Last data update: May 13, 2024. (Total: 46773 publications since 2009)
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Query Trace: Coelho L[original query] |
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Software testing in microbial bioinformatics: a call to action.
van der Putten BCL , Mendes CI , Talbot BM , de Korne-Elenbaas J , Mamede R , Vila-Cerqueira P , Coelho LP , Gulvik CA , Katz LS , The Asm Ngs Hackathon Participants . Microb Genom 2022 8 (3) Computational algorithms have become an essential component of research, with great efforts by the scientific community to raise standards on development and distribution of code. Despite these efforts, sustainability and reproducibility are major issues since continued validation through software testing is still not a widely adopted practice. Here, we report seven recommendations that help researchers implement software testing in microbial bioinformatics. We have developed these recommendations based on our experience from a collaborative hackathon organised prior to the American Society for Microbiology Next Generation Sequencing (ASM NGS) 2020 conference. We also present a repository hosting examples and guidelines for testing, available from https://github.com/microbinfie-hackathon2020/CSIS. |
Cabotegravir for HIV prevention in cisgender men and transgender women
Landovitz RJ , Donnell D , Clement ME , Hanscom B , Cottle L , Coelho L , Cabello R , Chariyalertsak S , Dunne EF , Frank I , Gallardo-Cartagena JA , Gaur AH , Gonzales P , Tran HV , Hinojosa JC , Kallas EG , Kelley CF , Losso MH , Madruga JV , Middelkoop K , Phanuphak N , Santos B , Sued O , Valencia Huamaní J , Overton ET , Swaminathan S , Del Rio C , Gulick RM , Richardson P , Sullivan P , Piwowar-Manning E , Marzinke M , Hendrix C , Li M , Wang Z , Marrazzo J , Daar E , Asmelash A , Brown TT , Anderson P , Eshleman SH , Bryan M , Blanchette C , Lucas J , Psaros C , Safren S , Sugarman J , Scott H , Eron JJ , Fields SD , Sista ND , Gomez-Feliciano K , Jennings A , Kofron RM , Holtz TH , Shin K , Rooney JF , Smith KY , Spreen W , Margolis D , Rinehart A , Adeyeye A , Cohen MS , McCauley M , Grinsztejn B . N Engl J Med 2021 385 (7) 595-608 BACKGROUND: Safe and effective long-acting injectable agents for preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection are needed to increase the options for preventing HIV infection. METHODS: We conducted a randomized, double-blind, double-dummy, noninferiority trial to compare long-acting injectable cabotegravir (CAB-LA, an integrase strand-transfer inhibitor [INSTI]) at a dose of 600 mg, given intramuscularly every 8 weeks, with daily oral tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) for the prevention of HIV infection in at-risk cisgender men who have sex with men (MSM) and in at-risk transgender women who have sex with men. Participants were randomly assigned (1:1) to receive one of the two regimens and were followed for 153 weeks. HIV testing and safety evaluations were performed. The primary end point was incident HIV infection. RESULTS: The intention-to-treat population included 4566 participants who underwent randomization; 570 (12.5%) identified as transgender women, and the median age was 26 years (interquartile range, 22 to 32). The trial was stopped early for efficacy on review of the results of the first preplanned interim end-point analysis. Among 1698 participants from the United States, 845 (49.8%) identified as Black. Incident HIV infection occurred in 52 participants: 13 in the cabotegravir group (incidence, 0.41 per 100 person-years) and 39 in the TDF-FTC group (incidence, 1.22 per 100 person-years) (hazard ratio, 0.34; 95% confidence interval, 0.18 to 0.62). The effect was consistent across prespecified subgroups. Injection-site reactions were reported in 81.4% of the participants in the cabotegravir group and in 31.3% of those in the TDF-FTC group. In the participants in whom HIV infection was diagnosed after exposure to CAB-LA, INSTI resistance and delays in the detection of HIV infection were noted. No safety concerns were identified. CONCLUSIONS: CAB-LA was superior to daily oral TDF-FTC in preventing HIV infection among MSM and transgender women. Strategies are needed to prevent INSTI resistance in cases of CAB-LA PrEP failure. (Funded by the National Institute of Allergy and Infectious Diseases and others; HPTN 083 ClinicalTrials.gov number, NCT02720094.). |
