-Multiple sclerosis (MS) is an autoimmune, demyelinating and degenerative disease that affects the central nervous system. Its prevalence and clinical aspects vary according to the continent considered, being more frequent in Caucasians and young individuals aged 20 to 40 years. Epidemiological data from Brazil show that prevalence is variable, being more frequent in the Southern and Southeastern areas of the country, rather than in the Northern and Northeastern areas. The purpose of this paper is to describe MS clinical and epidemiological features in the State of Bahia, in the Brazilian Northeastern region. Thus, we held a cross-sectional study over the period from February to May, 2005, in the Multiple Sclerosis Patient Support Center ("Núcleo de Apoio aos Pacientes com Esclerose Múltipla") of Bahia, which included all patients with a diagnosis of MS seen over this period of time. A total of 121 patients were investigated, being 80.2% females (female:male ratio=4:1), with higher frequency in mulatto individuals (64%), and the relapsing-remitting type (91.3%). Most patients (68.7%) had mild MS, and blacks were prone to worse prognosis compared to other patients.KEY WORDS: multiple sclerosis, epidemiology, reference center. Perfil clínico e epidemiológico da esclerose múltipla em um centro de referência do Estado da BahiaRESUMO -A esclerose múltipla (EM) é doença auto-imune, desmielinizante e degenerativa que afeta o sistema nervoso central. Sua prevalência e seus aspectos clínicos variam de acordo com o continente estudado, sendo mais freqüente em caucasianos e indivíduos jovens entre a terceira e quarta décadas de vida. Dados epidemiológicos sobre o Brasil demonstram que a prevalência é variável, sendo mais freqüente nas regiões sul e sudeste que no norte e nordeste. O objetivo desse estudo é descrever as características clíni-cas e epidemiológicas da EM no Estado da Bahia, nordeste brasileiro. Assim, realizamos estudo de corte transversal durante o período de fevereiro a maio de 2005, no Núcleo de Apoio ao Pacientes com Esclerose Múltipla da Bahia, incluindo todos os pacientes consecutivos, com diagnóstico de EM, atendidos nesse período. Foi estudado um total de 121 pacientes, 80,2% do gênero feminino com uma relação de 4:1 com o gênero masculino, sendo observado maior freqüência de mulatos (64%) e da forma surto-remissão (91,3%). A maioria dos pacientes (68,7%) foi classificada como EM leve, sendo que os negros apresentaram indícios de pior prognóstico em relação aos outros pacientes.
The aim of the present study was to evaluate the prevalence of HEV, TTV and GBV-C/GBV-C/HGV in patients with acute viral hepatitis A, B and non-A-C. We evaluated sera of 94 patients from a sentinel program who had acute hepatitis A (N = 40), B (N = 42) and non-A-C (N = 12); 71 blood donors served as controls. IgM and anti-HEV IgG antibodies were detected by enzyme immunoassay using commercial kits. TTV and GBV-C/HGV were detected by nested PCR; genotyping was done by sequencing and phylogenetic analysis. Anti-HEV IgG was present in 38, 10 and 17% of patients with hepatitis A, B and non-A-C. Four patients with hepatitis A and 1 with non-A-C hepatitis also had anti-HEV IgM detected in serum. TTV was detected in 21% of patients with acute hepatitis and in 31% of donors. GBV-C/HGV was detected in 9% of patients with hepatitis, and in 10% of donors. We found TTV isolates of genotypes 1, 2, 3, and 4 and GBV-C/HGV isolates of genotypes 1 and 2. Mean aminotransferase levels were lower in patients who were TTV or GBV-C/HGV positive. In conclusion, the detection of anti-HEV IgM in some acute hepatitis A cases suggests co-infection with HEV and hepatitis E could be the etiology of a few cases of sporadic non-A-C hepatitis in Salvador, Brazil. TTV genotype 1, 2, 3 and 4 isolates and GBV-C/HGV genotype 1 and 2 strains are frequent in the studied population. TTV and GBV-C/HGV infection does not appear to have a role in the etiology of acute hepatitis. Correspondence
OBJECTIVE:To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia.METHODS:A cross-sectional study was conducted in the Sistema Assistencial à Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0.RESULTS:Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups.CONCLUSION:Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.
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