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1.
J Hum Nutr Diet ; 34(3): 562-571, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33314352

RESUMO

BACKGROUND: Dietary counselling provided by a dietitian, with or without oral nutritional supplements, can impact on nutritional and clinical outcomes in head and neck cancer (HNC) patients undergoing radiotherapy. However, little is known about the role of adherence to oral nutritional interventions in this population. This review aimed to map the literature for evidence of adherence to oral nutritional interventions in HNC patients undergoing radiotherapy and to identify gaps in knowledge in this field. METHODS: A scoping review methodology was used to identify studies, extract data, and collate and summarise results. We searched Medline, Embase, Cochrane Central and CINAHL, from the earliest available time up to 8 January 2020. RESULTS: In total, 2315 unique articles were identified, 163 studies were assessed in full and niner were included in the scoping review. The use of different measures to assess adherence and variability in the timing of the assessments was noted across studies. Despite identifying studies that have measured adherence to oral nutritional interventions, very few studies monitored its influence on clinical and nutritional outcomes in HNC patients or reported factors related to adherence. CONCLUSIONS: A robust evidence base is lacking for adherence to oral nutritional intervention in HNC patients. Overall, further studies evaluating the impact of oral nutritional interventions in HNC patients undergoing radiotherapy should measure adherence to the intervention. Early recognition of non-adherence and the contributing factors could ensure intensification of nutritional support and better health outcomes.


Assuntos
Neoplasias de Cabeça e Pescoço/terapia , Terapia Nutricional/métodos , Cooperação do Paciente , Administração Oral , Humanos , Estado Nutricional , Avaliação de Resultados em Cuidados de Saúde , Radioterapia
2.
Braz. j. med. biol. res ; 44(10): 1006-1012, Oct. 2011. ilus, tab
Artigo em Inglês | LILACS | ID: lil-600699

RESUMO

The association of education, tobacco smoking, alcohol consumption, and interleukin-2 (IL-2 +114 and -384) and -6 (IL-6 -174) DNA polymorphisms with head and neck squamous cell carcinoma (HNSCC) was investigated in a cohort study of 445 subjects. IL-2 and IL-6 genotypes were determined by real-time PCR. Cox regression was used to estimate hazard ratios (HR) and 95 percent confidence intervals (95 percentCI) of disease-specific survival according to anatomical sites of the head and neck. Mean age was 56 years and most patients were males (87.6 percent). Subjects with 5 or more years of schooling had better survival in larynx cancer. Smoking had no effect on HNSCC survival, but alcohol consumption had a statistically significant effect on larynx cancer. IL-2 gene +114 G/T (HR = 0.52; 95 percentCI = 0.15-1.81) and T/T (HR = 0.22; 95 percentCI = 0.02-3.19) genotypes were associated with better survival in hypopharynx cancer. IL-2 +114 G/T was a predictor of poor survival in oral cavity/oropharynx cancer and larynx cancer (HR = 1.32; 95 percentCI = 0.61-2.85). IL-2 -384 G/T was associated with better survival in oral cavity/oropharynx cancer (HR = 0.80; 95 percentCI = 0.45-1.42) and hypopharynx cancer (HR = 0.68; 95 percentCI = 0.21-2.20), but an inverse relationship was observed for larynx cancer. IL-6 -174 G/C was associated with better survival in hypopharynx cancer (HR = 0.68; 95 percentCI = 0.26-1.78) and larynx cancer (HR = 0.93; 95 percentCI = 0.42-2.07), and C/C reduced mortality in larynx cancer. In general, our results are similar to previous reports on the value of education, smoking, alcohol consumption, and IL-2 and IL-6 genetic polymorphisms for the prognosis of HNSCC, but the risks due to these variables are small and estimates imprecise.