Identifying urban hotspots of dengue, chikungunya, and Zika transmission in Mexico to support risk stratification efforts: a spatial analysis
Dzul-Manzanilla F , Correa-Morales F , Che-Mendoza A , Palacio-Vargas J , Sánchez-Tejeda G , González-Roldan JF , López-Gatell H , Flores-Suárez AE , Gómez-Dantes H , Coelho GE , da Silva Bezerra HS , Pavia-Ruz N , Lenhart A , Manrique-Saide P , Vazquez-Prokopec GM . Lancet Planet Health 2021 5 (5) e277-e285 BACKGROUND: Effective Aedes aegypti control is limited, in part, by the difficulty in achieving sufficient intervention coverage. To maximise the effect of vector control, areas with persistently high numbers of Aedes-borne disease cases could be identified and prioritised for preventive interventions. We aimed to identify persistent Aedes-borne disease hotspots in cities across southern Mexico. METHODS: In this spatial analysis, geocoded cases of dengue, chikungunya, and Zika from nine endemic Mexican cities were aggregated at the census-tract level. We included cities that were located in southern Mexico (the arbovirus endemic region of Mexico), with a high burden of dengue cases (ie, more than 5000 cases reported during a 10-year period), and listed as high priority for the Mexican dengue control and prevention programme. The Getis-Ord Gi*(d) statistic was applied to yearly slices of the dataset to identify spatial hotspots of each disease in each city. We used Kendall's W coefficient to quantify the agreement in the distribution of each virus. FINDINGS: 128 507 dengue, 4752 chikungunya and 25 755 Zika clinical cases were reported between Jan 1, 2008, and Dec 31, 2016. All cities showed evidence of transmission heterogeneity, with a mean of 17·6% (SD 4·7) of their total area identified as persistent disease hotspots. Hotspots accounted for 25·6% (SD 9·7; range 12·8-43·0) of the population and 32·1% (10·5; 19·6-50·5) of all Aedes-borne disease cases reported. We found an overlap between hotspots of 61·7% for dengue and Zika and 53·3% for dengue and chikungunya. Dengue hotspots in 2008-16 were significantly associated with dengue hotspots detected during 2017-20 in five of the nine cities. Heads of vector control confirmed hotspot areas as problem zones for arbovirus transmission. INTERPRETATION: This study provides evidence of the overlap of Aedes-borne diseases within geographical hotspots and a methodological framework for the stratification of arbovirus transmission risk within urban areas, which can guide the implementation of surveillance and vector control. FUNDING: USAID, the US Centers for Disease Control and Prevention, the Canadian Institutes of Health Research, International Development Research Centre, Fondo Mixto CONACyT (Mexico)-Gobierno del Estado de Yucatan, and the US National Institutes of Health. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section. |
Phase II trial evaluating the clinical efficacy of cefixime for treatment of active syphilis in non-pregnant women in Brazil (CeBra)
Taylor MM , Kara EO , Araujo MAL , Silveira MF , Miranda AE , Branco Coelho IC , Bazzo ML , Mendes Pereira GF , Pereira Giozza S , Bermudez XPD , Mello MB , Habib N , Nguyen MH , Thwin SS , Broutet N . BMC Infect Dis 2020 20 (1) 405 BACKGROUND: Syphilis is a sexually and vertically transmitted infection caused by the bacteria Treponema pallidum for which there are few proven alternatives to penicillin for treatment. For pregnant women infected with syphilis, penicillin is the only WHO-recommended treatment that will treat the mother and cross the placenta to treat the unborn infant and prevent congenital syphilis. Recent shortages, national level stockouts as well as other barriers to penicillin use call for the urgent identification of alternative therapies to treat pregnant women infected with syphilis. METHODS: This prospective, randomized, non-comparative trial will enroll non-pregnant women aged 18 years and older with active syphilis, defined as a positive rapid