Navegando por Autor "MIRANDA, Esther Castello Branco Mello"

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Acesso aberto (Open Access)
Association of killer cell immunoglobulin-like receptor polymorphisms with chronic hepatitis C and responses to therapy in Brazil
(2013) VASCONCELOS, Janaina Mota de; MÓIA, Lizomar de Jesus Maués Pereira; AMARAL, Ivanete do Socorro Abraçado; MIRANDA, Esther Castello Branco Mello; TAKESHITA, Louise Yukari; OLIVEIRA, Layanna Freitas de; MENDES, Lilian de Araújo Melo; SASTRE, Danuta; TAMEGÃO-LOPES, Bruna Pedroso; PEDROZA, Larysse Santa Rosa de Aquino; SANTOS, Sidney Emanuel Batista dos; SOARES, Manoel do Carmo Pereira; ARAÚJO, Marialva Tereza Ferreira de; BANDEIRA, Camila Lucas; SILVA, Adriana Maria Paixão de Sousa da; MEDEIROS, Zilene Lameira de; SENA, Leonardo dos Santos; DEMACHKI, Sâmia; SANTOS, Eduardo José Melo dos
Soroprevalence for Hepatitis C virus is reported as 2.12% in Northern Brazil, with about 50% of the patients exhibiting a sustained virological response (SVR). Aiming to associate polymorphisms in Killer Cell Immunoglobulin-like Receptors (KIR) with chronic hepatitis C and therapy responses we investigated 125 chronic patients and 345 controls. Additionally, 48 ancestry markers were genotyped to control for population stratification. The frequency of the KIR2DL2 and KIR2DL2+HLA-CAsp80 gene and ligand was higher in chronic infected patients than in controls (p < 0.0009, OR = 3.4; p = 0.001, OR = 3.45). In fact, KIR2DL3 is a weaker inhibitor of NK activity than KIR2DL2, which could explain the association of KIR2DL2 with chronic infection. Moreover, KIR2DS2 and KIR2DS2+HLA-CAsp80 (p < 0.0001, OR = 2.51; p = 0.0084, OR = 2.62) and KIR2DS3 (p < 0.0001; OR = 2.57) were associated with chronic infection, independently from KIR2DL2. No differences in ancestry composition were observed between control and patients, even with respect to therapy response groups. The allelic profile KIR2DL2/KIR2DS2/KIR2DS3 was associated with the chronic hepatitis C (p < 0.0001; OR = 3). Furthermore, the patients also showed a higher mean number of activating genes and a lower frequency of the homozygous AA profile, which is likely secondary to the association with non-AA and/or activating genes. In addition, the KIR2DS5 allele was associated with SVR (p = 0.0261; OR = 0.184).The ancestry analysis of samples ruled out any effects of population substructuring and did not evidence interethnic differences in therapy response, as suggested in previous studies.