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , /genética , /genética , Polimorfismo Genético/genética , Consumo de Bebidas Alcoólicas/efeitos adversos , Estudos de Coortes , Carcinoma de Células Escamosas/etiologia , Intervalo Livre de Doença , Escolaridade , Genótipo , Neoplasias de Cabeça e Pescoço/etiologia , Prognóstico , Fatores de Risco , Fumar/efeitos adversos
3.
Braz J Med Biol Res ; 44(10): 1006-12, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21845339

RESUMO

The association of education, tobacco smoking, alcohol consumption, and interleukin-2 (IL-2 +114 and -384) and -6 (IL-6 -174) DNA polymorphisms with head and neck squamous cell carcinoma (HNSCC) was investigated in a cohort study of 445 subjects. IL-2 and IL-6 genotypes were determined by real-time PCR. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) of disease-specific survival according to anatomical sites of the head and neck. Mean age was 56 years and most patients were males (87.6%). Subjects with 5 or more years of schooling had better survival in larynx cancer. Smoking had no effect on HNSCC survival, but alcohol consumption had a statistically significant effect on larynx cancer. IL-2 gene +114 G/T (HR = 0.52; 95%CI = 0.15-1.81) and T/T (HR = 0.22; 95%CI = 0.02-3.19) genotypes were associated with better survival in hypopharynx cancer. IL-2 +114 G/T was a predictor of poor survival in oral cavity/oropharynx cancer and larynx cancer (HR = 1.32; 95%CI = 0.61-2.85). IL-2 -384 G/T was associated with better survival in oral cavity/oropharynx cancer (HR = 0.80; 95%CI = 0.45-1.42) and hypopharynx cancer (HR = 0.68; 95%CI = 0.21-2.20), but an inverse relationship was observed for larynx cancer. IL-6 -174 G/C was associated with better survival in hypopharynx cancer (HR = 0.68; 95%CI = 0.26-1.78) and larynx cancer (HR = 0.93; 95%CI = 0.42-2.07), and C/C reduced mortality in larynx cancer. In general, our results are similar to previous reports on the value of education, smoking, alcohol consumption, and IL-2 and IL-6 genetic polymorphisms for the prognosis of HNSCC, but the risks due to these variables are small and estimates imprecise.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , Interleucina-2/genética , Interleucina-6/genética , Polimorfismo Genético/genética , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Carcinoma de Células Escamosas/etiologia , Estudos de Coortes , Intervalo Livre de Doença , Escolaridade , Feminino , Genótipo , Neoplasias de Cabeça e Pescoço/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Fumar/efeitos adversos , Carcinoma de Células Escamosas de Cabeça e Pescoço
4.
Cancer Causes Control ; 22(7): 1037-46, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21607590

RESUMO

BACKGROUND: Cancers of the upper aerodigestive tract (UADT; including oral cavity, pharynx, larynx and oesophagus) have high incidence rates all over the world, and they are especially frequent in some parts of Latin America. However, the data on the role of the major risk factors in these areas are still limited. METHODS: We have evaluated the role of alcohol and tobacco consumption, based on 2,252 upper aerodigestive squamous-cell carcinoma cases and 1,707 controls from seven centres in Brazil, Argentina, and Cuba. RESULTS: We show that alcohol drinkers have a risk of UADT cancers that is up to five times higher than that of never-drinkers. A very strong effect of aperitifs and spirits as compared to other alcohol types was observed, with the ORs reaching 12.76 (CI 5.37-30.32) for oesophagus. Tobacco smokers were up to six times more likely to develop aerodigestive cancers than never-smokers, with the ORs reaching 11.14 (7.72-16.08) among current smokers for hypopharynx and larynx cancer. There was a trend for a decrease in risk after quitting alcohol drinking or tobacco smoking for all sites. The interactive effect of alcohol and tobacco was more than multiplicative. In this study, 65% of all UADT cases were attributable to a combined effect of alcohol and tobacco use. CONCLUSIONS: In this largest study on UADT cancer in Latin America, we have shown for the first time that a prevailing majority of UADT cancer cases is due to a combined effect of alcohol and tobacco use and could be prevented by quitting the use of either of these two agents.