treponemal and a positive non-treponemal RPR test with titer >/=1:16. Women will be a, domized in a 2:1 ratio to receive the oral third generation cephalosporin cefixime at a dose of 400 mg two times per day for 10 days (n = 140) or benzathine penicillin G 2.4 million units intramuscularly based on the stage of syphilis infection (n = 70). RPR titers will be collected at enrolment, and at three, six, and nine months following treatment. Participants experiencing a 4-fold (2 titer) decline by 6 months will be considered as having an adequate or curative treatment response. DISCUSSION: Demonstration of efficacy of cefixime in the treatment of active syphilis in this Phase 2 trial among non-pregnant women will inform a proposed randomized controlled trial to evaluate cefixime as an alternative treatment for pregnant women with active syphilis to evaluate prevention of congenital syphilis. TRIAL REGISTRATION: Trial identifier: www.Clinicaltrials.gov, NCT03752112. Registration Date: November 22, 2018. |
Flavopereirine - an alkaloid derived from Geissospermum vellosii - presents leishmanicidal activity in vitro
da Silva ESilva JV , Cordovil Brigido HP , Oliveira de Albuquerque KC , Miranda Carvalho J , Ferreira Reis J , Vinhal Faria L , Coelho-Ferreira M , Silveira FT , da Silva Carneiro A , Percario S , do Rosario Marinho AM , Dolabela MF . Molecules 2019 24 (4) Chemotherapy is limited in the treatment of leishmaniasis due to the toxic effects of drugs, low efficacy of alternative treatments, and resistance of the parasite. This work assesses the in vitro activity of flavopereirine on promastigote cultures of Leishmania amazonensis. In addition, an in silico evaluation of the physicochemical characteristics of this alkaloid is performed. The extract and fractions were characterized by thin-layer chromatography and HPLC-DAD, yielding an alkaloid identified by NMR. The antileishmanial activity and cytotoxicity were assayed by cell viability test (MTT). The theoretical molecular properties were calculated on the Molinspiration website. The fractionation made it possible to isolate a beta-carboline alkaloid (flavopereirine) in the alkaloid fraction. Moreover, it led to obtaining a fraction with greater antileishmanial activity, since flavopereirine is very active. Regarding the exposure time, a greater inhibitory effect of flavopereirine was observed at 24 h and 72 h (IC50 of 0.23 and 0.15 mug/mL, respectively). The extract, fractions, and flavopereirine presented low toxicity, with high selectivity for the alkaloid. Furthermore, flavopereirine showed no violation of Lipinski's rule of five, showing even better results than the known inhibitor of oligopeptidase B, antipain, with three violations. Flavopereirine also interacted with residue Tyr-499 of oligopeptidase B during the molecular dynamics simulations, giving a few insights of a possible favorable mechanism of interaction and a possible inhibitory pathway. Flavopereirine proved to be a promising molecule for its antileishmanial activity. |
Association and birth prevalence of microcephaly attributable to Zika virus infection among infants in Paraiba, Brazil, in 2015-16: a case-control study
Krow-Lucal ER , de Andrade MR , Cananea JNA , Moore CA , Leite PL , Biggerstaff BJ , Cabral CM , Itoh M , Percio J , Wada MY , Powers AM , Barbosa A , Abath RB , Staples JE , Coelho GE . Lancet Child Adolesc Health 2018 2 (3) 205-213 Background: In 2015, the number of infants born with microcephaly increased in Paraiba, Brazil, after a suspected Zika virus outbreak. We did a retrospective case-control investigation to assess the association of microcephaly and Zika virus. Methods: We enrolled cases reported to the national database for microcephaly and born between Aug 1, 2015, and Feb 1, 2016, on the basis of their birth head circumference and total body length. We identified controls from the national birth registry and matched them to cases by location, aiming to enrol a minimum of two controls per case. Mothers of both cases and controls were asked about demographics, exposures, and illnesses and infants were measured at a follow-up visit 1-7 months after birth. We took blood samples from mothers and