Epidemiological Profile Research Articles

Prevalence and distribution of HPV 16 and 18 with its epidemiological profile among cervical cancer patients: A prospective study from regional cancer centre of Gujarat, Western India

Cervical cancer (CC) is the leading cause of morbidity and mortality due to cancer among women in Indian. This study was conducted to determine the prevalence and distribution of HPV16/ 18 and epidemiological profile of CC patients from, Gujarat Western India.CC biopsy specimens of 400 patients were analyzed for HPV16 and 18 by type-specific PCR. In our study 74% of CC cases were positive for HPV, 67% had HPV16, 14.8% had HPV18 and 7.7% had both HPV16/18. The median age of the women with CC was 50 years and peak incidence (31.8%) was between 40 to 50 years. Majorities (68.5%) were postmenopausal. The median age of marriage was 20years. Squamos cell carcinoma (SCC) was found in 91% and adenocarcinoma (ADC) in 7.3% of the patients. As per study 7.8%, 16.3%, 58% and 2.5% of CC patients presented in FIGO stage I, II, III, and IV respectively. HPV16 was exhibited in, 68.8% and 66.4%, HPV18 in 14.9% and 15.9% of pre and postmenopausal patients respectively. HPV16 and HPV 18 positivity was 68.7% and 51.7% and 13.2% and 31% in SCC and in ADC respectively. HPV16 infection was higher in stage I and HPV18 in stage IV malignancy.There were two peaks of HPV16, first between 21 to 30 and second between 51 to 60 years among CC patients. HPV 16 is highly prevalent among all groups. In patients with adenocarcinoma, Stage IV malignancy & who had marriage before 18years, incidence of HPV18 was relatively high.

Epidemiological and clinical profile of HTLV-1 patients: a closer look at a reference center in Bahia, Brazil

Epidemiological and clinical profile of HTLV-1 patients: a closer look at a reference center in Bahia, Brazil

Epithelioid Angiosarcoma: A Diagnostic Dilemma with Clinically and Histopathologically Overlapping Features

Cutaneous angiosarcoma is a rare malignancy of endothelial cell origin that commonly presents in the head and neck region of elderly individuals and is known for high rates of lymph node metastasis and mortality. There is significant variability in the histopathologic features, and immunohistochemistry is necessary to help differentiate epithelioid angiosarcoma from lesions it may clinically mimic. Here, we report a rare case of poorly differentiated epithelioid angiosarcoma on the trunk initially diagnosed as poorly differentiated squamous cell carcinoma (SCC) on shave biopsy. A 56-year-old man presented for a full-body skin examination significant for a 5.6 x 2.8 mm brown-black macule on the left superomedial posterior trunk and a 5.0 x 2.7 mm pink, ulcerated papule on the right inferior posterior trunk. On histopathology, one lesion was found to be melanoma in situ, and the other showed ulcerated and infiltrative, poorly differentiated SCC. Post-excision histologic analysis of the right inferior back lesion revealed tumor cells immunoreactive to vimentin, ERG, and CD31 (PECAM-1). These findings suggested that the lesion previously diagnosed as SCC was an invasive, poorly differentiated epithelioid angiosarcoma. The patient underwent 40 sessions of radiotherapy. Epithelioid angiosarcoma occurring outside of the conventional epidemiologic profile is believed to portend higher mortality rates. This case highlights the importance of thorough clinical evaluation and appropriate histopathologic diagnosis of an aggressive neoplasm unlikely to present in this location. Further studies are required to explore potential risk factors, effective treatments, and long-term outcomes in patients with epithelioid angiosarcoma.

Towards an Individualized Care Pathway for the Elderly Intensive Care Patients: Retrospective Analysis of Factors Associated with Mortality in 684 Cases

As the population ages, the number of elderly patients admitted to the ICU continues to rise. The physiological changes associated with ageing represent a challenge for the management of this often-fragile population at high cognitive risk. An epidemiologic and evolution profile in our Moroccan context is necessary to improve survival and its quality in post-intensive care in our elders. This is a retrospective analytic study including all patients over 65 years of age admitted to the A4 polyvalent intensive care unit of the Hassan II University Hospital in Fez, from January 2017 to December 2021, excluding patients initially admitted for COVID-19 infection. The epidemiology, stay, management and outcome data were collected and analyzed.