Acesso aberto (Open Access)
Carcinoma hepatocelular e as infecções pelos vírus das hepatites B e C na Amazônia Oriental: estudo clínico-sorológico e de biologia molecular
(Universidade Federal do Pará, 1999-08-06) MIRANDA, Esther Castello Branco Mello; BENSABATH, Gilberta; http://lattes.cnpq.br/0818254462635138; CRUZ, Ermelinda do Rosário Moutinho da; http://lattes.cnpq.br/6061358867607317
In order to contribute to a better understanding of the possible role of hepatitis B and C in the etiopathogenis of hepatocellular carcínoma (HCC) in the East Amazon, there were studied 36 patients admited in three public hospitais in Belém/PA, from January,1992 to March,1999. The criteria to be enrolled in the study were the association of clinical and image procedures, alpha-fetoprotein (AFP) above 400nglml in the serum and/or histopathology examination compatible to hepatocellular carcinoma. Clinical aspects, biochemical and histological examination, serum levei of AFP and serological B and C hepatitis markers were evaluated. Polymerase chain reaction assays were used to detect serum virus nucleic acids, HBV DNA and HCV RNA. There was a predominance for male sex in the prevalence of HCC (p<0.01 ) in a ratio of 6.2 to 1 (male/female). Regarding age, the Mean and the Median were 50.8 and 53.0 years respectively, and the Amptitude was 6 to 81 years. Most patients (52.7%) carne from rural regions. Farmer was the main occupation referred (p<0.01). Alcohol abuse was observed in 33.3%. Abdominal pain and hepatomegaly were the most recorded sign and symptoms in 94.4% of patients. Cirrhosis was detected in 83.3%. The majority of it belonged to class B or class C of Child-Pugh classification. During diagnosis, 50% of patients had some kind of complication, specially portal-systemic encephalopathy and gastro-intestinal hemorrhage (upper digestive bleeding) related to the originai chronic liver disease. In 88,9% of the sample, one or more hepatitis B markers were positive. Also, 8,3% those patients had anti-HCV simultaneously positive. There were no serological markers in 11,1% of the casuistic. 58.3% had HBsAg serological positive test. Coinfection was detected in 2.8%. Antibodies to HBc were positive in 86%, being present in 25% of cases in association with the anti-HBs. Among patients positive to HBsAg, anti-HBe was observed in 85.7%, anti-HBe in 9.5% and IgM anti-HBc in 57.1%. There were no positive anti-HD in any sample case. The HBV DNA was found in 37.7% of ali patients and in 65% of the HBsAg positive. The HCV RNA was detected in 8.5% of the sample but in 100% of the patients positive to anti-HCV. Sera from patients negative to HBsAg or to anti- HCV had any evidence of HBV DNA or HCV RNA. The AFP was above the normal value in 88.9% of patients, with levels up to 400ng/ml in 75% of them and in 27.8% high titers superior to 70000 ng/ml were observed. The abdominal ultrasonography identified liver tumors with nodules, multiple or single, present respectively in 63.9% and 36.1% of the sample. The predominant histological tumor was trabecular well differentiated carcinoma (p<0.05). The least Mean age and the highest AFP serum levei (p<0.01 ) were recorded among patients HBsAg posítive. Most of patients had advanced illness. A death rate of 38.9% were recorded. In conclusion, hepatitis B virus infection seems to be important in the etiology of HCC in the East Amazon. Improving preventive measures such immunization and screening for early diagnosis of liver tumors in the risk population should be emphasyzed. Further control or direct studies need to be done to elucidate important possible cofactors in the region that may contribute to a better understanding of the mechanisms enrolled in hepatocarcinogenesis.
Acesso aberto (Open Access)
Infecções pelos vírus das hepatites B e C e o carcinoma hepatocelular na Amazônia oriental
(2004) MIRANDA, Esther Castello Branco Mello; MÓIA, Lizomar de Jesus Maués Pereira; AMARAL, Ivanete do Socorro Abraçado; BARBOSA, Maria Silvia de Brito; CONDE, Simone Regina Souza da Silva; ARAÚJO, Marialva Tereza Ferreira de; CRUZ, Ermelinda do Rosário Moutinho da; DEMACHKI, Samia; BENSABATH, Gilberta; SOARES, Manoel do Carmo Pereira
In order to contribute to a better understanding of the possible role of hepatits B and C in the etiopathogenis of HCC in the East Amazon, there were studied 36 patients in Belém/PA. Serological hepatitis markers were evaluated and polymerase chain reaction assays were used to detect HBV-DNA and HCV-RNA. Alcohol abuse was observed in 33.3% and cirrhosis in 83.3%. In 88.9% of the sample, one or more hepatitis B markers were positive. Also, 8.3% those patients had anti-HCV simultaneously positive. The HBsAg serological test was positive in 58.3%; anti-HBc in 86%; anti-HBe in 85.7%; anti-HBe in 9.5%; IgM anti-HBc in 57.1%. The HBV DNA was found in 37.7% and in 65% of the HBsAg positive. The HCV RNA was detected in 8.5% and in 100% of' the patients positive to anti-HCV. The AFP was above the normal value in 88.9% of patients, with levels up to 400ng/ml in 75% of them. In conclusion, hepatitis B virus infection seems to be important in the etiology of HCC and improving measures such immunization and screening in the risk population should be emphasyzed.