infants and classified those containing Zika virus IgM and neutralising antibodies as evidence of recent infection. We calculated prevalence of microcephaly and odds ratios (ORs) using a conditional logistic regression model with maximum penalised conditional likelihood, and combined these ORs with exposure probability estimates to determine the attributable risk. Findings: We enrolled 164 of 706 infants with complete information reported with microcephaly at birth, of whom we classified 91 (55%) as having microcephaly on the basis of their birth measurements, 36 (22%) as small, 21 (13%) as disproportionate, and 16 (10%) as not having microcephaly. 43 (26%) of the 164 infants had microcephaly at follow-up for an estimated prevalence of 5.9 per 1000 livebirths. We enrolled 114 control infants matched to the 43 infants classified as having microcephaly at follow-up. Infants with microcephaly at follow-up were more likely than control infants to be younger (OR 0.5, 95% CI 0.4-0.7), have recent Zika virus infection (21.9, 7.0-109.3), or a mother with Zika-like symptoms in the first trimester (6.2, 2.8-15.4). Once Zika virus infection and infant age were controlled for, we found no significant association between microcephaly and maternal demographics, medications, toxins, or other infections. Based on the presence of Zika virus antibodies in infants, we concluded that 35-87% of microcephaly occurring during the time of our investigation in northeast Brazil was attributable to Zika virus. We estimate 2-5 infants per 1000 livebirths in Paraiba had microcephaly attributable to Zika virus. Interpretation: Time of exposure to Zika virus and evidence of infection in the infants were the only risk factors associated with microcephaly. This investigation has improved understanding of the outbreak of microcephaly in northeast Brazil and highlights the need to obtain multiple measurements after birth to establish if an infant has microcephaly and the need for further research to optimise testing criteria for congenital Zika virus infection. Funding: Centers for Disease Control and Prevention. |
Phylogeny and antimicrobial resistance in Neisseria gonorrhoeae isolates from Rio de Janeiro, Brazil.
Costa-Lourenco APR , Abrams AJ , Dos Santos KTB , Argentino ICV , Coelho-Souza T , Canine MCA , Ferreira ALP , Moreira BM , Fracalanzza SEL , Trees DL , Bonelli RR . Infect Genet Evol 2017 58 157-163 Resistance in Neisseria gonorrhoeae is a global public health challenge. However, little is known about N. gonorrhoeae isolates from Brazil. In this study, we characterized 116 N. gonorrhoeae isolates obtained in Rio de Janeiro between 2006 and 2015 according to antimicrobial susceptibility profiles, resistance mechanisms, and clonal diversity. We determined antimicrobial minimal inhibitory concentrations by agar dilution, and whole genome sequencing was conducted to investigate alleles related to resistance, determine multilocus sequence typing profiles, and group isolates based on core genome single nucleotide polymorphisms. Resistance to penicillin, tetracycline, ciprofloxacin, and azithromycin was observed since 2006. Resistance to penicillin was mediated by beta-lactamase plasmids and chromosomal mutations in ponA and porB genes, and tetracycline resistance was mediated by TetM plasmids, and porB and rspJ mutations. Ciprofloxacin resistant isolates presented cumulative point mutations in the quinolone resistance-determining region (QRDR) of gyrA and parC. Alterations in rrl genes encoding 23S rRNA, mtrR, and the mtrR promoter region were responsible for resistance to azithromycin. Phylogenetic analysis identified seven main clades, which included isolates with similar resistance profiles that mainly belonged to a limited number of sequence types that occurred during different years. Our results demonstrated high penicillin, tetracycline, and ciprofloxacin resistance rates associated with the persistence of successful resistant gonococcal lineages, and the polyclonal emergence of azithromycin resistance. Moreover, we reinforce the importance of surveillance to monitor the evolution of this scenario and to allow the early detection of possible changes to azithromycin and ceftriaxone as effective treatment options in the city. |
