Evaluation of Glomerular Filtration Rate Trends in People Living With HIV Corrected by the Baseline Glomerular Filtration Rate.

Background: Chronic kidney disease, for which estimated glomerular filtration rate (eGFR) trajectories are early markers, is frequent in people living with HIV.

Setting: Identify eGFR trajectory patterns according to kidney function and assess associated factors over a 13-year follow-up period.

Methods: We evaluated longitudinal changes and its associated factors in eGFR of 3366 participants according to kidney function with a 2-level, linear, mixed model.

Secretory Leukocyte Protease Inhibitor Expression and High-Risk HPV Infection in Anal Lesions of HIV-Positive Patients.

Objective: The aim of this study was to evaluate secretory leukocyte protease inhibitor (SLPI) expression in anal biopsies from HIV-positive (HIV+) individuals, and compare that to anal intraepithelial neoplasia (AIN) diagnoses and human papillomavirus (HPV) status.

Design: This is a cross-sectional study of a cohort of 54 HIV+ (31 males and 23 females) from an AIDS clinic in Rio de Janeiro, Brazil.

Methods: The study material consisted of anorectal tissue biopsies obtained from HIV+ subjects, which were used to construct tissue microarray paraffin blocks for immunohistochemical analysis of SLPI expression.

Chlamydia trachomatis, Neisseria gonorrhoeae and syphilis among men who have sex with men in Brazil.

Background: Sexually transmitted diseases (STD) are frequently asymptomatic and increase the likelihood of transmitting and acquiring HIV. In Brazil, the guidelines for STDs diagnosis and treatment are based on the syndromic approach. Nucleic acid amplification tests (NAAT) has been recommended as routine STDs screening in some countries, especially for men who have sex with men (MSM).

Unprotected sexual practices among men who have sex with women and men who have sex with men living with HIV/AIDS in Rio de Janeiro.

Combined antiretroviral therapy is now acknowledged for preventing new HIV infections, besides decreasing mortality and morbidity. However, in many Latin America countries the epidemic is still driven by unprotected sexual intercourse. This study aims to describe sexual practices related to HIV/STD and to evaluate factors associated to unprotected sex among men who have sex with women (MSW) and men who have sex with men (MSM) under care at a reference center for HIV in Rio de Janeiro, Brazil.

Correlation of MCM2 detection with stage and virology of cervical cancer.

Unlabelled: The highly conserved mini-chromosome maintenance proteins (MCM) are important in the initiation of DNA replication. Few studies have correlated MCM expression with the progression of cancer.

Objectives: (i) To analyze the expression of MCM2 in cervical cancer; (ii) to correlate MCM2 expression with the clinical tumor staging according to FIGO classification, and (iii) to relate HPV type to MCM2 expression.

Screening for decreased glomerular filtration rate and associated risk factors in a cohort of HIV-infected patients in a middle-income country.

With the introduction of combined active antiretroviral therapy and the improved survival of HIV-infected patients, degenerative diseases and drug toxicity have emerged as long-term concerns. We studied the prevalence of decreased glomerular filtration rate (GFR) and associated risk factors in a cohort of HIV-infected patients from a middle-income country. Our cross-sectional study included all adult patients who attended an urban outpatient clinic in 2008.

Incidence of antiretroviral adverse drug reactions in pregnant women in two referral centers for HIV prevention of mother-to-child-transmission care and research in Rio de Janeiro, Brazil.

Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) infection remains an important cause of new HIV infections worldwide, especially in low and middle-resource limited countries. Safety data from studies involving pregnant women and prenatal antiretroviral (ARV) exposure are still needed once these studies are often small and with a limited duration to assess adverse drug reactions (ADR). The aim of this study was to estimate the incidence of ADR related to the use of antiretroviral therapy (ART) in pregnant women in two referral centers in Rio de Janeiro State.

A comparative analysis of clinical and molecular factors with the stage of cervical cancer in a Brazilian cohort.

Unlabelled: Cell cycle protein expression plays an important role in the pathophysiology of cervical cancer. However, few studies have attempted to correlate the use of these biomarkers with the clinical progression of the tumor.

