A multicenterstudy will be implemented in 27 reference obstetric units from several Brazilian regions (Appendix 1) under the coordination of the Department of Obstet- rics and Gynecology of the School of Medical Sciences, University of Campinas, São Paulo, Brazil. For a period of six months, researchers will perform a prospective sur- veillance and data collection to identify preterm birth cases, their main causes and consequences. A first step consisting of people training and database development will take place prior to the collection of data. During the period of data collection, two kinds of study will be car- ried out: a cross-sectional study to assess the preterm rate in each participant center, identifying preterm levels like late preterm (34 - 36.6 weeks), early preterm (32 - 33.6 weeks), and extreme preterm (< 32 weeks); their main causes (preterm labor, prelabor rupture of membranes and therapeutic preterm birth) and treatments in all par- ticipant centers, which will enable us to evaluate more effective treatment strategies to adopt in these situations. The other study will be a nested case-control study with preterm births identified by researchers in the first months of data collection, having term births as controls (one control for each preterm birth), and analyzing risk factors for preterm birth.
treated (14). In both studies the median daily dose of PEGV was 10 mg, and no patient received doses higher than 30 mg after a median time of exposure of 30.5 months. The results from the single center and the present multicenterstudy in Brazil are surprisingly better than expected, as in the last report from the ACROSTUDY, an average dose of 12.8 mg was associated with normal IGF-I in 53% of the patients at year 1 (12). A percentage of 73% of normal IGF-I, similar to that of our study, was described in the ACROSTUDY only at year 10 with a higher average dose of 18.9 mg (12). Besides the differences attributable to variable doses of PEGV in the studies, several other factors have been associated with the therapeutic responses to PEGV. Age, gender, body mass index, previous radiotherapy and the presence of diabetes have been suggested as predictive of the PEGV dose required for normalization of IGF-I levels (25-27). Height and weight were not available in our study, while age, gender, previous radiotherapy and diabetes were not correlated to PEGV dose and were not predictive of response to PEGV. On the other hand, we found that pre-treatment GH and IGF-I levels and time of exposure were predictors of response. In agreement, baseline GH and IGF-I levels have been correlated with the PEGV dose required to normalize serum IGF-I in patients with active acromegaly (28).
This multicenterstudy advances our understanding of the place that training on spirituality/religion and health should have in medical education. Many of these Brazilian medical students believed that spirituality had an influ- ence on patients’ health and wanted to address this in clinical practice. Nevertheless, the majority felt they were not prepared to do so and that medical school was not providing the necessary training. These results suggest that there is a gap between students’ attitudes/needs in this area and the training they are getting.
AKI is one of the most serious complications of leptospirosis, an important zoonosis in the tropics. Recently, NGAL, one of the novel AKI biomarkers, is extensively studied in various specific settings such as sepsis, cardiac surgery, and radiocontrast nephropathy. In this multicenterstudy, we aimed to study the role of NGAL as an early marker and an outcome predictor of leptospirosis associated AKI. Patients who presented with clinical suspicious- ness of leptospirosis were prospectively enrolled in 9 centers from August 2012 to Novem- ber 2014. The first day of enrollment was the first day of clinical suspicious leptospirosis. Blood and urine samples were serially collected on the first three days and day 7 after enrollment. We used three standard techniques (microscopic agglutination test, direct cul- ture, and PCR technique) to confirm the diagnosis of leptospirosis. KDIGO criteria were used for AKI diagnosis. Recovery was defined as alive and not requiring dialysis during hos- pitalization or maintaining maximum KDIGO stage at hospital discharge. Of the 221
SLE patients, although not large enough to allow more complex statistical analysis or subgroup analyses, al- lowed us to draw some interesting conclusions. Also, being a multicenterstudy, more national representa- tive findings could be obtained. Regarding the dura- tion of follow-up, our last time point (24 months) is equal or superior to most of the previous published data, an important aspect in a chronic, lifelong disease. Most studies had a follow-up period of 6 11,12,18 and 12
Our study has several limitations. First, as a multi-center study, reliable surveillance data may be diicult to enforce. Second, we did not evaluate the catheter-site care ater the insertion (e.g. dressing changes). hird, as an observational study, we could only demonstrate a possible association not causation. Finally, the data was in three hospitals and may not be generalizable to other settings. However, to our knowledge, this is the irst multicenterstudy aimed at iden- tifying risk factors for BSI in our country.