Increased rates of Guillain-Barre syndrome associated with Zika virus outbreak in the Salvador metropolitan area, Brazil
Styczynski AR , Malta JMAS , Krow-Lucal ER , Percio J , Nobrega ME , Vargas A , Lanzieri TM , Leite PL , Staples JE , Fischer MX , Powers AM , Chang GJ , Burns PL , Borland EM , Ledermann JP , Mossel EC , Schonberger LB , Belay EB , Salinas JL , Badaro RD , Sejvar JJ , Coelho GE . PLoS Negl Trop Dis 2017 11 (8) e0005869 In mid-2015, Salvador, Brazil, reported an outbreak of Guillain-Barre syndrome (GBS), coinciding with the introduction and spread of Zika virus (ZIKV). We found that GBS incidence during April-July 2015 among those ≥12 years of age was 5.6 cases/100,000 population/year and increased markedly with increasing age to 14.7 among those ≥60 years of age. We conducted interviews with 41 case-patients and 85 neighborhood controls and found no differences in demographics or exposures prior to GBS-symptom onset. A higher proportion of case-patients (83%) compared to controls (21%) reported an antecedent illness (OR 18.1, CI 6.9-47.5), most commonly characterized by rash, headache, fever, and myalgias, within a median of 8 days prior to GBS onset. Our investigation confirmed an outbreak of GBS, particularly in older adults, that was strongly associated with Zika-like illness and geo-temporally associated with ZIKV transmission, suggesting that ZIKV may result in severe neurologic complications. |
Reduced susceptibility to cefixime but not ceftriaxone: an uncertain perspective for the treatment of gonorrhoea in Brazil
da Costa Lourenco AP , Abrams AJ , Bastos Dos Santos KT , Coelho Souza T , Moreira BM , Fracalanzza SE , Trees D , Bonelli RR . Int J Antimicrob Agents 2017 49 (4) 515-516 Resistance to extended-spectrum cephalosporins (ESC) in Neisseria gonorrhoeae has been described in different countries and is an important cause for concern regarding the successful treatment of gonorrhoea [1]. Modifications of the penicillin-binding protein 2 (penA) gene are the main ESC resistance determinants in gonococcus [2]. Specific mosaic penA alleles are associated with cefixime minimum inhibitory concentrations (MICs) equivalent to the Clinical and Laboratory Standards Institute (CLSI) susceptibility breakpoint for cefixime (MIC ≤ 0.25 mg/L), which characterises reduced susceptibility to cefixime (CefRS) [3]. Thus, despite no longer being recommended as a first-line treatment for gonococcal infections (http://www.cdc.gov/std/tg2015/gonorrhea.htm), cefixime is considered a sentinel drug associated with the evolution of ESC resistance in N. gonorrhoeae [3]. Additional mutations in mosaic alleles, including A501P in penA XXXIV, and A311V, T316P and T483S in penA X, lead to high-level ESC resistance [2,4]. | Brazil currently recommends ciprofloxacin combined with azithromycin for gonorrhoea therapy in the vast majority of its territory, excluding some states where ciprofloxacin should be replaced with ceftriaxone owing to high documented resistance rates. This recommendation includes Rio de Janeiro and is based on small studies because Brazil lacks a surveillance programme for gonococcal resistance [5]. |
Health care-associated infection outbreak investigations in outpatient settings, Los Angeles County, California, USA, 2000-2012
OYong K , Coelho L , Bancroft E , Terashita D . Emerg Infect Dis 2015 21 (8) 1317-21 Health care services are increasingly delivered in outpatient settings. However, infection control oversight in outpatient settings to ensure patient safety has not improved and literature quantifying reported health care-associated infection outbreaks in outpatient settings is scarce. The objective of this analysis was to characterize investigations of suspected and confirmed outbreaks in outpatient settings in Los Angeles County, California, USA, reported during 2000-2012, by using internal logs; publications; records; and correspondence of outbreak investigations by characteristics of the setting, number, and type of infection control breaches found during investigations, outcomes of cases, and public health responses. Twenty-eight investigations met the inclusion criteria. Investigations occurred frequently, in diverse settings, and required substantial public health resources. Most outpatient settings investigated had >1 infection control breach. Lapses in infection control were suspected to be the outbreak source for 16 of the reviewed investigations. |
