Dissertações em Doenças Tropicais (Mestrado) - PPGDT/NMT
URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3559
O Mestrado Acadêmico em Doenças Tropicais iniciou em 2004 e pertence ao Programa de Pós-Graduação em Doenças Tropicais do Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA).
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Item Acesso aberto (Open Access) Avaliação da resposta imunológica a vacina da Hepatite B nos trabalhadores do Hospital Municipal de Imperatriz-MA(Universidade Federal do Pará, 2012) SANTOS, Wllington Jorge dos; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769The hospital offers risk when the exposure of health professionals and other workers to a variety of materials, especially organic. This study aims to determine the prevalence of serological markers for HBV (ABsAg, anti-HBc and anti-HBS) and analyze the immune response to hepatitis B vaccine among workers of the Municipal Hospital Imperatriz- MA. We consulted the medical records of 257 hospital workers in different categories of professionals. Was removed from the records information about the immunization schedule for hepatitis B, and the results of serological markers (HBsAg, Anti HBs, Anti HBC total) performed by them in 2010 and 2011. In search of serological markers for HBV was observed that had the HBsAg 0.4%, 10% anti-HBc and 34% anti-HBs. Based on the interpretation of serological markers surveyed 62% of employees are susceptible to HBV infection. The age group 41-60 years, the service time, where 72% of servers that had come in contact with HBV had more than three years service in the hospital was more frequent among employees reagents. The vaccination for HBV has been observed that among the servers that had come in contact with the virus most of them 84% had completed the immunization schedule. The results of this study highlights the need for intensification of strategies to improve vaccination coverage against hepatitis B, training of professionals about preventive measures against accidents with biological material and professional awareness of the use of personal protection equipment and collective.Item Acesso aberto (Open Access) Avaliação do estado secretor ABH e Lewis em mulheres não grávidas com e sem risco de desenvolver vulvovaginite por Candida sp(Universidade Federal do Pará, 2003) CARNEIRO, Ligia Maia; CORVELO, Tereza Cristina de Oliveira; http://lattes.cnpq.br/7253864056606024Na epidemiologic study of Candida sp infection prevalence in non-pregnant women was performed in a population of the north of Brazil (Belem-Pa, 2002). This paper aims to contribute to clear up the infection mechanisms of Candida sp and its possible association to ABO and Lewis group blood antigens and ABH substances secretory status. Such paper comprehended a total of 165 women admitted at the out-patient clinic of "Hospital da Policia Militar" and "Laboratorio de Analises Clinicas do Centro de Ciencias Biologicas da Universidade Federal do Para", who came to those units to undergo gynaecologic examinations, where blood, salive and vaginal mucus samples were taken. Candida sp infection presence was determined through the examination of fresh vaginal secretion and bacterioscopy of vaginal secretion. The identification of ABH and Lewis phenotipes in the blood was determined through direct hemaglutination tests and, in the salive, by Elisa Dot-blot. It was performed a standard form for the obtaining of epidemiologic information. Candida sp prevalation was 47.9%. Among the most commom signals and symptoms associed to Candida sp infections are pruritus and gleet. Women under 40 who did not use condoms and who have already had previous infections presented a higher risk of vulvo-vaginal infection caused by Candida sp. Infected and non-infected women with Candida sp had similar distribuition to the phenotypes of ABO, Lewis blood groups and ABH substances secretory status. And, comparing the expressions of Lewis antigens in the blood, save and vaginal mucus, it was verified that both secretions expressed Lewis antigens without any close relationship to erithrocitic Lewis phenotypes. In such context, it is considered that the nature of genetics diversity in the interaction between Candida sp and host requires more studies involving the identification of different types to determine their probable associations among ABH and Lewis blood