Assuntos
Carcinoma/etiologia , Etanol/efeitos adversos , Neoplasias de Cabeça e Pescoço/etiologia , Nicotiana/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Carcinoma/epidemiologia , Estudos de Casos e Controles , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia
5.
J Epidemiol Community Health ; 65(8): 709-14, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20724282

RESUMO

BACKGROUND: A higher burden of head and neck cancer has been reported to affect deprived populations. This study assessed the association between socioeconomic status and head and neck cancer, aiming to explore how this association is related to differences of tobacco and alcohol consumption across socioeconomic strata. METHODS: We conducted a case-control study in São Paulo, Brazil (1998-2006), including 1017 incident cases of oral, pharyngeal and laryngeal cancer, and 951 sex- and age-matched controls. Education and occupation were distal determinants in the hierarchical approach; cumulative exposure to tobacco and alcohol were proximal risk factors. Outcomes of the hierarchical model were compared with fully adjusted ORs. RESULTS: Individuals with lower education (OR 2.27; 95% CI 1.61 to 3.19) and those performing manual labour (OR 1.55; 95% CI 1.26 to 1.92) had a higher risk of disease. However, 54% of the association with lower education and 45% of the association with manual labour were explained by proximal lifestyle exposures, and socioeconomic status remained significantly associated with disease when adjusted for smoking and alcohol consumption. CONCLUSIONS: Socioeconomic differences in head and neck cancer are partially attributable to the distribution of tobacco smoking and alcohol consumption across socioeconomic strata. Additional mediating factors may explain the remaining variation of socioeconomic status on head and neck cancer.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Disparidades nos Níveis de Saúde , Fumar/epidemiologia , Classe Social , Idoso , Brasil/epidemiologia , Intervalos de Confiança , Feminino , Neoplasias de Cabeça e Pescoço/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Risco Ajustado
6.
Cancer Causes Control ; 21(11): 1799-806, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20623173

RESUMO

Cancers of the upper aerodigestive tract (UADT: oral cavity, oropharynx, hypopharynx, larynx, esophagus) have high incidence rates all over the world and they are especially frequent in some parts of Latin America. In this study, we have evaluated the role of the consumption of maté, a hot herb-based beverage, based on 1168 UADT squamous-cell carcinoma cases and 1,026 frequency-matched controls enrolled from four centers in Brazil and Argentina. The effect of maté drinking on the risk of head-and-neck cancers was borderline significant. A significant effect was observed only for cancer of the esophagus (OR 3.81 (95% CI 1.75-8.30)). While duration of maté drinking was associated with the risk of all UADT cancers, the association with cumulative maté consumption was restricted to esophageal cancer (p-value of linear trend 0.006). The analyses of temperature at which maté was drunk were not conclusive. The increased risk associated with maté drinking was more evident in never-smokers and never-alcohol drinkers than in other individuals. Our study strengthens the evidence of an association between maté drinking and esophageal cancer; the hypothesis of an association with other UADT cancers remains to be clarified.


Assuntos
Bebidas/efeitos adversos , Ingestão de Líquidos , Neoplasias Esofágicas/complicações , Neoplasias de Cabeça e Pescoço/complicações , Ilex paraguariensis/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Brasil/epidemiologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/etiologia , Estudos de Casos e Controles , Neoplasias Esofágicas/epidemiologia , Feminino , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto
7.
Carcinogenesis ; 31(6): 1054-9, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19955396