Tracking People Living with HIV in Loss to Follow Up in Central Brazil: A Call for Attention to Health Services.

Despite the effectiveness of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection remains a global public health concern. However, weaknesses in its management regarding access to integrated HIV care include treatment gaps and loss to follow-up (LTFU) from antiretroviral treatment (ART). This study aimed to characterize the epidemiological and clinical profiles of people living with HIV/AIDS (PLHA) in LTFU from HIV care in Campo Grande, Central Brazil. This retrospective cross-sectional study was conducted between January 2021 and April 2022 using secondary data from PLHA who had LTFU in Campo Grande. A total of 852 patients with PLHA were included in this study. The majority of participants in LTFU were male (63.1%), had a CD4 cell count > 200 cells/mm3 (68.2%), and had been treated for ≥ 3months (86.4%). Only 287 (33.7%) participants had undetectable HIV viral load. Of the total number of patients who returned to treatment during the study period, 448 (54.3%) were LTFU-positive. The tracking strategy was not applied to 556 (65.26%) patients, and 44.4% of the participants had been in spontaneous demand. These results highlight the relevance of patient-centered interventions and the need to ensure early treatment and promote retention in care systems with consequent viral suppression, impacting the healthcare indicators of the population, with emphasis on health managers and stakeholders in HIV care.

Scorpionism in children and adolescents: clinical and epidemiological factors associated with severe cases

Objective: To analyze the association between epidemiological and clinical factors and the severity of scorpion accidents in children and adolescents. Methods: This is a retrospective cross-sectional quantitative study that analyzed 648 medical records of patients aged between zero and twelve years. The outcome variable was the severity of scorpionism, with bivariate analysis (Pearson's chi-square test) and Poisson multivariate analysis to identify associated factors. Results: A total of 34.7% of the cases were severe, predominantly in female children, under three years old, non-white, urban and from Montes Claros. The majority of accidents occurred before 5pm, on the lower limbs, with care provided after 1am. Sequelae (PR=1.75; 95%CI 1.00-3.05) and ICU (PR=2.45; 95%CI 1.23-4.88) were associated with severity, while bites to the lower limbs reduced the prevalence of serious accidents (PR= 0.76; 95%CI 0.6-2.94). Conclusion: The epidemiological profile indicated that the majority of bites occurred before 5pm, with care after 1am, and bites to the lower limbs were associated with a lower prevalence. The clinical profile was related to ICU admission and the use of vasoactive amines. Given the importance of scorpionism in children, it is crucial to educate the population in order to prevent accidents and improve prognosis.

Epidemiological profile of neuroendocrine tumors in adults in Brazil.

Neuroendocrine tumors (NETs) are a set of diseases that originate from neuroendocrine cells, which comprises a diffuse endocrine system present in various organs of the body. These tumors are more frequent in the gastrointestinal tract (70%) and the bronchopulmonary system (20%-30%). A NET incidence rate of 1-5 per 100,000 inhabitants has been estimated for several European countries and the USA employing 20 years of data. However, no comprehensive studies on this rare neoplasm are available in Brazil. In this context, the aim of this study was to characterize the epidemiological NET profile in the country. This is a retrospective descriptive observational study based on data from Hospital Cancer Records available at the Brazilian National Cancer Institute and the São Paulo Oncocentro Foundation. Demographic, clinical and treatmentrelated variables were analyzed from selected cases employing descriptive statistics. A total of 15,859 cases were identified, most occurring in males (53.4%) and in individuals under 65 years old (63.3%). Small cell carcinoma was the most frequent histological type (46.7%). Bronchopulmonary tumors were the most frequent NETs, followed by pancreatic tumors, with cases mostly concentrated in high complexity centers in the Brazilian Southeast and treated mainly with surgery and chemotherapy, with over half of the patients diagnosed in advanced stages of the disease.

Cutaneous melanoma in adolescents and young adults.

