Immunoreactivity of five antigens of Mycobacterium tuberculosis in patients attending a public health care facility in an area with high endemicity for TB.

The objective of this study was to evaluate people attending a primary health clinic in Rio de Janeiro, Brazil for immunoreactivity to five Mycobacterium tuberculosis antigens, as these antigens are markers of immune response and factors associated with active TB. The serum antibody titers of different categories of patients (defined by microbiological and radiological characteristics and by response to therapy on follow-up) to 38 kDa, 16 kDa, MPT64, ESAT-6 and MT10.3 antigens were determined blind with ELISA.

Two-step tuberculin skin test and booster phenomenon prevalence among Brazilian medical students.

Setting: Five medical schools in three cities in Rio de Janeiro State, Brazil, with different tuberculosis (TB) incidence rates.

Objective: To evaluate the prevalence of the booster phenomenon and its associated factors in a young universally BCG-vaccinated TB-exposed population.

Design: A two-step tuberculin skin test (TST) was performed among undergraduate medical students.

Reliability assessment of a plaque scoring index using photographs.

Objectives: The need to evaluate the reliability of a clinical index before using it as a research tool is clearly recognized. Therefore the aim of this study was to evaluate whether a new calibration method by means of photographs would be useful for assessing the examiners' reliability in the interpretation of a plaque index.

Methods: Nine children were randomly recruited from a public school in Rio de Janeiro, Brazil.

Oral isotretinoin in photoaging: clinical and histopathological evidence of efficacy of an off-label indication.

Background: Despite evidences of the beneficial clinical effects of oral isotretinoin in the treatment of cutaneous photoaging, scientific evidences are still scarce, mainly supported by histopathological and morphometric studies.

Objectives: To analyse possible clinical and morphological changes resulting from the treatment of photoaging with oral isotretinoin.

Methods: Thirty female patients, aged 40 to 55 years, phototypes II to IV, with moderate to severe photoaging were randomly assigned to two groups of 15 each.

Evaluation of intra- and interobserver agreement and its clinical significance for scoring bcl-2 immunohistochemical expression in diffuse large B-cell lymphoma.

Immunohistochemistry (IHC) has become an essential part of diagnosis and clinical research in lymphomas. There is considerable heterogeneity, however, in IHC findings regarding expression rate and positivity cut-offs, which creates a degree of uncertainty that has prevented its incorporation for prognostic purposes. The purpose of the present study was to assess intra- and interobserver agreement in scoring bcl-2 expression on IHC.

Postobturation pain and associated factors in adolescent patients undergoing one- and two-visit root canal treatment.

Objectives: This prospective study evaluated the frequency and intensity of postobturation pain and associated factors in adolescents undergoing one- and two-visit root canal treatment.

Methods: 121 patients aged 11-18 years presenting with molars with pulp necrosis were assigned randomly into two treatment groups: one- and two-visit (including interappointment dressing with calcium hydroxide paste). The canals of all teeth were prepared using a preflaring (2/3 middle-cervical) and step-back (1/3 apical) preparation techniques and filled with laterally compacted gutta-percha and sealer.

The effect of addition of chemotherapy to radiotherapy in the treatment of women with cervical cancer: a survival analysis using propensity score.

Objective: To compare the overall survival of patients with cervical cancer treated exclusively with radiotherapy with that of patients treated with a combination of radio and chemotherapy.

Material And Methods: Retrospective analysis of all cases of cervical cancer registered at the Brazilian National Cancer Institute between 1999 and 2004, treated with radiotherapy exclusively or in combination with chemotherapy. The Kaplan-Meier curve and the log-rank test were used to assess overall survival.

Association between smoking and cutaneous ageing in a Brazilian population.

Objective: This study aims to determine the relationship between smoking and cutaneous ageing.

Methods: A cross-sectional study was carried out on 301 subjects (191 women and 110 men, aged between 25 and 86 years), of which 165 were non-smokers and 136 were smokers and ex-smokers. The association between tabagism and cutaneous ageing was controlled for other variables (solar exposure, age, skin phototype, sex, sunscreen use, alcohol consumption, coffee consumption, sports participation, body mass index, and history of relatives with precocious ageing).