The prevalence of diabetes is increasing quickly in devel- oping countries because of changes in lifestyle that have occurred in the last decades. According to the estimates provided by the World Health Organization (WHO), by the year 2025 more than 75% of people with diabetes will be living in developing countries . The majority of peo- ple with diabetes in these countries will be aged between 45-65 years, that corresponds to the most productive period of their lives. The last demographic census in Brazil has estimated a population of approximately 170 million people  with many people between 45-65 years. The prevalence of diabetes was estimated to be of 7.6% in a multicenterstudy conducted in 1988 . Although WHO has estimated a prevalence of diabetes in our country of 7.2% by the year of 2025, more recent data, though scarce and limited to some regions, showed a prevalence of 12.5% in 1999 . According to Brazilian National Data Survey, diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country .
To our knowledge, this is the largest systematic study that has compared clinical characteristics of OCD patients with and without comorbid TD. This comprehensive, multicenterstudy used structured assessment instruments applied by OCD experts. It is innovative in its use of specific and standardized instruments to assess the occurrence and severity of obsessive-compulsive symptom dimensions (DY- BOCS) and sensory phenomena (USP-SPS). As expected, the general prevalence of TS and chronic motor/vocal tics in the whole OCD sample was 8.9% and 20.1%, respectively, which is a finding that resembled early reports. 11 Moreover, consistent with previous studies, one-third of the subjects with TD presented a TS diagnosis. 20
In our study, no significant difference was observed when the fetal outcome of women who had hematopoietic malignan- cies was compared to that of women who had solid tumors. Although some authors suggest that hematopoietic malignancies dur- ing pregnancy might be associated with an increased number of complications due to the drugs employed to treat them as well as to their more aggressive behavior (11,21), this subject remains controversial. In fact, Ebert et al. (26) recently compared the rates of abortion, stillbirths, and fetal malforma- tions among 217 literature cases, afflicted by several diseases, in which cytotoxic treat- ment was employed during pregnancy. Ac- cording to this study, rheumatic diseases formed a group which was associated with the highest rates of adverse effects in preg- nancy (37.5%), followed, in order of fre- quency, by miscellaneous diseases, gyneco- logical malignancies, and finally by lympho- mas and leukemias, which had the lowest
Abstract: The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0–12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.
Abstract: The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects’ perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer’s exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.
In multiple regression, the type of vaccine was a sig- nificant predictor of the magnitude of the immune response (anti-HBs titers) in all age groups, adjusting for relevant covariates. The only significant modification of the effect of vaccine was found in children: in boys but not in girls the type of vaccine explained part of the difference in anti-HBs titers between vaccination groups. Among study subjects with age above 11 years, women had a stronger immune response compared to men. Nutritional status was an independent predictor of the strength of immune response only in young adults (higher BMI had weaker immune response) and newborns (larger infants had stronger immune response). The effect of BMI on the immune response among adolescents was not conclusive (marginal statistical significance).
According to a recent multicenterstudy by Stange  the overall incidence of HAT is less than 5% but the overall mortality rate after a diagnosis of thrombosis is 55% with an 80% rate of RET. This probably depends on two factors: 1) the use of older donors with arteries in a worse condition and 2) on the increased use of reduced livers such as ‘‘split right’’ grafts with hazardous vessels. The increasing rate of RET due to early graft failure (PNF - primary non-function or INF - Initial Not Function -) can also be explained by the larger use of the so-called ‘‘marginal donors’’ [9,10]. In our study, PNF was the primary indication for RET (32.2%) followed by HAT (27.6%); HCV recurrence was responsible for 12.5% of our RETs.
Differing from the other antigens for which minimum levels of protection have been established, there is currently no laboratory measurement for immunogenicity that can be correlated with protective efficacy for the antigens of the pertussis component . Consequently, the immunogenicity of the combined vaccine after the basic scheme in our study was compared with the immunogenicity found in a multicenterstudy of acellular pertussis vaccines (MAPT) promoted by the American National Institute of Allergy and Infectious Diseases. The latter was developed using the same diphtheria-tetanus-acellular pertussis vaccine that serves as basis for our combination vaccine. A field study in Italy demonstrated 84% efficacy for this DTPa vaccine . Since the GMT were similar to (55.1 U EL/mL vs. 54 U EL/mL for the anti-PT antibody and 183.1 U EL/mL vs. 185 U EL/mL for the anti-PRN antibody) or greater than (290.8 U EL/mL vs. 103 U EL/mL for the anti-FHA antibody) those obtained in the multicenterstudy , the comparison of the results demonstrates that the combination of the DTPa (diphtheria-tetanus-acellular pertussis) vaccine with the vaccine against hepatitis B did not result in decreased immunogenicity of the pertussis component of this combination, when compared to the uncombined DTPa vaccine. Consequently, this combination did not interfere in vaccine efficacy.