Objectives: 1) To analyze the expression of Ki-67, p53 and p16(INK4a) in cervical cancer, 2) to correlate the relative expression of these proteins as well as clinical parameters with the stage of disease, and 3) to determine the HPV DNA prevalence and subtype distribution.

An evaluation of p16(INK4a) expression in cervical intraepithelial neoplasia specimens, including women with HIV-1.

Although several studies have evaluated the role of p16(INK4a) as a diagnostic marker of cervical intraepithelial neoplasia (CIN) and its association with disease progression, studies regarding the role of p16(INK4a) in human immunodeficiency virus (HIV)-infected patients remain scarce. The present study was designed to determine the potential utility of p16(INK4a) as a diagnostic marker for CIN and invasive cervical cancer in HIV-positive and negative cervical specimens. An immunohistochemical analysis of p16(INK4a) was performed in 326 cervical tissue microarray specimens.

Evaluation of MCM-2 expression in TMA cervical specimens.

Background: Minichromosome maintenance proteins (MCM) are highly expressed in actively replicating cells. The need for biological markers for cervical carcinoma and its precursor lesions is emerging. Our main aim was to determine the immunohistochemical expression of MCM-2 in HIV-positive and -negative dysplastic cervical specimens.

Participation of women in HIV clinical trials: the IPEC-FIOCRUZ experience.

Background: Fifty percent of people living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) worldwide are female. In Brazil, for example, 240,000 women are infected with HIV, rates of infection in women have increased over the last two decades, and addressing HIV prevention and treatment for women at risk for, or living with, HIV/AIDS remains a challenge. To better address the needs of women living with HIV in Brazil, the Instituto de Pesquisa Clínica Evandro Chagas - Fundação Oswaldo Cruz (IPEC-FIOCRUZ) HIV Women's Cohort was established in 1996 to study the natural history of women seeking HIV care.

HIV rapid testing as a key strategy for prevention of mother-to-child transmission in Brazil.

Objective: To assess the feasibility of HIV rapid testing for pregnant women at maternity hospital admission and of subsequent interventions to reduce perinatal HIV transmission.

Methods: Study based on a convenience sample of women unaware of their HIV serostatus when they were admitted to delivery in public maternity hospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 and April 2002. Women were counseled and tested using the Determine HIV1/2 Rapid Test.

The decline in mortality from circulatory diseases in Brazil.

Objectives: Cardiovascular diseases are the leading cause of death in the world. Although mortality rates have declined gradually in developed countries, the scenario is less clear in developing countries. We describe the trends in cardiovascular mortality in Brazil over 24 years and investigate differences according to groups of diseases, sociopolitical region, gender, and age.

[Quality assessment of labor care provided in the Unified Health System in Rio de Janeiro, Southeastern Brazil, 1999-2001].

Objective: Quality of labor care has been recognized as a major factor for prevention of obstetric complications which can lead to maternal, perinatal and neonatal morbidity and mortality. The objective of the study was to assess quality of labor care by gestational risk and type of health provider.

Methods: Observational, cross-sectional study of labor care provided to 574 pregnant women.

[Use of psychoactive substances and contraceptive methods by the Brazilian urban population, 2005].

Objective: To analyze the relationship between utilization patterns for condoms and other contraceptive methods and the consumption of alcohol and drugs.

Methods: Exploratory study based on data from a probabilistic sample of 5,040 interviewees aged 16 to 65 years living in large urban regions of Brazil in 2005. The data were collected by means of questionnaires.

[Signs and symptoms associated with sexually transmitted infections in Brazil, 2005].

Objective: Sexually transmitted infections (STIs) are a major determinant of population disease burden worldwide. The objective of the study was to assess self-reported morbidity associated to STIs according to gender.

Methods: The study data were obtained from a 2005 study consisting of a multistage probabilistic sample of 5,040 respondents, aged 16-65 years, living in urban areas in Brazil.

[Reliability of birth defect data on birth certificates of Rio de Janeiro, Brazil, 2004].