RESUMO

Cancers of the upper aerodigestive tract [(UADT): oral cavity, pharynx, larynx and oesophagus] have high incidence rates in some parts of South America. Alterations in the TP53 gene are common in these cancers. In our study, we have estimated the prevalence and patterns of TP53 mutations (exons 4-10) in 236 UADT tumours from South America in relation to lifestyle risk factors, such as tobacco smoking and alcohol drinking. Moreover, we have conducted a pilot study of EGFR mutations (exons 18-21) in 45 tumours from the same population. TP53 mutation prevalence was high: 59% of tumours were found to carry mutant TP53. We found an association between TP53 mutations and tobacco smoking and alcohol drinking. The mutation rate increased from 38% in never-smokers to 66% in current smokers (P-value for trend = 0.09). G:C>T:A transversions were found only in smokers (15%). Alcohol drinkers carried more G:C>A:T transitions (P = 0.08). Non-exposed individuals were more probable to carry G:C>A:T transitions at CpG sites (P = 0.01 for never-smokers and P < 0.001 for never-drinkers). EGFR mutations were found in 4% of cases. Inactivation of TP53 by mutations is a crucial molecular event in the UADT carcinogenesis and it is closely related to exposure to lifestyle risk factors. EGFR mutations do not appear to be a common event in UADT carcinogenesis in this population.


Assuntos
Receptores ErbB/genética , Neoplasias Esofágicas/epidemiologia , Genes p53 , Neoplasias de Cabeça e Pescoço/epidemiologia , Estilo de Vida , Adulto , Idoso , Estudos de Casos e Controles , Cocarcinogênese , Neoplasias Esofágicas/genética , Feminino , Neoplasias de Cabeça e Pescoço/genética , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores de Risco , América do Sul/epidemiologia
8.
J Neurol Neurosurg Psychiatry ; 80(7): 755-61, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19279029

RESUMO

BACKGROUND: There have been few population based studies on stroke risk factors and prognosis conducted in Brazil. The objective of this study was to evaluate, over a 2 year period, the incidence of the subtypes of first ever stroke, the prevalence of cardiovascular risk factors and functional prognosis in a city located in the south of Brazil. METHODS: The period from January 2005 to December 2006 was evaluated prospectively by compiling data on first ever stroke cases, medications used prior to the morbidity and the incidence of traditional risk factors. The annual incidence was adjusted for age using the direct method. Patients were monitored for at least 6 months following the event. RESULTS: Of 1323 stroke cases, 759 were first ever stroke cases. Of these, 610 were classified as infarctions, 94 as intracerebral haemorrhage and 55 as subarachnoid haemorrhage. The crude incidence rate per 100 000 inhabitants was 61.8 for infarction (95% CI 57.0 to 66.9), 9.5 for intracerebral haemorrhage (95% CI 7.7 to 11.6) and 5.6 for subarachnoid haemorrhage (95% CI 4.2 to 7.3). The 30 day case fatality was 19.1%. The most prevalent cardiovascular risk factor was arterial hypertension. By post-stroke month 6, 25% had died (95% CI 21.4 to 29.1) whereas 61.5% had regained their independence (95% CI 56.2 to 68.3). CONCLUSIONS: Case fatality rate, prognosis and incidence adjusted for stroke subtypes were similar to those found in other population based studies. The prevalence rates of ischaemic heart disease, dyslipidaemia, arterial hypertension and diabetes suggest that Joinville presents a mixed pattern of cardiovascular risk, a pattern seen in developed and developing countries alike.


Assuntos
Doenças Cardiovasculares/complicações , Diabetes Mellitus/fisiopatologia , Dislipidemias/complicações , Acidente Vascular Cerebral/epidemiologia , Fatores Etários , Idoso , Infarto Encefálico/epidemiologia , Brasil/epidemiologia , Hemorragia Cerebral/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Incidência , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/complicações , Pacientes Ambulatoriais , Vigilância da População , Prevalência , Prognóstico , Fatores de Risco , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/mortalidade , Hemorragia Subaracnóidea/epidemiologia
9.
J Neurol Neurosurg Psychiatry ; 80(7): 749-54, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19147630