This is the first Brazilian multicenterstudy addressing C. albicans serotypes and antifungal susceptibility pro- files (using the NCCLS methodology) of yeasts obtained from Aids patients with oropharyngeal candidiasis. We found a high prevalence of C. albicans recovered from HIV-infected and Aids patients with OPC (91%). Non- albicans species were isolated from 12 (9%) patients ei- ther as the sole isolate (n = 3) or in addition to C. albicans (n = 9), these being considered cases of co-infection. C. glabrata was the most frequent non-albicans species recovered in this series, followed by C. tropicalis, C. parapsilosis, C. krusei, and T. inkin. Oropharyngeal can- TABLE I
The present review of the literature included seven articles. 13-17,22,23 The most recent article, Brocklehurst et al., 13 is a multicenterstudy involving nine countries. Of the studies included, this was the most important one. It included a population of 3,493 patients, a sample much larger than that of the other studies, whose samples ranged from 24 to 60 patients. This was the only study with a score of 5 according to the instrument designed by Jadad et al. 12
The data found in the survey show that 25% of the diabetics did not know they had the disease and were diagnosed during the investigation, and that approxima- tely one third of patients who already knew they had dia- betes were unaware of the potential chronic outcomes. This study conirms the increased prevalence of DM in Brazil and emphasizes the need for its early conclusion, as well as the importance of strict adherence to medical treatment in order to prevent its much feared complica- tions.
ABSTRACT: BACKGROUND: It is well known that exercise has a significant effect on respiratory functions. As reports on effects of exercise in Akhada Pahalwan on Pulmonary Functions are not available; the present study was carried out in young male adults of Eighteen to Thirty years of age group to assess their Pulmonary Functions. METHODS: Subjects were divided into two groups (study group and control group). Subjects of Study group (Akhada Pahalwan, n = 37) were engaged in exercise in Akhada for at least two years. Control group (n = 30) was of medical students not engaged in any regular exercise. Lung volumes were recorded by Pulmonary Function test machine and analysed statistically. RESULTS: It was found that akhada pahalwan (Study group) had larger lung volume as compared to control group.
chamber of the study eye(s); risk of visual field or visual acuity worsening as a consequence of participation in the trial, in the investigator’s opinion; intraocular conventional surgery or laser surgery in the study eye(s) less than 3 months prior to the screening/baseline visit; progressive retinal or optic nerve disease from any cause; corneal dystrophies in either eye; concurrent infectious/noninfectious conjunctivitis, keratitis, or uveitis in either eye; history of ocular herpes simplex; history or risk of uveitis or cystoid macular edema; severe allergic rhinitis; unwillingness to accept the risk of darkened irides or eyelash changes; known medical history of allergy, hypersensitivity, or poor tolerance to any components of the study medication that was deemed to be clinically significant, in the investigator’s opinion; use of topical or systemic beta-adrenergic blockers or topical or systemic steroids; bronchial asthma or history of bronchial asthma, bronchial hyperreactivity, or severe chronic obstructive pul- monary disease that would preclude the safe administration of a topical beta-blocker; sinus bradycardia, second-degree or third-degree atrioventricular block, sinoatrial block, overt cardiac failure, or cardiogenic shock that would preclude the safe administration of a topical beta-blocker; use of systemic medications known to affect IOP, which had not been on a stable course for 7 days prior to the screening/baseline visit or which had an anticipated dosing change during the course of the study; any clinically significant, serious, or severe medical or psychiatric condition; any condition that, in the investi- gator’s opinion, would interfere with optimal participation in the study or present a special risk to the patient; participa- tion in any other investigational study within 30 days prior to the screening/baseline visit; women who were pregnant or lactating; and women of childbearing potential who were not using reliable means of birth control.