were the Southeast region (8.7 new cases/100,000 inhabitants) and the South (13.9 new cases/100,000 inhabitants). There was a predominance of men with respect to the incidence rate (8.0 new cases/100,000 inhabitants) compared to women (5.5 new cases/100,000 inhabitants). Injection drug use was the most common source of infection, and members of the white race, residents of urban areas, and those aged 60 to 64 years had the highest incidences.nnnCONCLUSIONSnOver the last 10 years, the incidence of hepatitis C in Brazil has increased, mainly in the South and Southeast. The adoption of fast, accurate diagnostic methods, together with epidemiological awareness, can facilitate early intervention measures for adequate control of the disease.

Metanálise do uso de redes bayesianas no diagnóstico de câncer de mama

The aim of this study was to determine the accuracy of Bayesian networks in supporting breast cancer diagnoses. Systematic review and meta-analysis were carried out, including articles and papers published between January 1990 and March 2013. We included prospective and retrospective cross-sectional studies of the accuracy of diagnoses of breast lesions (target conditions) made using Bayesian networks (index test). Four primary studies that included 1,223 breast lesions were analyzed, 89.52% (444/496) of the breast cancer cases and 6.33% (46/727) of the benign lesions were positive based on the Bayesian network analysis. The area under the curve (AUC) for the summary receiver operating characteristic curve (SROC) was 0.97, with a Q* value of 0.92. Using Bayesian networks to diagnose malignant lesions increased the pretest probability of a true positive from 40.03% to 90.05% and decreased the probability of a false negative to 6.44%. Therefore, our results demonstrated that Bayesian networks provide an accurate and non-invasive method to support breast cancer diagnosis.O objetivo deste estudo foi avaliar a acuracia das redes bayesianas no apoio ao diagnostico de câncer de mama. Foram realizadas revisao sistematica e metanalise, que incluiram artigos e relatorios publicados entre Janeiro de 1990 e Marco de 2013. Foram incluidos estudos transversais prospectivos e retrospectivos que avaliaram a acuracia do diagnostico de lesoes de mama (condicao alvo) usando as redes bayesianas (teste em avaliacao). Quatro estudos primarios que incluiram 1.223 lesoes de mama foram analisados, 89,52% (444/496) dos casos de câncer de mama e 6,33% (46/727) das lesoes benignas foram positivas tendo-se como base a analise das redes bayesianas. A area dentro da curva SROC (caracteristica de operacao do receptor sumaria) foi 0,97, com um valor Q* de 0,92. O uso de redes bayesianas no diagnostico de lesoes malignas aumentou a probabilidade pre-teste para um verdadeiro positivo de 40,03% para 90,05% e diminuiu a probabilidade de um falso negativo para 6,44%. Portanto, nossos resultados demonstraram que as redes bayesianas oferecem um metodo acurado e nao invasivo no apoio ao diagnostico de câncer de mama.

Incidence of tuberculous meningitis in the State of Santa Catarina, Brazil

INTRODUCTIONnThe aim of this study was to estimate the incidence of tuberculous meningitis in the State of Santa Catarina (SC), Brazil, during the period from 2001 to 2010.nnnMETHODSnEcological, temporal, and descriptive methods were employed using data obtained from the Information System on Disease Notification (Sistema de Informação de Agravos de Notificação).nnnRESULTSnOne hundred sixteen reported cases of tuberculous meningitis occurred from 2001 to 2010, corresponding to 1.2% (0.2 cases/100,000 inhabitants) of all meningitis cases reported in SC. There was a predominance of new cases in males, corresponding to 56.9% of new cases (0.2 cases/100,000 inhabitants; males vs. females; p=0.374), in patients aged 20-39 years, corresponding to 52.6% of new cases (0.5 cases/100,000 inhabitants; 20-39 years versus others; p<0.001), and in urban areas, corresponding to 91.4% of new cases (0.2 cases/100,000 inhabitants; urban vs. rural; p=0.003). In 48.3% of cases, the outcome was death.nnnCONCLUSIONSnThe incidence rate of tuberculous meningitis in SC has increased within the last decade, with the most affected population comprising young adult white males with an average education. Thus, tuberculous meningitis remains a serious disease, emphasizing the need for disease prevention with vaccination campaigns against tuberculosis, the development of faster and more accurate diagnostic methods, and the use of current epidemiological knowledge regarding the disease to facilitate the establishment of early treatment.

Associação entre a qualidade de vida e adesão à medicação de indivíduos hipertensos

Objetivo Avaliar a associacao entre a qualidade de vida e a adesao a medicacao de individuos hipertensos. Metodos Estudo transversal, realizado com 432 hipertensos cadastrados em sistema informatizado publico federal. Os dados foram coletados no domicilio por entrevista estruturada com questoes relacionadas a variaveis socioeconomicas, clinicas, avaliacao da adesao ao tratamento e o WHOQOL-BREF para a qualidade de vida. Utilizou-se o teste de H de Kruskal-Wallis para medir a associacao entre as escalas da qualidade de vida e a classificacao da adesao ao tratamento. Resultados Os escores mais baixos estavam presente no dominio autoavaliacao e os mais altos foram encontrados no social. Os individuos que possuiam adesao extrema ao tratamento anti-hipertensivo apresentaram escores mais altos na avaliacao da qualidade de vida em comparacao com individuos classificados como nao adesao extrema ao tratamento anti-hipertensivo. Conclusao A associacao entre a qualidade de vida e adesao a medicacao em individuos hipertensos nao foi preditiva, sendo que os melhores escores estavam presentes nos individuos hipertensos que apresentaram alta adesao a medicacao e os piores escores da qualidade de vida se apresentaram nos individuos de nao adesao extrema e limitrofe a nao adesao total.