Acesso aberto (Open Access)
Prevalência de genótipos e de mutantes pré-core A-1896 do vírus da hepatite B e suas implicações na hepatite crônica, em uma população da Amazônia oriental
(2004) CONDE, Simone Regina Souza da Silva; MÓIA, Lizomar de Jesus Maués Pereira; BARBOSA, Maria Silvia de Brito; AMARAL, Ivanete do Socorro Abraçado; MIRANDA, Esther Castello Branco Mello; SOARES, Manoel do Carmo Pereira; BRITO, Elizabete Maria de Figueiredo; SOUZA, Olglaíze do Socorro Costa; ARAÚJO, Marialva Tereza Ferreira de; DEMACHKI, Samia; REBELLO, João Renato Pinho; MESQUITA, Michele Gomes Soares; BERTOLLINI, Denis Alberto; ISHAK, Ricardo
Hepatitis B virus (HBV) infection presents itself with a variety of clinical manifestations. The present work aims to describe the prevalence of HBV genotypes and the occurrence of precore mutation A-1896 in a population group of the Eastern Amazon region of Brazil and to correlate them with the clinical presentation of chronic HBV infection. 51 HBsAg carriers (HBV-DNA positive) were selected and divided into three groups: A (14 asymptomatic subjects), B (20 HBeAg positive symptomatic patients) and C (17 HBeAg negative symptomatic patients). Using an automa ed DNA sequencer ABI model 377 by sequencing for determined of genotypes and precore mutation. The results showed that the genotype A was the most commonly found (81,1%, 89,5% and 93,7% in groups A, B and C, respectively) and precore mutation A-1896 was described in 11,5% (3/26) of group A subjects. Genotype A of HBV was the most prevalent (89,1%) and low occurrence of precore mutation A-1896, both not associate with the worst outcome of the chronic infection of HBV.
Acesso aberto (Open Access)
Programa de hepatopatias do Hospital da Fundação Santa Casa de Misericórdia do Pará: infra-estrutura e epidemiologia clínica em 10 anos de atendimento
(2004) MÓIA, Lizomar de Jesus Maués Pereira; AMARAL, Ivanete do Socorro Abraçado; CONDE, Simone Regina Souza da Silva; BARBOSA, Maria Silvia de Brito; MIRANDA, Esther Castello Branco Mello; MACEDO, Zilvana Pinheiro de; ARAÚJO, Marialva Tereza Ferreira de; DEMACHKI, Samia; SOARES, Manoel do Carmo Pereira
The Liver Diseases Program of the Hospital Santa Casa de Misericordia do Pará was create because of the need to attend patients with liver diseases of the Amazônia area, taking as priority to attend with quality, diagnosis of aetiologies, clinical following and specific treatment. This study aim to describe dates related to epidemiology, aetiologics agents and histopathologic analisys. One thousand sixthy nine patients were evaluated through medical, laboratory, endoscopic, ultrasound or computadorized tomography and histopathologic examination. Nine hundred thirty five (63,6%) patients within 1469 patients were diagnose as chronic liver disease. The average age was 50 year, 666 (71,2%) were male, and the most patients lived in Belem, state of Pará. The aetiologic agents most prevail were alcoholism (53,7%) and viral hepatitis (39,1%). Hepatic biopsy were done in 403 (43,1%) within the 935 patients and the results showed chronic hepatitis (34%) and chirrosis (34%). In sumary the chronic liver disease in the amazon region is more prevail in male than female, the alcoholism is the principal aetiologie, and the most of these cases were diagnose in the severe phase.