groups phenotypes with cadidiasis.Item Acesso aberto (Open Access) Caracterização sorológica e detecção molecular do HTLV em amostras de pacientes com distúrbios neurológicos no Estado do Pará, Brasil (1996-2005)(Universidade Federal do Pará, 2006-07-07) LIMA, Telma Vitorina Ribeiro; LINHARES, Alexandre da Costa; http://lattes.cnpq.br/3316632173870389Human T-lymphotropic virus tipe 1 is recognized as the etiologic agent of tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM). A very similar clinical disease has been increasingly associated to HTLV-2, whose pathogenicity still requires further assessments. This transversal, retrospective epidemiological survey aimed to determine the prevalence of HTLV among individuals with neurological disturbances and further evaluate cases of inconclusive serology using molecular biology methods. The present study involved patients inhabitants of Pará State and/or admitted at health institutions of the and who were referred to the Virology Section of Instituto Evandro Chagas (IEC) by local doctors between January of 1996 and December 2005, to search for the presence of HTLV-1/2 serum antibodies. Of these patients 353 were selected, with age between 9 months and 79 years, who presented at least one signal or symptom of the Marsh’s Complex (1996), as well as had HTLV-1/2 positive serology at screening and confirmatory ELISA. The overall prevalence of HTLV antibodies by ELISA as 8,8% (31/353), with rates of 10,6% (19/179) and 6,9% (12/174) for female and male patients, respectively. Among HTLV-1/2 the 31 ELISA-positive patients it was noted that 15 (48.4%) of 31 had paresis (n = 8), parestesis (n = 5), and paraplegia (n = 3). Of these 31 HTLV ELISA positive patients, 25 could be submitted to WB for assessment of viral types, which were distributed as follow: 80% (20/25) were HTLV-1, 12% (3/25) were HTLV-2, one case was of HTLV-1+HTLV-2 infection (4%), and serum from one patient yielded an indeterminate profile (4%). Only 14 of these 25 patients could be re-localised for collection of an additional sample for molecular analysis. It was observed that 78.6% of samples typed by WB had the proviral TAX region successfully amplified by nested-PCR. In addition, types were confirmed as based on results obtained from the amplification of the POL region using real-time PCR; this denoted good specificity and sensitivity of the WB used in this study. The sample defined as HTLV-1+HTLV-2 infection by WB was amplified in its TAX region but real time PCR confirmed HTLV-1 infection only. The patient with WB indeterminate profile and one of samples typed as HTLV-2 by WB were amplified by nested-PCR but the real time PCR was negative for HTLV-1 and HTLV-2 in both samples. One patient presenting clinical manifestations of crural myalgia and parestesia with duration of about 7 years reacted HTLV-2-positive by both WB and real-time PCR, a denoting a clear HTLV-2- related chronic myelopathy. This study has identified a case of possible vertical transmission in two distinct situations: a patient whose mother presented antibodies for HTLV-1 by WB and two sisters who reacted HTLV-1-positive by WB and real-time PCR. Although of epidemiological relevance, results from this study warrant further and broader analyses concerning the molecular epidemiology of HTLV types and subtypes HTLV. In addition, a more complete clinical assessment of neurological symptoms should be further performed, in order to better characterise cases of HTLV-related chronic myelopathy in our region.Item Acesso aberto (Open Access) Correlação entre a avaliação clínica e o padrão de resposta imunológica periférica de pacientes acometidos por Paraparesia espástica tropical/mielopatia associada ao Vírus linfotrópico de celulas T humanas do tipo 1 (HTLV-1)(Universidade Federal do Pará, 2012) DIAS, George Alberto da Silva; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973Human T lymphotropic virus type 1 (HTLV-1) is an exogenous retrovirus that persistently infects 20–30 million people worldwide. This virus is etiologically related to the development of adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) a chronic disease of the central nervous system. The majority of HTLV-1-infected individuals remain lifelong asymptomatic carriers (ACs) of the virus. However, about 3-5% can develop ATL or HAM/TSP. The virus preferentially infects CD4+ T cells – main host cell of HTLV-1 – and rapidly induces cell activation and proliferation and expression of many host genes, including IFN-γ. The exact mechanism underlying these immunological and clinical events still remains unknown. In the current study, we evaluated the peripheral immune response and correlated with clinical symptoms like spasticity and weakness of the lower extremities, and gait abnormalities. 