RESUMO

BACKGROUND: Studying stroke rates in a whole community is a rational way to assess the quality of patient care and primary prevention. However, there are few studies of trends in stroke rates worldwide and none in Brazil. OBJECTIVE: Established study methods were used to define the rates for first ever stroke in a defined population in Brazil compared with similar data obtained and published in 1995. METHODS: All stroke cases occurring in the city of Joinville during 2005-2006 were prospectively ascertained. Crude incidence and mortality rates were determined, and age adjusted rates and 30 day case fatality were calculated and compared with the 1995 data. RESULTS: Of the 1323 stroke cases registered, 759 were first ever strokes. The incidence rate per 100 000 was 105.4 (95% CI 98.0 to 113.2), mortality rate was 23.9 (95% CI 20.4 to 27.8) and the 30 day case fatality was 19.1%. Compared with the 1995 data, we found that the incidence had decreased by 27%, mortality decreased by 37% and the 30 day case fatality decreased by 28%. CONCLUSIONS: Using defined criteria we showed that in an industrial southern Brazilian city, stroke rates are similar to those from developed countries. A significant decrease in stroke rates over the past decade was also found, suggesting an improvement in primary prevention and inpatient care of stroke patients in Joinville.


Assuntos
Assistência ao Paciente/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Intervalos de Confiança , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente/métodos , Assistência ao Paciente/tendências , Prevenção Primária/tendências , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/terapia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Braz J Med Biol Res ; 39(4): 545-53, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16612479

RESUMO

Genomics is expanding the horizons of epidemiology, providing a new dimension for classical epidemiological studies and inspiring the development of large-scale multicenter studies with the statistical power necessary for the assessment of gene-gene and gene-environment interactions in cancer etiology and prognosis. This paper describes the methodology of the Clinical Genome of Cancer Project in São Paulo, Brazil (CGCP), which includes patients with nine types of tumors and controls. Three major epidemiological designs were used to reach specific objectives: cross-sectional studies to examine gene expression, case-control studies to evaluate etiological factors, and follow-up studies to analyze genetic profiles in prognosis. The clinical groups included patients' data in the electronic database through the Internet. Two approaches were used for data quality control: continuous data evaluation and data entry consistency. A total of 1749 cases and 1509 controls were entered into the CGCP database from the first trimester of 2002 to the end of 2004. Continuous evaluation showed that, for all tumors taken together, only 0.5% of the general form fields still included potential inconsistencies by the end of 2004. Regarding data entry consistency, the highest percentage of errors (11.8%) was observed for the follow-up form, followed by 6.7% for the clinical form, 4.0% for the general form, and only 1.1% for the pathology form. Good data quality is required for their transformation into useful information for clinical application and for preventive measures. The use of the Internet for communication among researchers and for data entry is perhaps the most innovative feature of the CGCP. The monitoring of patients' data guaranteed their quality.


Assuntos
Bases de Dados Factuais , Estudos Epidemiológicos , Projeto Genoma Humano , Internet , Neoplasias/genética , Adulto , Brasil , Criança , Humanos
11.
Braz. j. med. biol. res ; 39(4): 545-553, Apr. 2006. ilus, tab
Artigo em Inglês | LILACS | ID: lil-425086

RESUMO

Genomics is expanding the horizons of epidemiology, providing a new dimension for classical epidemiological studies and inspiring the development of large-scale multicenter studies with the statistical power necessary for the assessment of gene-gene and gene-environment interactions in cancer etiology and prognosis. This paper describes the methodology of the Clinical Genome of Cancer Project in São Paulo, Brazil (CGCP), which includes patients with nine types of tumors and controls. Three major epidemiological designs were used to reach specific objectives: cross-sectional studies to examine gene expression, case-control studies to evaluate etiological factors, and follow-up studies to analyze genetic profiles in prognosis. The clinical groups included patients' data in the electronic database through the Internet. Two approaches were used for data quality control: continuous data evaluation and data entry consistency. A total of 1749 cases and 1509 controls were entered into the CGCP database from the first trimester of 2002 to the end of 2004. Continuous evaluation showed that, for all tumors taken together, only 0.5 percent of the general form fields still included potential inconsistencies by the end of 2004. Regarding data entry consistency, the highest percentage of errors (11.8 percent) was observed for the follow-up form, followed by 6.7 percent for the clinical form, 4.0 percent for the general form, and only 1.1 percent for the pathology form. Good data quality is required for their transformation into useful information for clinical application and for preventive measures. The use of the Internet for communication among researchers and for data entry is perhaps the most innovative feature of the CGCP. The monitoring of patients' data guaranteed their quality.