Is organic farming safer to farmers' health? A comparison between organic and traditional farming
Costa C , Garcia-Leston J , Costa S , Coelho P , Silva S , Pingarilho M , Valdiglesias V , Mattei F , Dall'armi V , Bonassi S , Laffon B , Snawder J , Teixeira JP . Toxicol Lett 2014 230 (2) 166-76 Exposure to pesticides is a major public health concern, because of the widespread distribution of these compounds and their possible long term effects. Recently, organic farming has been introduced as a consumer and environmental friendly agricultural system, although little is known about the effects on workers' health. The aim of this work was to evaluate genetic damage and immunological alterations in workers of both traditional and organic farming. Eighty-five farmers exposed to several pesticides, thirty-six organic farmers and sixty-one controls took part in the study. Biomarkers of exposure (pyrethroids, organophosphates, carbamates, and thioethers in urine and butyrylcholinesterase activity in plasma), early effect (micronuclei in lymphocytes and reticulocytes, T-cell receptor mutation assay, chromosomal aberrations, comet assay and lymphocytes subpopulations) and susceptibility (genetic polymorphisms related to metabolism - EPHX1, GSTM1, GSTT1 and GSTP1 - and DNA repair-XRCC1 and XRCC2) were evaluated. When compared to controls and organic farmers, pesticide farmers presented a significant increase of micronuclei in lymphocytes (frequency ratio, FR=2.80) and reticulocytes (FR=1.89), chromosomal aberrations (FR=2.19), DNA damage assessed by comet assay (mean ratio, MR=1.71), and a significant decrease in the proportion of B lymphocytes (MR=0.88). Results were not consistent for organic farmers when compared to controls, with a 48% increase of micronuclei in lumphocytes frequency (p=0.016) contrasted by the significant decreases of TCR-Mf (p=0.001) and %T (p=0.001). Our data confirm the increased presence of DNA damage in farmers exposed to pesticides, and show as exposure conditions may influence observed effects. These results must be interpreted with caution due to the small size of the sample and the unbalanced distribution of individuals in the three study groups. |
Prechewing and prewarming food for HIV-exposed children: a prospective cohort experience from Latin America
Gaur AH , Cohen RA , Read JS , Hance LF , Dominguez K , Alarcon JO , Menezes J , Peixoto MF , Mussi-Pinhata MM , Coelho DF , Mitchell C , Siberry GK . AIDS Patient Care STDS 2013 27 (3) 142-5 Gaur et al.1 reported HIV infection in three children in the United States from infected adults feeding them prechewed food. This practice is common among HIV-infected care providers around the world.2–6 Prechewing involves chewing food before feeding it to a child. Prewarming (or precooling) involves holding food in the mouth to adjust the temperature before offering it to a child. These practices may expose the child to blood from the mouth of an HIV-infected adult. The context of these practices and the efficiency of related HIV transmission have not been described. We previously surveyed HIV-infected pregnant women in Latin America about these practices and advised against them.3 We now follow up on this sensitized cohort, characterize the frequency and context of these practices through 18 months postpartum, and assess the risk of HIV transmission. | Women were enrolled at 12 sites (Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative [NISDI] Longitudinal Study in Latin American Countries7 [LILAC]) in Argentina, Brazil, and Peru, and followed for 18 months postpartum. At study visits (antepartum and 6, 12, and 18 months postpartum), enrolled mothers (or alternative providers) were interviewed using a standardized questionnaire about prechewing/prewarming. Information about factors influencing risk of HIV transmission, including symptoms of disrupted oral mucosal integrity in the child or the adult and the HIV/hepatitis B/hepatitis C infection status of the adult, were collected. At the end of each interview, a scripted statement was read to respondents regarding the potential risk of HIV transmission associated with these practices and advising against them. |