28 HTLV-1 infected patients were studied. Eight of them developed HAM/TSP and 20 were ACs. Total RNA was extracted from peripheric limphomononuclear cells using the TrizolR reagent (Invitrogen, Carlsbad, CA, USA). The quantitative real-time PCR was performed to quantify IFN-γ, IL-4, IL-5 and IL-10. Total RNA (1μg) of each sample was subjected to reverse transcription with Superscript III (Invitrogen). Real-time PCR was performed in StepOne Plus (Applied Biosystems, Foster City, CA) and signal detection was obtained with the Sybr Green reagent (Applied Biosystems). The amount of mRNA in the sample was expressed as the relative amount to the GAPDH and β-actin genes, according to the formula 2-ΔCT, where ΔCT is CTgene – CThousekeeping. The clinical symptoms of each patient were examined. Spasticity was assessed on the Modified Ashworth Scale, the weakness of the lower limb was measured using a manual scale, and the gait was given scores to the devices that assist in gait. The HAM/TSP patients showed higher expression of IFN-γ (Median: 2,9 x 10-3) than Acs (Median: 1,1 x 10-3), with p = 0,0710. The IFN-γ expression was positively correlated to spasticity (r = 0,2795), weakness (r = 0,6580) and gait (r = 0,7216). Interestingly, patients who need wheelchairs had a higher IFN-γ expression than those who don’t need wheelchair (p = 0,0371). The HAM/TSP patients showed higher Th1 response than ACs. The higher IFN-γ expression is correlated with the development and progression of the HAM/TSP.Item Acesso aberto (Open Access) Detecção in situ de citocinas de perfil TH1 e TH2 por imunoistoquímica e relação com a atividade de macrófagos nas formas polares da doença de Hansen(Universidade Federal do Pará, 2009) SILVA, Dayse Danielle de Oliveira; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054Leprosy is an infectious disease that has a slow and progressive evolution, with high incidence and prevalence in the states that compose the Legal Amazon. Considering the number of cases, the Pará state plays a prominent role in the national context. In order to evaluate the cytokine profile and the macrophages activity in the polar forms of leprosy and correlate with their histopathological aspects, a transversal study was performed, with a sample of 29 patients who had one of the polar forms of leprosy, namely tuberculoid or virchowian, from who skin biopsies of leprosy lesions were taken. It could be observed, through the analysis of this immunohistochemical material, that the studied groups showed no significant variation in the levels of IL-10, TGF-β, CD68, iNOS and Lysozyme. The levels of IL-4 were not expressive in the analyzed tissues and the levels of IFN-γ were higher in patients in the MHV group. In the virchowian pole, all cytokines tended towards a negative correlation with the macrophages activity. In the tuberculoid pole, the level of IL-10 showed a negative correlation with the levels of iNOS, IFN-γ and lysozyme, indicating a macrophage activity inhibition for this cytokine. It can be concluded that there is no difference in cytokine expression of TH1 and TH2 profile in polar forms of Hansen's disease and cytokines have a tendency to negative correlation with the activity of macrophages in MHV pole and a tendency to positive correlation in the pole MHT. Further research is needed to clarify why some populations have more susceptibility to leprosy than others. A similar study with a larger number of individuals may have a more significant outcome.Item Acesso aberto (Open Access) Imunomarcação tecidual para o fator XIIIa+ em dendrócitos dérmicos de lesões cutâneas com doença de Jorge Lobo(Universidade Federal do Pará, 2010) CARNEIRO, Clivia Maria Moraes de Oliveira; BRITO, Arival Cardoso de; http://lattes.cnpq.br/0563291980190339Jorge Lobo's disease (DJL) is a deep fungal infection caused by Lacazia loboi which mainly affects males farmers, with the clinical form keloid and location of the lower limbs. The highest incidence is found in the Brazilian Amazonia. There are few reports on immune tissue lesions of patients. This study aims to evaluate a possible role in the pathogenesis of the disease by factor XIIIa dermal dendrocytes (FXIIIa DD) in skin lesions, using the technique of immunohistochemistry. 