ALUISIO AUGUSTO COTRIM SEGURADO

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Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina - Docente
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina - Líder

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Autor: SEGURADO, Aluisio C. ×

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Agora exibindo 1 - 10 de 22
  • article 2 Citação(ões) na Scopus
  • article 9 Citação(ões) na Scopus
    High-risk human papillomavirus test in anal smears: can it optimize the screening for anal cancer?
    (2021) KIMURA, Cintia M. S.; NAHAS, Caio S. R.; V, Edesio Silva-Filho; RIBEIRO, Vinicius L.; SEGURADO, Aluisio C.; ALCANTARA, Flavio F. P.; CECCONELLO, Ivan; NAHAS, Sergio C.
    Objective: The current method for screening anal cancer is anal cytology, which has low sensitivity. Since high-risk human papillomavirus (HR-HPV) is associated with almost 90% of cases of anal cancer, the objective of this study is to evaluate whether testing for HR-HPV can optimize the screening. Design: Prospective study with patients enrolled in a screening program for anal dysplasia. Considering high-resolution anoscopy (HRA)-guided biopsy as the gold standard for diagnosis of high-grade squamous intraepithelial lesions, the diagnostic performance of anal cytology, HR-HPV testing, and the combination of both was calculated. Settings: A single center for anal dysplasia. Participants: A total of 364 patients (72% males, 82% HIV-positive). Intervention: Patients underwent anal cytology, HR-HPV test, and HRA-guided biopsy of the anal canal. Main outcome measures: Ability of cytology and HR-HPV test (individually and combined) to detect high-grade squamous intraepithelial lesions, and analysis of the cost of each diagnostic algorithm. Results: Cytology alone was the cheapest approach, but had the lowest sensitivity [59%, 95% confidence interval (CI) 46-71%], despite of highest specificity (73%, 95% CI 68-78%). Cotesting had the highest sensitivity (85%, 95% CI 74-93%) and lowest specificity (43%, 95% CI 38-49%), and did not seem to be cost-effective. However, HR-HPV testing can be used to triage patients with normal and atypical squamous cells of undetermined significance cytology for HRA, resulting in an algorithm with high sensitivity (80%, 95% CI 68-89%), and specificity (71%, 95% CI 65-76%), allied to a good cost-effectiveness. Conclusion: HR-HPV testing is helpful to optimize the screening in cases of normal and atypical squamous cells of undetermined significance cytology.
  • article 110 Citação(ões) na Scopus
    Epidemiology of gonorrhoea: a global perspective
    (2019) KIRKCALDY, Robert D.; WESTON, Emily; SEGURADO, Aluisio C.; HUGHES, Gwenda
    Although understanding the local epidemiology of gonorrhoea is critical for local efforts, understanding the multinational epidemiology may support development of national and international prevention and control policies and strategies. In this paper, current epidemiology of gonorrhoea is reviewed through an international lens and with a focus on selected populations. The World Health Organization (WHO) estimates that similar to 87 million new gonococcal infections occurred among people aged 15-49 years in 2016. Gonorrhoea rates are rising in many countries. Gay, bisexual and other men who have sex with men, racial or ethnic minorities, Indigenous populations and sex workers appear to bear disproportionate burdens of gonorrhoea. International travel can facilitate spread of gonorrhoea, including resistant strains, across international borders. Critical gaps in epidemiological knowledge are highlighted, including data on gonorrhoea among transgender persons and the burden of extragenital gonorrhoea. Even as further data are gathered, action - informed by currently available data - is needed now to confront this growing international threat.
  • article 31 Citação(ões) na Scopus
    MAIT cells are reduced in frequency and functionally impaired in human T lymphotropic virus type 1 infection: Potential clinical implications
    (2017) PAQUIN-PROULX, Dominic; GREENSPUN, Benjamin C.; COSTA, Emanuela A. S.; SEGURADO, Aluisio C.; KALLAS, Esper G.; NIXON, Douglas F.; LEAL, Fabio E.