Cutaneous malignant melanoma (CMM) ranks among the five most common cancers in young people in high-income countries and it features peculiar clinicopathological traits. Very few studies have addressed the quality of care and the costs for adolescents and young adults (AYA) population. To provide a comprehensive epidemiological and clinicopathological profile of CMM in AYA. The study also addresses the cost-of-illness and the diagnostic-therapeutic performance indicators by patient age category. This population-based cohort study included 2435 incident CMM (age range 15-65 years; age 15-39 = 394; age 40-65 = 2041), as recorded in 2015, 2017 and 2019 by the Regional Veneto Cancer Registry (Italy). Cramer's-V tested the strength of association between pairs of variables. The Kaplan-Meier method was used to test the association between age and survival rate. The clinical performance indicators were computed using the Clopper-Pearson exact method. In AYA patients (16.2%), CMM incidence rates increased significantly from 1990 to 2019. Low-stage CMM (p = 0.007), radial growth pattern (p = 0.026) and lower Clark levels (p = 0.007) prevailed; males had less advanced malignancies (p = 0.003), with the trunk as the most common primary site (67.5%); the lower limbs (32.6%) were the most common primary site for females (p < 0.001). Overall survival was better in AYA than adults. No significant difference was detected in the clinical management of the two age groups, with the only exception of the margin in wide local excision. The care costs were lower in AYA (€195.99 vs. €258.94, p = 0.004). In AYA patients, the CMM clinicopathological presentation shows a distinctive profile. The present results provide critical information for optimizing primary and secondary prevention strategies and for tailoring diagnostic therapeutic procedures to the peculiar profile of AYA CMM patients.

Epidemiological, clinicopathological, and evolutionary profile of familial non-medullary thyroid carcinoma (FNMTC) in 3 families

Epidemiological, clinicopathological, and evolutionary profile of familial non-medullary thyroid carcinoma (FNMTC) in 3 families

Epidemiological profile of chronic renal disease in obese people: prospective study in avicenna military hospital - marrakech

Epidemiological profile of chronic renal disease in obese people: prospective study in avicenna military hospital - marrakech

Abstract PO5-27-04: The epidemiological profile and lifestyle of non-village indigenous women from Amazonas, Brazil and the likely impact on breast cancer mortality

Abstract Introduction: The high and growing incidence of breast cancer is a reality in almost every continent. However, the low mortality from this neoplasm among indigenous people of Amazonas, Brazil, is an intriguing fact (table 1). Inspite having a lower life expectancy at birth, the magnitude of low mortality is even greater. Indigenous women have gradually integrated into the non-indigenous community, and the reality of low mortality from breast cancer may be at risk of not existing in the future if the justification is in their reproductive epidemiological profile and lifestyle. Objective: This work seeks to find variables that can justify the fact that indigenous women from the Amazon region die less from breast cancer when compared to non-indigenous women. To achieve this, we evaluated reproductive epidemiological factors and lifestyle in non-village indigenous women and compared them with the same data in non-indigenous women. Methods: This is a cross-sectional study consisting of a convenience sample in which all indigenous people treated at the Mastology Outpatient Clinic of the Getúlio Vargas University Hospital of the Federal University of Amazonas were invited to participate from September 2020 to March 2023. There were 126 women: 39 non-village indigenous people who have lived in Manaus for more than 5 years and are integrated into society, 47 non-village indigenous people who live in riverside and interior populations of Amazonas - or in Manaus for less than 5 years - and 40 non-indigenous individuals. A questionnaire in interview format was administered with the objective of evaluating epidemiological and reproductive aspects such as age, education, BMI, menarche, parity, age at first pregnancy, breastfeeding, use of hormonal medications as well as lifestyle factors including smoking, alcohol consumption, dietary habits, physical activity, use of herbs, roots and seeds for therapeutic purposes and practice of religious devotional habits. Results: There was no difference in age, BMI, education, menarche and parity between the interviewed patients, nor in the assessment of the consumption of milk, sugar, fruits, vegetables and legumes, smoking habits, alcohol intake or physical activity between the groups. Indigenous women living in Manaus had a lower age at first pregnancy when compared to non-indigenous women. The variable “breastfeeding time” did not reach statistical significance but demonstrated a very close index (p 0.058) and a tendency to suggest that indigenous people, regardless of their place of residence, breastfeed for a longer duration. Non-indigenous women had a longer history of using hormonal medications when compared to indigenous women living in Manaus. Regarding meat consumption habits, indigenous women living in riverside and interior populations showed higher percentages of sporadic consumption of beef, sporadic consumption of wild animals, and daily consumption of white meat compared to non-indigenous people. On the other hand, non-indigenous women had a higher percentage of never having consumed wild animal meat when compared to the two other groups. Among indigenous women from riverside populations, there was a lower percentage of religious practices. The consumption of herbs, roots or seeds for therapeutic purposes was more commonly observed among indigenous people living in Manaus when compared to non-indigenous people. Conclusion: No epidemiological or lifestyle variables were found in both groups of indigenous people that justify the low mortality from breast cancer in these women. However, although the variable “breastfeeding time” did not reach statistical significance, it demonstrated a very close index (p 0.058) and a tendency to suggest that indigenous people, regardless of their place of residence, breastfeed for a longer duration. This could be a potential explanation for the low mortality from this disease among indigenous women. Table 1: Participation of breast cancer deaths in the total number of deaths in women over 20 years of age in the State of Amazonas Source: prepared by researchers Table 2 - Menarch, parity (childbirth and miscarage), breastfeed, Family history of breast cancer, image exam Table 3: Red and white meat consumption Citation Format: Maria Riselda Vinhote Da Silva, Lilian Cristina De Souza Guimarães, Afonso Nazário, Mariana Guimaraes De Oliveira Castro. The epidemiological profile and lifestyle of non-village indigenous women from Amazonas, Brazil and the likely impact on breast cancer mortality [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-27-04.

