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Dissertação Acesso aberto (Open Access) Caracterização epidemiológica, genotípica e fenotípica da criptococose em uma unidade de referência no estado do Pará(Universidade Federal do Pará, 2012) FURTADO, Karen Cristini Yumi Ogawa; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539Cryptococcosis is a fungal infection caused by an encapsulated yeast Cryptococcus genus that affects both humans and animals, and is considered as an opportunistic infection commonly associated with immunosuppression. This is one of human fungal infections cause significant morbidity and mortality in both immunocompetent and in immunocompromised individuals and appears mainly in the form of meningoencephalitis. The aim of this study was to characterize epidemiological, genotypic and phenotypic cryptococcosis in a reference unit in the state of Pará. The target population was composed of patients treated at the University Hospital João de Barros Barreto/UFPA, January 2010 to December 2011 with laboratory confirmed diagnosis of cryptococcosis. Personal, clinical and laboratory data were collected from a review of medical records file HUJBB and the isolates were identified and characterized morphologically and biochemically. The type sexed and genotype were identified by PCR using specific primers. From January 2010 to December 2011 were identified 59 cases of cryptococcosis. Most patients were men (36/59, 61%), aged 5-70 years, mean 30.8 years. The predominant age group was 34-43 years (39% of cases). The main signs and symptoms presented by them were headache (85.5%), vomiting (80%) and fever (76.4%). All children (6/6) were HIV negative, and as the causative agent C. gattii (31.6%), while in adults 71.1% of infections were caused by C. neoformans, most HIV positive. The cases of death and recurrence were higher among patients infected with C. neoformans and the presence of sequelae was more frequent among patients infected with C. gattii. All isolates were MAT α and there was a predominance of two molecular types: VNI (64.4%) and VGII (35.6%). This study reinforces that the state of Pará is endemic to infection by Cryptococcus spp., Whose main clinical presentation, meningoencephalitis determines high rates of morbidity and mortality.Tese Acesso aberto (Open Access) Indução de escleróticas in vitro e análise da resposta imune dos pacientes de cromoblastomicose em tratamento com itraconazol(Universidade Federal do Pará, 2009-06-26) SILVA, Moisés Batista da; SALGADO, Claudio Guedes; http://lattes.cnpq.br/2310734509396125Chromoblastomycosis (CBM) is a chronic fungal disease witch affects the skin, characterized for slowing development of polymorphic skin, that present infiltrated inflammatory granulomatous in the presence of sclerotics cells, characteristic of this illness. One of the objectives of this study was to evaluate the induction of scleroticts cells for natural mediums, with biomasses of Bactris gasipaes and Theobroma grandiflorum, whose respective species had induced in vitro similar sclerotics cells to those found in tissue of patients, in 10 and 2 days, respectively, what it made possible the production of a powder medium inductor, already donated to other groups that study the CBM. Another objective was to evaluate the histopathology of the CBM in the patients, before and during the use of itraconazole (ITZ). For this, the technique of ELISA for the cytokines was used TNF-α, circulating IL-4 and IL-10, and the immunohistochemestry of biópsias in different times of treatment - that it allowed to analyze the quantitative and qualitative alterations of the cellular types during 12 months of the treatment with ITZ in the 200 dose of mg/dia - with antibodies anti- CD20, anti-CD8 and anti-CD68. How much the cytokines, the circulating IL-10 did not show significant change, while IL-4 and TNF-α had presented an increase of the levels throughout 12 months of treatment. In relation to the immunophenotyping, it had a significant reduction in the inflammatory process and the cellular infiltrated during 3 and 6 months of the treatment, whereas only to the 12 months had the significant regression of the number of sclerotics cells. The immunophenotyping disclosed that the macrophages are mainly located in the areas central areas of granuloma, whereas cells TCD8+ are in the periphery and cells TCD20+, which were found throughout the tissues, with a significant increase after 6 months of the treatment, returning to the initial levels after one year. The cytotoxic macrophages and lymphocytes were having presented a significant increase after 12 months of treatment with ITZ. These results demonstrate that the formation of granuloma in the CBM is similar to those observed in other granulomatous infectious disease, and that the presence of IL-4 and IL-10 can be related with the persistence of fungi in the injuries and with the difficulty of cure observed in these patients.Dissertação Acesso aberto (Open Access) Qualidade bacteriológica da água domiciliar e superficial na área insular do município de Belém(Universidade Federal do Pará, 2006) VALE, Elivam Rodrigues; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098The ambient sanitation is one of the most important ways of prevention of illnesses, but unhappyly it is not a reality in all the sectors of the population, generating a preoccupying situation for the professionals of Public Health. Problematic relative to the health and the environment reveals particularly important for the brazilian north region, where people inhabit the edges of rivers and igarapés with lack or even though, infrastructure of sanitation absence, being displayed to possible risks of contamination. In this study, of expedition descriptive character, were used quali-quantitative methods, aiming at bacteriological diagnostics of the water consumed for the marginal inhabitants of the region of the islands, more specifically in the islands of Paulo da Cunha (Grande island) and Murutucu in the agricultural zone of the city of Belém-Pará. 96 water samples stored in the residences and 80 superficial water samples had been collected in ten points located surrounding area of the islands. It was evaluated the number of Termotolerants Coliforms and Standard Counting of Heterotrofics Bacteria in the water stored for consumption, as well as Termotolerants coliforms, fecals Estreptococos/Enterococos and bacterial enteropathogens in the superficial water. In the Grande island the results disclose concentrations that had varied of 25 to 3600, 15 to 420 and 15 to 420, for termotolerants Coliforms, fecals Estreptococos and Enterococos, respectively, in relation to the Murutucu island these values had varied of 540 to 2600, 44 to 680 and 44 to 448, respectively for the same pointers. The presence of Salmonella spp was observed in 27,5% in Grande island and 12.5% in the Murutucu island. It was verified that 58.7% and 66%, of the water samples of consumption in the islands Grande and Murutucu, had been respectively considered improper for consumption, with presence of termotolerants coliforms. In relation to heterotrofics bacteria, 41.3% in Grande island e 15% in the Murutucu island had 500 more than UFC/mL. Considering itself the results gotten in the present work verify that the water used in the agricultural zones can function as a factor of risk to the human health that use it.