    HTLV-1 infection is associated with several inflammatory disorders, including the neurode-generative condition HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). It is unclear why a minority of infected subjects develop HAM/TSP. The cellular immune response has been implicated in the development of inflammatory alterations in these patients; however the pathogenic mechanisms for disease progression remain unclear. Furthermore, HTLV-1-infected individuals have an increase incidence of Mycobacterium tuberculosis (Mtb) infection, suggesting that immunological defect are associated with HTLV-1 infection. Evidence suggests an important role for Mucosal-associated invariant T (MAIT) cells in the early control of Mtb infection. Chronic viral infections like HIV and HCV have been associated with decreased frequency and functionality of MAIT cells. We hypothesized that HTLV-1 infection is associated with similar perturbations in MAIT cells. We investigated MAIT cell frequency, phenotype, and function by flow cytometry in a cohort of 10 asymptomatic and 10 HAM/TSP HTLV-1 infected patients. We found that MAIT cells from HTLV-1-infected subjects were reduced and showed high co-expression of the activation markers CD38 and HLA-DR but normal levels of CCR6 and CD127. MAIT cells had a lower expression of the transcription factor PLZF in HAM/TSP patients. Unlike Tax-specific CD8+T cells, which are hyperfunctional, MAIT cells from HTLV-1-infected subjects had a poor IFN gamma response following antigen stimulation. MAIT cell perturbations in HTLV-1 infection were not associated with HTLV-1 proviral load and MAIT cells were not infected by HTLV-1 in vivo. Rather, MAIT cells loss was associated with immune activation. Overall, our results do not support a role for MAIT cells in HAM/TSP pathogenesis but reduced numbers of MAIT cells, together with their poor functionality, could contribute to the increased susceptibility of HTLV-1-infected individuals to other infectious agents.
  • conferenceObject
    GENDER-AGE CHARACTERISTICS OF ACUTE SEXUAL VIOLENCE VICTIMS: 2001-2013, BRAZIL
    (2017) NISIDA, Isabelle V. V.; BOULOS, Maria I. C.; ATUI, Fabio; DIEGOLI, Carlos A.; SEGURADO, Aluisio C.
  • article 15 Citação(ões) na Scopus
    Setting up hospital care provision to patients with COVID-19: lessons learnt at a 2400-bed academic tertiary center in SAo Paulo, Brazil
    (2020) PERONDI, Beatriz; MIETHKE-MORAIS, Anna; MONTAL, Amanda C.; HARIMA, Leila; SEGURADO, Aluisio C.
    As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of SAo Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing hospital demand, reengineering care provision to optimize clinical outcomes and minimize intra-hospital coronavirus infection. In this paper we describe how the largest public hospital complex in Latin America faced this unprecedented burden, managing severe COVID-19 cases while sustaining specialized care to patients with other conditions. In our strategic plan a 900 bed hospital was exclusively designated for COVID-19 care and continuity of care to those not infected with coronavirus ensured in other inpatient facilities. After 152 days, 4241 patients with severe COVID-19 were hospitalized, 70% of whom have already been discharged, whereas the remaining Institutes of the complex successfully maintained high complexity inpatient and urgent/emergency care to non-COVID-19 patients. (C) 2020 Sociedade Brasileira de Infectologia.
  • article 12 Citação(ões) na Scopus
    Clinical features of COVID-19 by SARS-CoV-2 Gamma variant: A prospective cohort study of vaccinated and unvaccinated healthcare workers
    (2022) LUNA-MUSCHI, Alessandra; BORGES, Igor C.; FARIA, Elizabeth de; BARBOZA, Antonio S.; MAIA, Fernando L.; LEME, Mariana D.; GUEDES, Ana Rubia; MENDES-CORREA, Maria Cassia; KALLAS, Esper G.; SEGURADO, Aluisio C.; DUARTE, Alberto J. S.; LAZARI, Carolina S.; ANDRADE, Pamela S.; SALES, Flavia C. S.; CLARO, Ingra M.; SABINO, Ester C.; LEVIN, Anna S.; COSTA, Silvia F.