Abstract PO3-09-12: Exploring Gender-Specific Patterns of Breast Cancer in Brazil: A Comparative Epidemiological Study

Abstract Introduction: Male breast cancer constitutes approximately 1% of all breast cancer cases, and limited studies have focused on this population, resulting in a lack of understanding of the disease in men. This study aims to describe the epidemiological profile of male breast cancer in Brazil and compare it with female breast cancer. Methods: A comprehensive observational cross-sectional study was conducted using retrospective data from the DATASUS database (SISCAN/Cancer Information System) spanning the period from 2017 to 2021. Male and female patients diagnosed with breast cancer (ICD C50) during this period were included. Statistical analysis involved absolute values, percentages, and a 95% confidence interval (p &amp;lt; 0.05). Results: Analysis of the study period revealed 4,326 cases (1.8%) of male breast cancer and 236,597 cases (98.2%) of female breast cancer in Brazil. The southeast region had the highest concentration of cases for both sexes, while the northeast region showed a higher prevalence in males (p &amp;lt; 0.0004). Noteworthy findings include a higher mean age among males (59.5 years) compared to females (55.7 years) and a higher prevalence of advanced stages at diagnosis in males (72.8% vs. 59.3%). Diagnostic approaches, subtype distribution, and treatment modalities also differed between the genders. Conclusions: Male breast cancer presents with more advanced stages at diagnosis compared to females, necessitating more aggressive surgical interventions. However, males benefit from earlier initiation of treatment. These findings contribute to a better understanding of male breast cancer, enabling the development of tailored management strategies for this unique patient population. Comparison between male and female MC XX XX Source: Panel-Oncology Brazil (accessed 15/04/2023) Citation Format: Marcelo Antonini, Gabriel Pannain, Steffi Buttenbender, Andre Mattar, Reginaldo Coelho Lopes, Odair Ferraro. Exploring Gender-Specific Patterns of Breast Cancer in Brazil: A Comparative Epidemiological Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-09-12.

Abstract PO3-17-01: Brazilian Real-world data of HR+ HER2- early-stage Breast Cancer (BC) patients are poor when compared to control arms of recent adjuvant clinical trials