Assuntos
Adulto , Criança , Humanos , Bases de Dados Factuais , Estudos Epidemiológicos , Projeto Genoma Humano , Internet , Neoplasias/genética , Brasil
12.
Eur J Clin Microbiol Infect Dis ; 21(6): 438-43, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12111599

RESUMO

The prevalence of GB virus C (GBV-C) varies widely throughout the world. A cross-sectional study was conducted in the city of São Paulo, Brazil, to estimate the prevalence of GBV-C infection and to identify associated risk factors, using a large sampling of the general population rather than blood donors or an illness-related group of subjects. GBV-C RNA was detected by reverse-transcriptase polymerase chain reaction using primers directed to the 5' noncoding region (NCR) and nonstructural 5A region (NS5A) in serum samples from 1,039 healthy individuals 2 years of age or more. Fifty-two individuals were positive for both sets of primers and one was positive for NS5A only (prevalence of GBV-C infection, 5.1%; 95%CI, 3.9-6.7%). No child under 5 years of age was found positive. Among subjects aged 5 years or more, the prevalence of infection increased consistently with age, up to 30-39 years (8.3%), and decreased from then on. The number of sexual partners in the last 3 years (2 or more: OR, 2.6; 95%CI, 1.3-5.5) and history of contact with blood-sucking insects (OR, 2.5; 95%CI 1.2-5.4) were independently associated with GBV-C infection. In conclusion, the prevalence of GBV-C infection is high in São Paulo. In addition to parenteral transmission, another route, e.g. sexual or vertical, may be involved.


Assuntos
Infecções por Flaviviridae/epidemiologia , Flaviviridae/isolamento & purificação , Hepatite Viral Humana/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por Flaviviridae/virologia , Hepatite Viral Humana/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/sangue , Fatores de Risco
14.
Br J Cancer ; 86(5): 705-11, 2002 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-11875730

RESUMO

Four-hundred-forty-five husbands of women with invasive cervical carcinoma, 165 of women with in situ cervical cancer, and 717 of control women (age range 19-82 years) were interviewed and a sample of exfoliated cells from the penis obtained in seven case-control studies conducted by the International Agency for Research on Cancer. The characteristics of human papillomavirus-positive and human papillomavirus-negative husbands were compared using odds ratios and 95% confidence intervals. Thirteen per cent of the husbands of control women, 18% of the husbands of women with invasive cervical carcinoma, and 21% of the husbands of in situ cervical carcinoma women were positive for penile human papillomavirus DNA. Human papillomavirus 16 was detected in 45 husbands, human papillomavirus 18, 31 or 33 in 19, and human papillomavirus 6/11 in 6, but the majority of human papillomavirus infection (158) was with other or unspecified human papillomavirus types. The same human papillomavirus type was seldom identified in both husband and wife. The strongest variation in penile human papillomavirus infection was by country, with percentages among the husbands of control women ranging between 3% in Spain and 39% in Brazil. Having had over 50 lifetime sexual partners, compared with only one, was associated with an odds ratio of 2.3.