33 skin biopsies were analyzed from patients with DJL. The control group consisted of 10 normal skin biopsies originating from patients without dermatological diseases and 61 biopsies from patients with paracoccidioidomycosis (PCM). The results obtained by records analyzing patients' revealed that DJL affects mainly men (84.8%), farmers (72.7%) with 46-65 years old (51.5%), coming from the northeastern Pará state (51.5%) with clinical form keloid (81.8%) and predominant location of lesions in the lower limbs (45.5). The values of the count of FXIIIa DD in skin lesions of DJL were not affected by variations in gender, age, occupation, origin, clinical manifestation and localization of lesions. The amount of FXIIIa DD in patients with DJL was higher than that found in the control group of patients with healthy skin and in the group of patients with PCM to both the histopathology of loose granuloma (GF) and organized granuloma (GBO). Because of FXIIIa DD be considered precursors of Langerhans cells (LCs) can be suggested that their increase in DJL reflects a reservoir for the LCs and transform them time and again, don’t allowing their decrease. It has been demonstrated the increase in the levels of Th2 cytokines (TGF-β) in the DJL, and the increase of FXIIIa DD that is able to secrete the factor TNF-α, observed in this study, shows a dominance of Th1. Whereas there is a co expression of cytokine profiles of both, the study suggests the existence of mixed patterns. So, the results obtained in this work suggest that DJL is a spectral disease, with a tendency of resistance or susceptibility. What might explain the existence of focal cases even with long duration of disease and disseminated cases like early manifestation of DJL.Item Acesso aberto (Open Access) Imunoreatividade para tgf- β e caspase-3 e sua relação com o controle da resposta imune tecidual nas formas polares da hanseníase(Universidade Federal do Pará, 2007-11-30) ALMEIDA, Fabricio Anderson Carvalho; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054Leprosy is a chronic infect-contagious disease that accompanies the humanity for many years. Brazil occupies the second place in numbers of cases, and the state of Para is that presents the largest number of absolute cases. This study had as objective to evaluate the immunorreactivity for TGF-β and caspase-3 in the lepromatous and tuberculoid clinical forms of the leprosy evil trying to correlate the immunomarking pattern with the tissue control of the immune response of the host to the bacillus, through a retrospective study of paraffin enclosed tissue of 30 patients, being fifteen presenting in the lepromatous form and fifteen with the tuberculoid type of disease. The patients followed the protocol of leprosy diagnosis according to criteria of Health Ministry of Brazil and histopathologic features. It was observed that the lepromatous form of the leprosy presented a significant statistically correlation (p=0,4630) among TGF-β to caspase-3, evidencing that as the cytokine as the imunomarking of the apoptosis increase inch by inch and simultaneously in this polar form and that indirectly appear to a role of TGF-β in the control of the immunologic response in its place to the infection for the Mycobacterium leprae.Item Acesso aberto (Open Access) Infecção persistente pelos flavivírus Ilhéus e Rocio em hamsters dourados jovens (Mesocricetus auratus)(Universidade Federal do Pará, 2009-08-28) HENRIQUES, Daniele Freitas; VASCONCELOS, Pedro Fernando da Costa; http://lattes.cnpq.br/0973550817356564Ilheus (ILHV) and Rocio (ROCV) are flaviviruses (family Flaviviridae, genus Flavivirus) of great importance to public health in Brazil because these viruses are associated to encephalitis cases in humans. Recent studies have reported persistence of experimental infections (in vivo and in vitro) and clinical reports. The purpose of this study was to investigate in vivo the possible occurrence of persistent infection caused by ILHV and ROCV using young golden hamsters (Mesocricetus auratus) as experimental model. Hamsters were inoculated intraperitoneally