Manual and electronic probing of the periodontal attachment level in untreated periodontitis: a systematic review.

Objective: A systematic review of clinical trials has been performed to evaluate the reproducibility of manual (MP) and electronic probes (EP) in the measurement of clinical periodontal attachment level (AL) in untreated periodontitis subjects.

Methods: Systematic electronic (PubMed Medline and Latin American and Caribbean Health Science--LILACS literature databases) and hand searches (English, Spanish and Portuguese languages; search terms "periodontitis diagnosis", "clinical attachment level measurements", "clinical attachment level detection", "clinical diagnosis of periodontitis", "manual probe", "electronic probe", "periodontitis or periodontal disease or attachment level or clinical attachment level") were performed to identify clinical trials involving CAL measurements, MP and EP in untreated periodontitis subjects. Quality and external validity were determined for selected studies.

The relationship between alcohol dependence and periodontal disease.

Background: The aim of this study was to evaluate the relationship between alcohol dependence and periodontal disease.

Methods: A cross-sectional study of 49 alcoholic and 49 non-alcoholic men was conducted at Philippe Pinel Institute, Rio de Janeiro, Brazil. Subjects were screened for alcohol dependence using the CAGE (cut-down, annoyed, guilty, eye-opener) questionnaire and the criteria of the International Statistical Classification of Diseases, 10th Revision.

A latitudinal gradient study of common anti-infectious agent antibody prevalence in Italy and Colombia.

Background: Infectious agents are important in the pathogenesis of autoimmune disease since they are a major part of the environmental trigger of autoimmunity. A negative relationship between latitude and infectious disease species richness has been suggested.

Objectives: To examine whether their prevalence differs in two latitudinally different populations.

The cigarette burden (measured by the number of pack-years smoked) negatively impacts the response rate to platinum-based chemotherapy in lung cancer patients.

Purpose: To evaluate the impact of the cigarette burden (CB) on the response rate to platinum-based chemotherapy (CT) in patients with lung cancer (LC).

Methods: Retrospective study of patients with LC treated by CT from 2000 to 2005, in a tertiary referral center in Brazil. The CB was measured by the number of pack-years smoked (PY).

McNemar chi2 test revisited: comparing sensitivity and specificity of diagnostic examinations.

When evaluating a novel diagnostic examination for clinical use, it should be compared with a reference standard, defined as the best available examination, which may include clinical and laboratory criteria. The novel examination and reference standard's results are usually presented in the form of a 2 x 2 table, which allows calculation of sensitivity, specificity and accuracy. It has been recommended that the measures of statistical uncertainty should be reported, such as the 95% confidence interval, when evaluating the accuracy of diagnostic examinations.

Reliability of two methods for measurement of alveolar bone level in children.

Objectives: To determine the intra- and interexaminer reliability of two methods (calliper and computerized images) for measuring the alveolar bone level on bitewing radiographs of pre-school children and to determine the extent to which one method can measure more sites.

Methods: Standardized paediatric bitewings were analysed with either an image analysis program (ImageTool) or a digital calliper (Digimatic Caliper). With each method, radiographs were measured three times by three trained examiners.

Prevalence of oral manifestations of HIV infection in Rio De Janeiro, Brazil from 1988 to 2004.

After the introduction of highly active antiretroviral therapy (HAART), several studies have shown a decrease in the prevalence of HIV-associated oral lesions. The goal of this study is to evaluate the prevalence of oral manifestations of HIV in Brazil. A retrospective epidemiologic analysis was performed of medical records of HIV-positive patients who attended Clementino Fraga Filho University Hospital and the Stomatology Clinic of Federal University of Rio de Janeiro from 1988 to 2004.

807C/T polymorphism in the platelet glycoprotein Ia gene in young patients with ischemic stroke of undetermined etiology.

Platelet membrane glycoprotein receptors mediate key reactions in arterial thrombosis. The relationship between glycoprotein Ia polymorphisms and the risk of ischemic stroke, however, remains controversial. A matched case-control study was conducted to evaluate this question in young patients.

Pleural fluid ADA, IgA-ELISA and PCR sensitivities for the diagnosis of pleural tuberculosis.