Assuntos
Carcinoma in Situ/virologia , Carcinoma/virologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Pênis/virologia , Comportamento Sexual , Infecções Tumorais por Vírus/complicações , Neoplasias do Colo do Útero/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/etiologia , Carcinoma in Situ/etiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/transmissão , Pênis/citologia , Prevalência , Fatores de Risco , Cônjuges , Infecções Tumorais por Vírus/transmissão , Neoplasias do Colo do Útero/etiologia
15.
Rev Saude Publica ; 35(5): 436-42, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11723514

RESUMO

OBJECTIVE: Selecting controls is one of the most difficult tasks in the design of case-control studies. Hospital controls may be inadequate and random controls drawn from the base population may be unavailable. The aim was to assess the use of hospital visitors as controls in a case-control study on the association of organochlorinated compounds and other risk factors for breast cancer conducted in the main hospital of the "Instituto Nacional de Câncer" - INCA (National Cancer Institute) in Rio de Janeiro (Brazil). METHODS: The study included 177 incident cases and 377 controls recruited among female visitors. Three different models of control group composition were compared: Model 1, with all selected visitors; Model 2, excluding women visiting relatives with breast cancer; and Model 3, excluding all women visiting relatives with any type of cancer. Odds ratios (OR) and 95% confidence intervals were calculated to test the associations. RESULTS: Age-adjusted OR for breast cancer associated with risk factors other than family history of cancer, except smoking and breast size, were similar in the three models. Regarding family history of all cancers, except for breast cancer, there was a decreased risk in Models 1 and 2, while in Model 3 there was an increased risk, but not statistically significant. Family history of breast cancer was a risk factor in Models 2 and 3, but no association was found in Model 1. In multivariate analysis a significant risk of breast cancer was found when there was a family history of breast cancer in Models 2 and 3 but not in Model 1. CONCLUSIONS: These results indicate that while investigating risk factors unrelated to family history of cancer, the use of hospital visitors as controls may be a valid and feasible alternative.


Assuntos
Neoplasias da Mama/epidemiologia , Estudos de Casos e Controles , Visitas a Pacientes , Adulto , Idoso , Neoplasias da Mama/induzido quimicamente , Feminino , Humanos , Hidrocarbonetos Clorados , Inseticidas/efeitos adversos , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
16.
AIDS Patient Care STDS ; 15(7): 391-7, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11483166

RESUMO

We investigated whether women positive for human immunodeficiency virus (HIV) infection were late in seeking an anonymous HIV counseling and testing service, and the factors associated with a low CD4 count, in São Paulo, Brazil. Seventy-one consecutive HIV-1-seropositive women were interviewed by means of a structured questionnaire. Blood samples were collected for CD4+ T-lymphocytes count and determination of HIV-1 subtypes. Hepatitis C, syphilis, human T-cell lymphotrophic virus type I (HTLV-I), and HTLV-II infections were assessed by serologic tests. More than 70% of the women had less than 500 CD4+ cells/mm3 (20% below 200). Low CD4 count was significantly associated with sex work history, condom use in the last 6 months, and seropositivity to HTLV-I and syphilis. There was no relation between low CD4 count and HIV-1 subtypes. These results indicate that in Sao Paulo many women are seeking an anonymous testing service late in the course of HIV infection. The main purposes of anonymous HIV testing services - early diagnosis of infection, and counseling to prevent infection - are not being achieved. Another strategy for reducing the interval between infection and diagnosis in women must be addressed.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , HIV-1 , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HTLV-I/complicações , Infecções por HTLV-I/epidemiologia , Hepatite C/complicações , Hepatite C/epidemiologia , Humanos , Inquéritos e Questionários , Sífilis/complicações , Sífilis/epidemiologia , Saúde da Mulher
17.
Rev Inst Med Trop Sao Paulo ; 43(3): 133-7, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11452320

RESUMO

In order to contribute to a better understanding of the forms of acquisition of hepatitis C virus (HCV) in Brazil, with special emphasis on sexual transmission, we determined the presence of HCV infection in regular partners and in non-sexual home communicants of blood donors seen at Fundação Pró-Sangue Hemocentro de São Paulo from January 1992 to July 1996. Of 154 blood donors with HCV infection (index cases), 111 had had regular partners for at least 6 months. Sixty-eight of 111 partners were evaluated for HCV infection. Of these, 8 (11.76%) were considered to have current or previous HCV infection; a history of sexually transmissible diseases and index cases with a positive HCV-RNA test were more prevalent among partners with HCV infection. Of the 68 index cases whose partners were studied, 56 had non-sexual home communicants. Of the total of 81 home communicants, 66 accepted to be evaluated for HCV infection. None of them was HCV-positive, suggesting that the high prevalence of HCV infection among partners may be attributed at least partially to sexual transmission.


