The data obtained suggest a greater prevalence of renal failure in men than in women, of stroke in white men than in white women, and of left ventricular hypertrophy in men than in women aged 49 years and above.

Schistosomiasis mansoni has been well documented as one of the causes of infectious glomerulopathy, with mesangiocapillary glomerulonephritis being the most frequent lesion observed in this condition. Twenty-one patients with hepatosplenic schistosomiasis mansoni and biopsy-documented mesangiocapillary glomerulonephritis (MCGN) were studied and compared with 19 patients with the idiopathic form of MCGN. Nephrotic syndrome was the most frequent clinical presentation in both groups. At the time of diagnosis nine patients with hepatosplenomegaly (4 with associated arterial hypertension) and 12 (8 with arterial hypertension) among the patients with idiopathic MCGN had renal insufficiency. At the end of the follow-up period 16 patients with hepatosplenic schistosomiasis and MCGN (75.2 months) and 15 with the idiopathic form (52.1 months) had renal failure. Also, when compared at 48 months of follow-up, no difference in renal function could be detected in both groups. No benefits related to anti-parasitic treatment in the schistosomiasis group and immunosuppression therapy in either group could be documented. The progression of the renal disease, as assessed by the reciprocal of serum creatinine versus time, and the survival curve, were not different between the two groups. It is concluded that MCGN in patients with the hepatosplenic form of schistosomiasis mansoni is a progressive disease not influenced by anti-parasitic or immunosuppressive therapy, and presents a clinical course similar to that of the idiopathic form.

Objective: To determine the rate of adherence to treatment with inhaled corticosteroids in patients with severe asthma, to identify predictive factors for adherence and to evaluate the relationship between adherence to treatment and parameters of clinical and functional response. Methods: Prospective cohort study of patients enrolled in the Program for the Control of Asthma and Allergic Rhinitis in the state of Bahia, Brazil. The study comprised 160 patients with severe asthma, monitored for 180 days in order to evaluate adherence (dependent variable) to the prescribed inhaled corticosteroid. Independent variables were assessed at baseline and for a six-month follow-up period by means of interviews and the completion of a standardized questionnaire. Patients recorded the missed doses in a diary. Results: Of the 160 patients, 158 completed the study. Adherence rate was 83.8%. Of the 158 patients, 112 (70.9%) were considered adherent (cut-off point: 80% of prescribed doses administered). There was a significant association between asthma control and adherence to treatment. Predictors of poor adherence were adverse effects, living far from the referral center, limited resources to pay for transportation and dose schedule. Other factors, such as depressive symptoms, religion and economic status, were not associated with poor adherence. Conclusions: Adherence to asthma treatment was high and was associated with the clinical response to treatment, in a sample of patients with severe asthma enrolled in a public program that provides free medication and the assistance of a multiprofessional specialized team in a referral center.Keywords: Asthma; Directly observed therapy; Treatment outcome; Patient compliance; Pharmacy. ResumoObjetivo: Determinar a taxa de adesão ao tratamento padrão com corticóide inalatório em pacientes com asma grave, identificar seus fatores preditores e avaliar a relação entre adesão ao tratamento e os parâmetros de resposta clínica e funcional. Métodos: Coorte prospectiva de pacientes atendidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia, Brasil. O estudo incluiu 160 pacientes com asma grave, acompanhados por um período de 180 dias para medida da adesão (variável dependente) ao corticóide inalatório prescrito. As variáveis independentes foram determinadas na avaliação inicial e durante seis meses através de entrevistas e aplicação de questionário estruturado. Os pacientes registraram em um diário as doses não utilizadas. Resultados: Do total de 160 pacientes, 158 completaram o estudo. A taxa de adesão ao tratamento foi de 83,8%. Dos 158 pacientes, 112 (70,9%) foram considerados aderentes ao tratamento (ponto de corte: 80% de todas as doses administradas). Houve associação significante entre o controle da asma e adesão ao tratamento. Os fatores relacionados a uma baixa adesão foram efeitos adversos, local de residência distante do centro de referência, dificuldade de pagar pelo transporte e regime posológico. Outros fatores, como sintomas depressivos, religião e classe eco...