with a suspension of brains of newborn mice infected with titers of 9.8 and 9.6 DL50/ 0.02 mL of ROCV and ILHV respectively, and at pre-determined intervals, they were anesthetized and sacrificed for collection of blood samples, serum and urine and organ fragments during four months (120 days) post-inoculation (p.i.). Viral quantification was calculated in samples of brain, liver and blood, using the technique of Real Time RT-PCR (qRT-PCR). All collected specimens were inoculated into VERO cells for confirmation of viral replication; and viral antigens in the cell cultures were detected by indirect immunofluorescence test; the levels of antibodies were determined by hemagglutination-inhibition test. Histopathological examination by hematoxylin-eosin and detection of viral antigens by imunohistochemistry were assayed in viscera and central nervous tissue samples collected during the kinetics. The study showed that young golden hamsters are good experimental model for persistent infection by the flaviviruses ILHV and ROCV. Both viruses induced strong immune response, although the levels of antibodies to ILHV were greater than for ROCV. The ROCV has demonstrated to be more pathogenic in these animals, suggesting higher ability to cause neuronal invasiveness than ILHV. Infected viscera samples inoculated in VERO cells resulted in growth of both viruses from all infected organ, blood, serum and urine samples and were confirmed by indirect immunofluorescence assay. Regarding persistence of infection, ROCV was detected in the brain, liver and blood by qRT-PCR, for three months p.i., while ILHV persistence was observed only in the brain for 30 days p.i. by qRT-PCR. The ROCV was able to produce histopathological changes, and immuno-labeled cells expressing viral antigens in liver, kidney, lung and brain samples during four month were confirmed by imunohistochemistry. To the ILHV, the histopathological changes and expression of viral antigens in samples from the liver, kidney and lung were only confirmed up to 30 days p.i., but the brain was positive for four months p.i.; The findings obtained in this study showed that both viruses have capacity to cause persistent infection in hamsters intraperitoneally infected, studies additional are needed to determine the pathophysiology and pathogenesis of ILHV and ROCV persistent infections.Item Acesso aberto (Open Access) Persistência de anticorpos neutralizantes contra o vírus rábico após quatro anos de vacinação em regimes de pré e pós-exposição e doses de reforço, em população de área rural exposta a agressão por morcegos hematófagos no Brasil(Universidade Federal do Pará, 2012) SOUZA, Rhomero Salvyo Assef; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539Rabies is a cosmopolitan zoonosis characterized as an acute viral encephalitis, progressive killing around 55.000 people annually worldwide each year. The rabies virus is transmitted by domestic animals and rural and wild, and now, in the Brazilian Amazon has been observed often outbreaks of human rabies transmitted by bats. The shape of most successful treatment after possible exposure to rabies virus is immunoprophylaxis. This study presents itself as a prospective cohort of maintaining rabies virus neutralizing antibodies in 508 previously vaccinated individuals in a population of the municipality of Augusto Corrêa- Pará- Brazil, from 2007 to 2009. To this end, serum samples were collected for measurement of antibodies by the technique RFFIT. The study sample the genre was predominantly male, with the median age about 16 years with interquartile range between 8 and 30 years, and there was a greater concentration in the age groups 2-9 years and 10 to 19 years; and most of subjects performed the immunization schedule full exposure. The production of neutralizing antibodies against rabies virus in protective levels (> 0.05 IU/mL) occurred in 87.3% of subjects in the first year of the study and preservation of seroprotection was 85.6% in the second year and 93.2% the following year. The study showed better immune profile in females compared to males; in the age groups 30-39 years and 50-59 years; and the group of 32 subjects who received a booster dose, as indicated by antibody titers. In this study, population investigated showed good levels of neutralizing antibodies (> 0.5 IU/mL) against the rabies virus after 4 years of vaccination.