Assuntos
Hepatite C/transmissão , Comportamento Sexual , Doenças Virais Sexualmente Transmissíveis/virologia , Adolescente , Adulto , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Busca de Comunicante , Feminino , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Parceiros Sexuais , Doenças Virais Sexualmente Transmissíveis/diagnóstico , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Doenças Virais Sexualmente Transmissíveis/transmissão
18.
Sex Transm Dis ; 28(4): 187-94, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11318248

RESUMO

BACKGROUND: Data comparing type-specific herpes simplex virus type 2 (HSV-2) seroprevalence and risk factors between comparable populations are largely unavailable, particularly from less-developed countries. GOAL: To examine the seroprevalence of HSV-2 infection and the risk factors for this infection among women in São Paulo, Brazil, and Manila, the Philippines. STUDY DESIGN: Altogether, 552 middle-aged women participating as control subjects in two cervical cancer studies were screened for type-specific HSV-2 antibodies. RESULTS: Herpes simplex virus type 2 seroprevalence was higher in Brazil (42%) than in the Philippines (9.2%). The mean ages of Brazilian (n = 181) and Filipino (n = 371) women were 52.4 and 46.6 years, respectively. Brazilian participants had more lifetime sexual partners, less education, and more often a husband with other sexual partners than Filipino women. Herpes simplex virus type 2 was independently associated with younger age at first intercourse in both countries. More than one lifetime sexual partner, a husband with other sexual partners, urban/semi-urban residence, and no history of condom use were HSV-2 risk factors in Brazil, but not in the Philippines, where long-term hormonal contraceptive use was associated with increased risk. CONCLUSIONS: The higher HSV-2 seroprevalence in Brazil than in the Philippines may be explained largely by differences in the sexual behavior of women and their husbands. Herpes simplex virus type 2 seroprevalence data may be used as a marker of past sexual behavior for the direct comparison of different population groups.


Assuntos
Anticorpos Antivirais/sangue , Herpes Genital/epidemiologia , Herpesvirus Humano 2/imunologia , Brasil/epidemiologia , Preservativos , Feminino , Humanos , Pessoa de Meia-Idade , Filipinas/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Comportamento Sexual , Parceiros Sexuais
20.
Semin Oncol ; 28(2): 188-97, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11301382

RESUMO

Cervical cancer is a common cause of morbidity and mortality in developing countries. In Latin America, the incidence rates in several cities are among the highest worldwide, probably due to a high frequency of risk factors and/or a low screening coverage for cervical cancer. Epidemiologic studies conducted in Latin America (and some in the Caribbean), that have investigated the main risk factors for the disease, as well as screening coverage by Papanicolaou (Pap) smear, were reviewed. The prevalence of human papillomavirus (HPV) infection among women with negative Pap smears does not seem to explain the risk observed in Latin American countries. Results of some studies have suggested that reproductive factors and male sexual behavior might be responsible, at least partially, for the high occurrence of cervical cancer in Latin America. Concerning cytology screening, many women have a smear taken regularly (some every year). However, a significant proportion of women, probably those with a high risk of cancer of the cervix, have never had a Pap test. To reduce cervical cancer in these countries, screening programs in Latin America should have a wider coverage, especially reaching those women at higher risk. Semin Oncol 28:188-197.


Assuntos
Países em Desenvolvimento , Neoplasias do Colo do Útero/epidemiologia , Feminino , Humanos , América Latina/epidemiologia , Teste de Papanicolaou , Fatores de Risco , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal
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