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Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

World Journal of Gastroenterology 2020年第44期26卷 6993-7004页

作者： Flora Maria Lorenzo Fortes Ney Boa Sorte Victor D Mariano Laila D Andrade Fernanda A Oliveira Monique CA Santos Claudia Ivanilda N dos Santos catharina a passos Mila P Pacheco Valdiana C Surlo Neogelia P de Almeida Jaciane AM Fontes Andrea M Pimentel Raquel Rocha Genoile Oliveira Santana Pharmaceutical Sciences Pos-graduation Program State University of BahiaSalvadorBA 40460-120Brazil Outpatient Gastroenterology Unit General Hospital Roberto SantosSalvadorBA 40286-901Brazil Life Sciences Department State University of BahiaSalvadorBA 41150-000Brazil Department of Medicine FTC UniversitySalvadorBA 41741-590Brazil Department of Sciences of Nutrition School of NutritionFederal University of BahiaSalvadorBA 41701-035Brazil

BACKGROUND There has been an increase in cases of inflammatory bowel disease(IBD)in recent years.There is also greater access and availability of immunosuppressive and biological agents,which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing.Tuberculosis(TB)remains a public health problem,and it has a high incidence in several countries.Therefore,knowledge of the risk of developing TB in patients with IBD is important.AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America.METHODS A standard questionnaire included demographic variables,clinical aspects of IBD disease,history of active TB during treatment,active TB characteristics and evolution,initial screening and results and time from the start of anti-tumor necrosis factor alpha(TNFα)to TB development.RESULTS Azathioprine,anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence.The TNFα blockers increased the relative risk of developing active TB compared to other treatments.All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB.After adjustment for sex,age,type of IBD and latent TB,anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment.Late TB,which was diagnosed 3 mo after the start of anti-TNFα,was the most frequent.CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America.This risk was increased when anti-TNFα was combined with azathioprine.The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

关键词： Inflammatory bowel disease Therapy Tumor necrosis factor alpha Relative risk Tuberculosis Latent tuberculosis

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Epidemiological Profile of Breast Neoplasia in the Municipality of Valença (RJ Brazil): Study from 2009 to 2017

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Journal of Biosciences and Medicines 2020年第6期8卷 179-187页

作者： catharina Ferrari Salgado Fernandes Helena Torres passos Izabela Cristina Ferreira Marina Coelho de Paulo Raquel Alencar Sampaio Ferraz Filomena Aste Silveira João Alfredo Seixas Daniel Almeida da Costa Faculty of Medicine of Valenç a UNIFAA Valen&ccedil a Brazil

Breast neoplasms are the main oncological pathology in Gynecology and Obstetrics, with increasing rates of incidence and mortality in the female population. According to the World Health Organization (WHO), more than 1 million new cases of breast cancer are diagnosed worldwide every year. This study aims to understand and analyze the epidemiological profile of patients diagnosed with breast cancer in the last nine years in the city of Valença—RJ, Brazil. A descriptive, documentary-retrospective analysis was carried out from January 2009 to December 2017, on 96 records of women who underwent breast biopsy at the Escola Escola de Valença (HEV), referred by the HEV Gynecology outpatient clinic. The results compared the variables age, race, parity, alcoholism, smoking, comorbidities, histological type, family history and screening performed with the scenario of breast cancer in the world, concluding that it is essential to identify patients at risk development of breast cancer to guide prevention, screening and early detection of pathology. The cases in the municipality are similar to other studies in relation to smoking, alcohol consumption, associated comorbidities, histological type and family history. However, the prevalence in younger people stands out, as well as the high percentage of women who have not had previous screening, which highlights the importance of the development and spread of women’s health in this city in the south of the state.

关键词： Breast Neoplasia Epidemiological Profile Comorbidity

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