Abstract INTRODUCTION: In Brazil, BC is the most common neoplasm among women, with 73k new cases annually. Adjuvant hormone therapy (HT) options are evolving with personalized strategies based on risk stratification. Real-world data (RWD) plays a crucial role in understanding the outcomes in BC patients (pts) in low- and middle-income countries, where significant health disparities, access gaps, and barriers to the implementation of guidelines exist. This study aims to assess the epidemiologic profile, practice patterns, and real-world outcomes of pts with ER+ HER2- stage I-III BC treated in the largest network of private oncology services in Brazil and compare results with control arms of recent clinical trials evaluating CDK4/6 inhibitors in adjuvant setting. METHODS: Retrospective RWD study from Oncoclínicas Group with longitudinal EHR data from 2017 to 2022 merged in a platform where structured variables (demographics, tumor staging, pharmacy records) are integrated with unstructured data from physician notes and digitized pathology-molecular reports using technology-based abstraction performed by expert human curators that follow mCODE standards and predefined ontology. Treatment patterns and invasive disease-free survival (IDFS) outcomes were collected. Regarding risk stratification, pts were classified as high-risk (HR) if: (i) 4+ axillary lymph nodes (LN), or (ii) 1-3 LN and grade 3 and/or Ki620% and/or high-risk ODX/Mammaprint; intermediate-risk (IR) if: (iii) 1-3 LN with grade 1-2 and/or Ki67 &amp;lt; 20% and/or non-high-risk ODX/Mammaprint, or (iv) N0 with grade 2-3 and/or Ki67 &amp;gt;20% and/or high-risk ODX/Mammaprint; and low-risk (LR) if: (v) all other stages I and IIA not having the risk factors above. RESULTS: From over 30k BC pts in Oncoclínicas Database, 19k had HR+/HER2- early BC, 12k were treated in high-volume clinics, and 1,786 cases were selected for the study (diagnosis and first treatment in the last 6 years, complete histopathology and pharmacy registries). The median age was 57 years (27-96), 566 (32%) pts were premenopausal, 1052 (59%) had stage I disease, 372 (21%) stage IIA, 165 (9%) stage IIB and 197 (11%) stage III BC. Regarding risk stratification, 1,179 (66%) were LR, 351 (20%) IR, and 256 (14%) HR. In post-menopausal pts, aromatase inhibitor (AI) was used by 74% of pts with LR, 79% with IR and 83% with HR. In premenopausal pts, ovarian function suppression (OFS) – combined with tamoxifen or AI – was prescribed to 18% of LR pts, 15% of IR pts, and 48% of HR pts. Chemotherapy (CT) was offered to 32%, 38%, and 73% of postmenopausal pts in LR, IR, and HR groups. In premenopausal pts, 55%, 57%, and 78% received CT in LR, IR, and HR groups. The 3-year iDFS in the general population was 85%, reaching 80% in premenopausal and 86% in postmenopausal pts. The overall 3y iDFS was 87% in the LR, 86% in IR, and 72% in HR. Among premenopausal pts, the 3y iDFS was 81% in LR, 92% in IR, and 64% in the HR group. While the risk distribution of our cohort is similar to recent clinical trials, the 3y iDFS outcomes were numerically lower to those observed in the control groups of the pivotal trials evaluating adjuvant CDK4/6 inhibitors. In the HR group, the 3y iDFS was 72% (versus 84% 3y iDFS in the control arm of the MonarchE trial). Combining the IR/HR groups, the 3y iDFS was 80% (versus 87% in the control arm of NATALEE trial). CONCLUSION: In this large RWD cohort treated in a private setting in Brazil, most pts are diagnosed with stage I and LR BC. In this cohort, a significant proportion of premenopausal pts with IR/HR are not treated with OFS and do not receive CT. Real-world survival outcomes of Brazilian women with HR+ HER2- early BC treated in private clinic are inferior to those observed in recent clinical trials, especially in the premenopausal pts. In public healthcare system, where prevalence of HR disease is higher and access to essential treatments more limited, outcomes might even be worsened compared to the ones presented here. Citation Format: Aline Goncalves, Tomas Reinert, Max S. Mano, Heloisa Cruz, Cristiano Resende, Gustavo Bretas, Carlos Barrios, Matheus Costa e Silva, Rafael Paes, Guilherme Silva, Erika Martins, Fernanda Koyama, Bruno Ferrari, Carlos Gil Ferreira, Pedro Aguiar Junior, Rodrigo Dienstmann. Brazilian Real-world data of HR+ HER2- early-stage Breast Cancer (BC) patients are poor when compared to control arms of recent adjuvant clinical trials [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-17-01.

Fourteen-year trends in overweight, general obesity, and abdominal obesity in Amazonian indigenous peoples.