The diagnosis of pleural tuberculosis (pTB) is difficult, and more sensitive and specific techniques are needed. In the period August 1998 to November 2002, we evaluated 132 patients with a pleural effusion submitted to a thoracentesis and pleural biopsy in a tertiary care hospital in Rio de Janeiro, Brazil. Three tests were performed and compared in the pleural fluid: ADA activity measurement, IgA-ELISA for two combined specific Mycobacterium tuberculosis antigens, and polymerase chain reaction (PCR) for detection of M.

Sensitivity analysis for unmeasured confounders using an electronic spreadsheet.

In studies assessing the effects of a given exposure variable and a specific outcome of interest, confusion may arise from the mistaken impression that the exposure variable is producing the outcome of interest, when in fact the observed effect is due to an existing confounder. However, quantitative techniques are rarely used to determine the potential influence of unmeasured confounders. Sensitivity analysis is a statistical technique that allows to quantitatively measuring the impact of an unmeasured confounding variable on the association of interest that is being assessed.

Use of sensitivity analysis to assess the effects on anti-hepatitis A virus antibodies of access to household water supply.

The objective of this study was to assess the impact of a possible unmeasured confounding variable in a previously published association between the effects of household water supply and positive results for hepatitis A serology. This was estimated using a path of integration between two methods of sensitivity analysis, called Rosenbaum's method and Greenland's external adjustment. The association between household water supply and positive results for hepatitis A (outcome) serology was insensitive to confounding unless the odds ratio for the association between the confounder and the outcome was > or = 4.

Nitric oxide levels and the severity of juvenile idiopathic arthritis.

In this study, we evaluate the distribution of nitric oxide (NO) in the serum of juvenile idiopathic arthritis (JIA) patients, correlating it with parameters of the severity of the disease. Ninety-seven patients with mean age 11.7 years and disease duration 4.

[The effect of propylthiouracil on the efficacy of radioiodine (I-131) therapy in graves hyperthyroidism].

Aiming at evaluating the effect of antithyroid drugs on the efficacy of radioiodine treatment (RAI) we retrospectively analyzed 226 patients with Graves disease hyperthyroidism submitted to RAI between 1990 and 2001: 58 patients without any antithyroid drug (ATD) prior to RAI, 119 patients using propylthiouracil (PTU) and 49 patients using methimazole (MMI) prior to RAI. Clinical and laboratory parameters 1 year after RAI defined their clinical status (cured or not cured). High serum free T4 and 131-iodine uptake were negatively related with cure as well as lower RAI doses (mCi) and larger goiters (p< 0.

Socioeconomic inequality and short-term outcome in Hodgkin's lymphoma.

Socioeconomic status (SES) is a determinant of outcome in various types of cancer. The aim of this study is to analyze the impact of the SES in Hodgkin's lymphoma (HL). From 2001 to 2005, 194 consecutive patients were prospectively followed in 5 institutions.

[Mechanical ventilation in Brazil: epidemiological aspects].

Background And Objectives: There are few epidemiological studies in mechanical ventilation, and the aim of the study is to show how this procedure is being used in Brazil.

Methods: A 1-day point prevalence study was performed in 40 ICUs, with 390 patients; 217 of these patients were in mechanical ventilation. The results evaluated were the characteristics of ventilated patients, their distribution in Brazil, the mechanical ventilation's causes, the main ventilatory modes, the more important ventilators settings, and the weaning stage of mechanical ventilation.

Choosing incentives to stimulate tuberculosis treatment compliance in a poor county in Rio de Janeiro state, Brazil.

Background: Tuberculosis (TB) treatment default is a major constraint of TB control, resulting in continued disease transmission and possibly the emergence of multidrug resistance. Marginalized populations may abandon treatment before being cured. The objective of this study was to evaluate the socioeconomic status (SES) of TB patients and identify potential incentives for improving treatment compliance by SES.

Effect of age on survival of critically ill patients with cancer.

Objectives: To estimate the effects of age on 6-month survival of critically ill patients with cancer.

Design: Prospective cohort study analyzed using Cox proportional hazard models.

Setting: Ten-bed oncologic medical-surgical intensive care unit.