Micronucleus frequencies in lymphocytes and reticulocytes in a pesticide-exposed population in Portugal
Costa C , Silva S , Neves J , Coelho P , Costa S , Laffon B , Snawder J , Teixeira JP . J Toxicol Environ Health A 2011 74 960-70 A wide range of chemical products known to be acutely toxic is currently used in the agricultural sector, including numerous pesticides with different compositions. Nevertheless, the effects in human health as result of chronic exposure to low levels are not yet completely understood. The methodology for determination of micronuclei (MN) in lymphocytes (CBMN) is well established, and accumulating data demonstrated a correlation to enhanced risk of cancer development. However, analysis of MN in reticulocytes (MN-RET) in humans is a recent tool on human biomonitoring. The aim of this study was to examine the influence of pesticide exposure on MN-RET and CBMN frequencies. In total, 177 individuals were studied (93 controls and 84 exposed). All individuals included in the exposed group were exposed regularly to various chemicals. Both MN-RET and CBMN were significantly higher in the exposed subjects compared to controls. The CBMN frequencies were quantitatively higher in females than males, especially within the exposed group. Smoking habits exerted no marked influence on the frequency of the biomarkers studied. A significant and positive correlation was found between both indicators. Within the exposed group, data showed that there was a significant correlation between MN-RET and recent exposure (exposure in the previous 10 d) that is not found when considering CBMN. It is conceivable that due to the short life span of reticulocytes, MN-RET were found to be more reliable to characterize recent genetic damage as opposed to CBMN. |
Knowledge and practice of prechewing/prewarming food by HIV-infected women
Gaur AH , Freimanis-Hance L , Dominguez K , Mitchell C , Menezes J , Mussi-Pinhata MM , Peixoto MF , Alarcon J , Coelho DF , Read JS . Pediatrics 2011 127 (5) e1206-11 OBJECTIVE: HIV transmission has been associated with offering a child food prechewed by an HIV-infected caregiver. We assessed awareness of prechewing and oral prewarming of food by an adult before offering it to a child among HIV-infected pregnant women and clinical investigators in 3 Latin American countries. METHODS: HIV-infected pregnant women at 12 sites (Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative Perinatal Longitudinal Study in Latin American Countries, a prospective cohort trial) in Argentina, Brazil, and Peru were administered a screening survey about prechewing/prewarming of infant foods and cautioned against these feeding practices. Survey responses were analyzed, overall, and stratified according to country. RESULTS: Of the 401 HIV-infected pregnant women interviewed, 34% had heard about prechewing (50% from Argentina, 32% from Brazil, and 36% from Peru), 23% knew someone who prechewed food for infants, and 4% had prechewed food in the past. Seventeen percent had heard about oral prewarming of food, 13% knew someone who prewarmed food for infants, and 3% had prewarmed food for an infant in the past. Women who reported knowing someone who prechewed were more likely to also know someone who prewarmed food (P < .0001). Few site investigators anticipated that their patients would be aware of these practices. CONCLUSIONS: Prechewing food, a potential risk factor for HIV transmission, and orally prewarming food, which has not been associated with HIV transmission but might expose a child to blood from an HIV-infected adult, are not uncommon practices in Latin America. Both practices should be further investigated. Site investigator responses underscore that health care providers could be missing information about cultural practices that patients may not report unless specifically asked. |
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