Available data show that the epidemiological profile of most indigenous Brazilian populations is characterized by the coexistence of long-standing health problems (high prevalence of infectious and parasitic diseases, malnutrition, and deficiency diseases, such as anemia in children and women of reproductive age), associated with new health problems, especially those related to obesity (hypertension, type 2 diabetes mellitus and dyslipidemia). Based on this scenario, this study analyzed the nutritional profile of the adult population of seven indigenous peoples from the Brazilian Amazon in the years 2007 and 2021. A total of 598 adults individuals were analyzed in 2007 (319 women and 279 men) and 924 in 2021 (483 women and 441 men), from seven indigenous peoples located in the state of Pará, who were assisted during health actions carried out in 2007 and in 2021. Body mass index classification used the World Health Organization criteria for adults: low weight, < 18.5kg/m2; normal weight, ≥ 18.5 and < 25kg/m2); overweight, ≥ 25 and < 30kg/m2, and obesity, ≥ 30kg/m2. A waist circumference (WC) < 90cm in men and < 80cm in women was considered normal. The data revealed heterogeneous anthropometric profiles, with a low prevalence of nutritional changes in the Araweté, Arara and Parakanã peoples, and high proportions of excess weight and abdominal obesity in the Kararaô, Xikrin do Bacajá, Asurini do Xingu and Gavião peoples, similar to or even higher than the national averages. Different stages of nutritional transition were identified in the indigenous peoples analyzed, despite apparently having been subjected to the same environmental pressures that shaped their nutritional profile in recent decades, which may indicate different genetic susceptibilities to nutritional changes. The evidence shown in this study strongly suggests the need to investigate in greater depth the genetic and environmental factors associated with the nutritional profile of Brazilian indigenous peoples, with assessment of diet, physical activity and sociodemographic and socioeconomic variables that enable the development of appropriate prevention and monitoring measures.

Epidemiological profile of community antibiotic resistance in community laboratories

Epidemiological profile of community antibiotic resistance in community laboratories

Epidemiological and molecular study of Providencia rettgeri outbreak at a university hospital during the COVID-19 reference center.

In 2014, Brazil detected New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales from a Providencia rettgeri isolate obtained through surveillance swabs in the Southern region. Subsequently, various species have reported several NDM enzymes. However, comprehensive data on the current epidemiology of NDM-producing P. rettgeri in Brazil remains limited. This study, aimed to provide a detailed characterization of the phenotypic, genotypic, and epidemiological profile of clinical isolates of P. rettgeri NDM. From April 2020 to December 2022, 18 carbapenem-resistant P. rettgeri strains, previously identified using Vitek2®, were isolated at the University Hospital of Londrina. Resistance and virulence genes were assessed through genetic analysis using ERIC PCR and NextSeq (Illumina) sequencing. Statistical analysis was conducted using SPSS version 2.0. Genomic analysis confirmed the presence of β-lactamase blaNDM-1 and blaOXA-1. All isolates showed the presence of the NDM encoding gene and genetic similarity above 90% between isolates. Clinical parameters of patients infected with P. rettgeri exhibited significant association with mechanical ventilation, prior use of carbapenems, and polymyxins. We also report a significant association between P. rettgeri infection and death outcome. This study characterizes NDM-1 metallo-β-lactmases isolates, among P. rettgeri isolates from patients at the University Hospital (HU), during the COVID-19 pandemic. The emergence of this novel resistance mechanism among P. rettgeri poses a significant challenge, limiting the therapeutic options for infections in our hospital.

Epidemiological Profile of Meningitis Reports in Brazilian Regions between 2007 and 2015

Abstract Meningitis is an inflammation that affects meninges of the nervous system and can cause severe sequelae, which makes it important to understand the epidemiological profile of the disease to aid in control policies. The objective of this study was to describe the epidemiological profile of meningitis in different Brazilian regions from 2007 to 2015. We did a descriptive observational study of all 184,868 reports of meningitis cases made by SUS in DATASUS between 2007 and 2015 in Brazil. It was observed that most case occurred in male and white persons. In general, the etiology was viral and bacterial. About 50% of the cases occurred in children up to 9 years old, but with higher lethality in the elderly. There was a nearly 40% drop in the number of notifications from 2007 to 2014, but with more lethality. We conclude that the decrease in cases is due to the success of control policies, but we need to keep our attention to the notifications due to the increase in lethality. Keyword: Meningitis, Public health, Neglected disease.