This study assessed the reliability of birth certificate data related to birth defects in Brazil's Live Birth Information System (SINASC). We selected 24 maternity hospitals in the Unified National Health System (SUS) and compared the reports of birth defects from birth certificates with medical records of mothers and live born infants in the city of Rio de Janeiro for the year 2004. After transposing the data to a specific form, the birth defects were coded by types and organ systems and compared to the SINASC data.

[Birth defects in Rio de Janeiro, Brazil: an evaluation through birth certificates (2000-2004)].

To evaluate the occurrence of birth defects in the city of Rio de Janeiro, Brazil, using the Live Birth Information System (SINASC), we performed a cross-sectional study on all live newborns with birth defects from January 1, 2000, to December 31, 2004. The variables referred to birth defects (presence and system affected), type of health service, mothers, gestations, live births, and deliveries. Prevalence of birth defects was 83/10,000 live births.

[Time to kidney transplantation in chronic renal failure patients in the State of Rio de Janeiro, Brazil, 1998-2002].

This study analyzes the characteristics of 14,419 chronic renal failure patients treated with hemodialysis and time to first kidney transplantation in the State of Rio de Janeiro, Brazil, from 1998 to 2002. Survival analysis methods were used, such as the Kaplan-Meier non-parametric method and the semi-parametric method with the Cox proportional hazards model. Besides the survival model for transplantation, time to death was analyzed to compare the two models' estimates.

[Evaluation of quality of epidemiological and demographic variables in the Live Births Information System, 2002].

This study evaluates the quality of data in the Brazilian Live Births Information System (SINASC), focusing on the methodological clarity of documentation and adequate data completeness and consistency at the national, regional, and State levels in 2002. The variables analyzed were: skin color/race of newborn, maternal schooling, maternal marital status, maternal occupation, maternal age, prenatal visits, live births, stillbirths, and birth weight. For most of the variables, SINASC shows good data completeness and consistency, but there were serious problems with the quality of data on previous children and maternal occupation.

[Consequences of sociodemographic inequalities on birth weight].

Objective: To analyze sociodemographic inequalities in prenatal and childbirth care and their consequences on birth weight.

Methods: The study was based on a sample of 10,072 postpartum women treated at public (those outsourced by the National Health System) and private maternity hospitals in Rio de Janeiro, Brazil, from 1999 to 2001. To test the association between birth weight and maternal sociodemographic and biological characteristics and prenatal care (modified Kotelchuck index), postpartum women were stratified by level of schooling and two multiple linear regressions were performed.

[Reliability of birth certificate data in Rio de Janeiro, Brazil, 1999-2001].

The objective of this article is to assess coverage and reliability of data from the Information System on Live Births in the City of Rio de Janeiro, based on an analysis of live birth certificates issued by the various hospitals and compared to information from the "Study on Neonatal and Perinatal Morbidity and Mortality and Care in the City of Rio de Janeiro". A total of 9,608 interviews with post-partum women were paired case-by-case with the respective birth certificates. The statistical analysis consisted of calculating the Kappa index adjusted to the prevalence of categorical variables and the intra-class correlation coefficient for continuous variables, with a 95% significance level.

[Use of the modified Kotelchuck index in the evaluation of prenatal care and its relationship to maternal characteristics and birth weight in Rio de Janeiro, Brazil].

The Kotelchuck index (KI) was modified and used to evaluate prenatal care provided in the City of Rio de Janeiro, Brazil, in a sample of 9,920 post-partum women following singleton deliveries. Ordinal logistic regression (OLR) and multivariate linear regression (LMR) were used to estimate the importance of demographic, psychosocial, and obstetric factors for modified KI and the effects on birth weight (BW), respectively. Only 38.

[Consistency between data sources and inter-observer reliability in the Study on Neonatal and Perinatal Morbidity and Mortality and Care in the City of Rio de Janeiro].

The objective of this study was to evaluate the quality of data in the research project entitled "Study on Neonatal and Perinatal Morbidity and Mortality and Care in the City of Rio de Janeiro", analyzing the completeness of patient records, inter-observer reliability, and concordance of collected data. The study interviewed a sample of 10,072 post-partum women, corresponding to 10.0% of the deliveries in the City of Rio de Janeiro.