Programa de Pós-Graduação em Doenças Tropicais - PPGDT/NMT
URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/3558
O Programa de Pós-Graduação em Doenças Tropicais (PPGDT) integra o Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA), realizando atividades de ensino, pesquisa e extensão e atuando na formação de docentes-pesquisadores para o estudo e o ensino das doenças tropicais e das patologias regionais no estado do Pará e na Amazônia.
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Navegando Programa de Pós-Graduação em Doenças Tropicais - PPGDT/NMT por Autor "ALBERIO, Carlos Augusto Abreu"
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Item Acesso aberto (Open Access) Efeitos adversos do novo tratamento para tuberculose no Brasil(Universidade Federal do Pará, 2012) ALBERIO, Carlos Augusto Abreu; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098Tuberculosis remains a public health problem in Brazil. Several attempts have been made to improve cure rates of the disease, such as DOTS (Directly Observed Treatment in Short – Course) which aims to reduce drop-outs and improve patient compliance to treatment. Due to the increased primary resistance to isoniazid, the Ministry of Health decided to modify the treatment regimen, adjusting doses of isoniazid and pyrazinamide, and adding ethambutol in the intensive phase of treatment. The absence of data on adverse effects in Brazilian subjects under this new regimen, this study aimed to describe the occurrence of such events, comparing them to previous treatment. To this end, a cross-sectional, retrospective, analytical study was accomplished in the period from September to December 2011, with survey data from medical records of 35 subjects under the new treatment and 42 under the old treatment, from a secondary referral service for the treatment of tuberculosis in Belém (Pará). The most common major adverse effect on the new treatment was the liver disease, whereas the most common minor adverse event was gastric irritation. The liver disease was more frequent in patients who underwent the old treatment. Gastric irritation and itchy skin were more common in females, while patients from the fourth decade of life had a higher occurrence of itchy skin. Those retreatment had increased incidence of gastric irritation and arthralgia, independent of treatment. Already liver disease was more frequent in patients who were considered new cases underwent in the old treatment. In the temporal evolution of the adverse effects, itchy skin and arthralgia were more frequent at the beginning of treatments. In the old treatment, neuropathy is more frequent from the middle of therapy, while the headache has an irregular distribution. These data indicate that the new treatment of tuberculosis decreased occurrence of liver disease.Item Acesso aberto (Open Access) Monitorização terapêutica de fármacos utilizados no tratamento da tuberculose no Brasil(Universidade Federal do Pará, 2018-12-07) ALBERIO, Carlos Augusto Abreu; VIEIRA, José Luiz FernandesTuberculosis continues to be a public health problem throughout Brazil. Several efforts have been made to increase their cure rates, such as the use of the DOTS strategy (Directly Observed Treatment for Short Term) to reduce cases of abandonment and improve adherence to treatment. As a result of the increase in primary resistance to isoniazid, the Ministry of Health modified the therapeutic regimen in 2010, adjusting the doses of isoniazid and pyrazinamide, and adding ethambutol in the intensive treatment phase. Due to the lack of data on serum concentrations of first-line drugs in the brazilian population in this new scheme, this study aimed to determine the serum concentrations of rifampicin, isoniazid and pyrazinamide during treatment and its associations with hematological and biochemical alterations, adverse reactions and clinical outcomes. A prospective cohort study was carried out between september 2013 and november 2016 in two basic health units in the city of Belém (Pará). The most common adverse effects were gastric irritation and pruritus, especially in the intensive phase of treatment and the most frequent clinical outcome was discharge by cure (87.5%). There was a high rate of smear negative (98,90%) in the end of intensive treatment phase. Hematological parameters were determined by automatic cell counter (Cobas 2300®) and biochemical parameters by spectrophotometry (Varian®), which did not present any relevant changes during treatment. The drugs analyzed were rifampicin, isoniazid, and pyrazinamide, and their serum concentrations were determined by reverse phase high performance liquid chromatography (HPLC-RP). Rifampicin and isoniazid presented serum concentrations within the minimum inhibitory concentration (MIC), except for pyrazinamide, which presented values below MIC (3.3 μg/ml), but with a maximum concentration (Cmax) well above the recommended values (63.3 μg/ml). Female patients had higher serum rifampicin concentrations than males. The serum concentrations of rifampicin and isoniazid did not show significant variations between the intensive phase and the maintenance phase. The findings of this study allow us to conclude that the current treatment is safe and effective, since the minor adverse reactions were the most frequent, there were no relevant hematological and biochemical alterations, and the majority of the patients evolved to cure.