Clinical Profile of Acute Poisoning Cases at a Tertiary Care Hospital in Kashmir, India: A Descriptive Cross Sectional Study

Acute poisoning from a variety of substances is common in every part of the world. The sooner the initial resuscitation, decontamination, and use of specific antidotes, the better the outcome. The main objective of this study was to describe the clinical profile and outcome of poisoning cases admitted to SKIMS Medical college, a tertiary care hospital located in central part of Jammu and Kashmir India. Descriptive cross sectional evaluations were conducted on all cases that were admitted to the hospital’s emergency room over a period of one year from March 2022 to February 2023. The following parameters were examined using data taken from hospital medical records: socioeconomic factors, substances consumed, routes of intake, clinical symptomatology and severity of poisoning.300 patients were included in the study with different poisonings of which 35% were males and 65% were females. The most common form of poisoning was due to pesticides followed by rodenticides and opioid intoxication respectively. Majority of the patients had suicidal intent followed by accidental ingestion reported mainly in children. Few patient required intensive care admissions rest all were managed in general ward depicting mild severity of poisoning in majority of the patients. Three patients were brought dead to hospital secondary to opoid overdose and one patient died in hospital who had pesticide ingestion complicated by ventilator associated pneumonia. The less mortality in this study was likely due to mild severity of poisoning, early gut lavage and easy access to hospital. The effects of poisoning on the human body are negative regardless of the agents or method used and this has an impact on the treatment and outcome. Due consideration must be given to clinical, toxicological and epidemiological profiles. Therefore precise and prompt diagnosis, adequate treatment and effective preventative efforts are required. This study highlighted the importance of awareness and for the establishment of poison information centre for the better management and prevention of all poisoning cases.

Post-traumatic Fat Embolism in Intensive Care

Fat embolism syndrome (FES) is a group of clinical, biological and radiological symptoms resulting from obstruction of the microcirculatory network by microdroplets of insoluble fat. It is a complication most often observed in the aftermath of a polytrauma involving several long bone fractures, but it can also occur outside the traumatic context. The aim of this study was to examine the epidemiological, pathogenic, clinical, paraclinical, therapeutic and evolutionary aspects of fat embolism syndrome. This was a retrospective study including all cases of post-traumatic fat embolism collected in the surgical intensive care unit of the Chu Ibn Rochd in Casablanca over a period of 5 years. 24 cases of post-traumatic fat embolism were collected. Male sex, age less than 40 years and the presence of a femur fracture were the dominant characteristics of the epidemiological profile of the trauma patient presenting with this syndrome occurring mainly within 72 hours of the trauma. The clinico-biological presentation was dominated by respiratory distress, consciousness disorders, anaemia, thrombocytopenia and hypocholesterolaemia. The management of FES was symptomatic, combining early immobilisation of fracture sites, optimal analgesia and maintenance of an effective blood volume. 41.66% of patients required mechanical ventilation and 75% underwent osteosynthesis of their fracture sites. 25% developed ARDS and the mortality rate was 26.08%.

American Trypanomiasis and Chagas Disease Sexual Transmission to Naïve Mates: Prevention And Control

Chagas disease is the most lethal endemic condition in the Western Hemisphere. Its high morbidity and mortality make the disease a major public health problem in Latin America. At the public hospitals' autopsy rooms, Chagas cardiomyopathy is a leading cause of people’s death, usually at 45 ± 10 years of age. Over the last decades, the disease epidemiologic profiles changed drastically with migration to the five Continents. The immigration of people from Latin America to the Northern Hemisphere bears health concerns, notably, the sexual transmission of Trypanosoma cruzi agent of Chagas disease from males and females to naïve mates, and its vertical transference to progeny. The family-based Chagas disease introduces substantial changes in concepts of disease prevention and control. The treatment of Chagas disease with nitro derivatives is unsatisfactory. In the absence of a drug to eradicate the T. cruzi infection, its control requires a robust program of education, information, and communication for health. Its prevention can be achieved through social activists participating in public and private organizations at schools, social clubs, churches, and people’s organizations for health and education.