  • article 3 Citação(ões) na Scopus
    Covid-19 Social Distancing, Lifestyle and Health Outcomes Among Persons Living with HIV (PLWH): A Web-based Survey
    (2022) VICENTE, Beatriz M.; NETO, Joao Valentini; QUARESMA, Marcus Vinicius L. dos Santos; VASCONCELOS, Janaina Santos; BAUCHIUNAS, Roseli Espindola; SANTOS, Elisabete C. M. dos; PICONE, Camila M.; IBRAHIM, Karim Y.; I, Vivian Avelino-Silva; MELO, Camila M. de; SEGURADO, Aluisio C.; RIBEIRO, Sandra Maria Lima
    We investigated changes in lifestyle, depressive symptoms, self-perception of health, and body weight changes of persons living with HIV (PLWH) during the COVID-19 social distancing (SD). In a Web-based cross-sectional survey, participants (n = 406) were questioned about lifestyle and health status before and during SD. Most responders were men, 50 + years old, high education level; 49.8% had their income reduced during SD. About 9% were diagnosed with COVID-19, of whom 13.5% required hospitalization. During SD: - most participants did not change their food intake, although 25% replaced healthy foods with unhealthy ones; -more than half mentioned poor sleep quality; -about 50% increased their sedentary behavior. Depressive symptoms (reported by 70.9%) were associated with sedentary behavior, poor sleep quality, and reduced income. About one-third had a negative perception of their health status, which was inversely associated with practicing physical exercises and positively associated with sedentarism and poor sleep quality. More than half increased their body weight, which was associated with a lower intake of vegetables. The older age reduced the odds of the three outcomes. Carefully monitoring PLWH regarding SD will enable early interventions toward health.
  • article 17 Citação(ões) na Scopus
    A sexualidade de Adolescentes Vivendo com HIV: direitos e desafios para o cuidado
    (2011) PAIVA, Vera; AYRES, Jose Ricardo Carvalho de Mesquita; SEGURADO, Aluisio C.; LACERDA, Regina; SILVA, Neide Gravato da; SILVA, Mariliza Henrique da; GALANO, Eliana; GUTIERREZ, Pilar Lecussan; MARQUES, Heloisa Helena de Souza; NEGRA, Marinella Della; FRANCA JR., Ivan
    Sexuality and reproductive healthcare represent relevant issues for comprehensive care of HIV-positive adolescents. However, public policies and health services give this issue insufficient attention. The scope of this article is to assess how HIV-positive young people and teenagers cope with their sexuality, dating and the urge to have children and start a family. In a qualitative study, in-depth interviews were staged with 21 HIV-positive (contracted by vertical, sexual or intravenous transmission) teenagers and 13 caregivers of children and youths living in Sao Paulo and Santos. The interviews revealed the different ways teenagers cope with their sexuality and with the anxiety of HIV disclosure in this context. Lack of information about HIV prevention, lack of support and skills to cope with their sexuality were revealed in the reports. Furthermore, stigma and discrimination were the most frequently reported difficulties. The main challenges to be faced in Brazil in regard to this issue are discussed, especially the need to consider HIV-positive youth as entitled to sexual rights. Recommendations are also made for incorporating the issue into a humanized and comprehensive care approach
  • article 21 Citação(ões) na Scopus
    HTLV-1 Tax Specific CD8+ T Cells Express Low Levels of Tim-3 in HTLV-1 Infection: Implications for Progression to Neurological Complications
    (2011) NDHLOVU, Lishomwa C.; LEAL, Fabio E.; HASENKRUG, Aaron M.; JHA, Aashish R.; CARVALHO, Karina I.; ECCLES-JAMES, Ijeoma G.; BRUNO, Fernanda R.; VIEIRA, Raphaella G. S.; YORK, Vanessa A.; CHEW, Glen M.; JONES, R. Brad; TANAKA, Yuetsu; NETO, Walter K.; SANABANI, Sabri S.; OSTROWSKI, Mario A.; SEGURADO, Aluisio C.; NIXON, Douglas F.; KALLAS, Esper G.
    The T cell immunoglobulin mucin 3 (Tim-3) receptor is highly expressed on HIV-1-specific T cells, rendering them partially ""exhausted'' and unable to contribute to the effective immune mediated control of viral replication. To elucidate novel mechanisms contributing to the HTLV-1 neurological complex and its classic neurological presentation called HAM/TSP (HTLV-1 associated myelopathy/tropical spastic paraparesis), we investigated the expression of the Tim-3 receptor on CD8(+) T cells from a cohort of HTLV-1 seropositive asymptomatic and symptomatic patients. Patients diagnosed with HAM/TSP down-regulated Tim-3 expression on both CD8(+) and CD4(+) T cells compared to asymptomatic patients and HTLV-1 seronegative controls. HTLV-1 Tax-specific, HLA-A*02 restricted CD8(+) T cells among HAM/TSP individuals expressed markedly lower levels of Tim-3. We observed Tax expressing cells in both Tim-3(+) and Tim-3(-) fractions. Taken together, these data indicate that there is a systematic downregulation of Tim-3 levels on T cells in HTLV-1 infection, sustaining a profoundly highly active population of potentially pathogenic T cells that may allow for the development of HTLV-1 complications.