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Acidentes ofídicos ocorridos no município de Santarém (PA) no período de 2000-2009
(Universidade Federal do Pará, 2012) SINIMBÚ, Valter Pinheiro; SOUZA, Givago da Silva; http://lattes.cnpq.br/5705421011644718
It surveyed the epidemiological profile of snakebites and risk factors associated with its incidence among residents of the municipality of Santarém (PA) and occurred in the decade of 2000-2009. Approaches the study with a descriptive-analytical methodology, observational and retrospective, with the use of a properly coded database, provided by the National Notifiable Diseases (SINAN) of the Ministry of Health. During the period, there were 2283 cases, accounting an annual incidence ranging between 70 to 105 cases / 100,000 population with a fatality rate of 0.66%. The accidents predominated in rural people (87%) in the months of Amazon rainy (January to June) in male patients (79%) aged 20-29 years. Almost all cases were treated at the emergency room of the county (88%) located in the urban area. Most patients (56%) came to the Health Unit 6 hours after the accident due to difficulties in access by geographic factors and river transport. Were classified as mild in severity (38%), moderate (55%) and severe (6%). Due to the frequency of species of snakes in the region, Bothrops accounted for the majority with 70.9%, followed by laquéticos accidents (11.3%) and more frequent in Amazonian forests, the crotalic (2.1%) and rare Micrurus (0.2%) and 15.3% in the species was not identified. In 91% of these patients the serum therapy was instituted. Unable to determine the occupancy of these patients, nor their level of education due to lack of completion of the case report forms. The lower limbs were the regions mostly affected (82%), which draws attention to the adoption of simple but effective preventive measures. Because of the high incidence of cases (the largest in Brazil), difficulties in patient access to prompt and effective care (increasing the morbidity and mortality), and little importance given by health professionals with regard to whether the information necessary for a better assessment and protection of the residents of this region, concludes that these accidents, although endemic in much of the world, particularly the tropics, remains, according to WHO definition, a problem neglected (by patients, professionals and society). There is need for more research, more ads and more awareness.
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Adolescentes rurais: comportamentos de risco para doenças crônicas não transmissíveis em um município do interior do estado do Pará
(Universidade Federal do Pará, 2019-03-15) OLIVEIRA, Victor Vieira de; ARAÚJO, Marília de Souza; http://lattes.cnpq.br/9371703949781020
Recent studies have demonstrated the epidemiological transition and the increased occurrence of Noncommunicable Chronic Diseases (NCD), especially among adolescents in less developed countries, and in those who live in poor areas. Although it is recognized that these diseases are more commonly perceived in adults, their manifestations are the result of the interaction of risk factors acquired at an early age. Therefore, the objective of this research was to identify the risk factors for NCDs in adolescents from the rural area of a town in the northeast of the state of Pará, Brazil, as well as to present the risk factors for NCDs through the following variables: physical activity, tobacco use, alcohol consumption, Body Mass Index, waist circumference and blood pressure, identifying the possible associations between these variables with the socio-demographic, socioeconomic conditions and with the behavioral and alimentary markers. An observational, cross-sectional epidemiological study was carried out on a representative sample of students of both sexes, aged between 15 and 19 years, enrolled in the regular high school of six public schools in the rural area of the municipality of Ipixuna-PA. The data were obtained through a questionnaire and clinical evaluation, being analyzed by means of explanatory analysis and univariate and multiple logistic regression, considering a significance level of 5% (p < 0,05) and a 95% confidence interval (CI). The sample consisted mostly of female individuals, with an average age of 17 years, who were insufficiently active, who had already experienced alcohol and tobacco, belonging to the most socially vulnerable strata and who had a poor-fiber diet, but rich in fats and sugar. The sedentary lifestyle was significantly related to the female sex, while the risk of altered blood pressure and tobacco experimentation were significantly related to the male sex. Socioeconomic conditions have been shown to influence mainly blood pressure increase, tobacco experimentation, and waist circumference, while older age has been shown to be a protective factor for abdominal obesity. Likewise, the consumption and experimentation of alcohol and tobacco showed to have their use combined, as well as the presence of abdominal obesity and overweight. Inadequate feeding, in turn, was associated with the greater risk of the adolescent being insufficiently active. This study makes clear the need for more effective public policies aimed at raising awareness of the need for a healthier lifestyle among adolescents in rural areas.
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Análise de série temporal da hanseníase no estado do Pará
(Universidade Federal do Pará, 2016) PINHEIRO, Helder Henrique Costa; ARAÚJO, Marizeli Viana de Aragão; http://lattes.cnpq.br/7849256617873180; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
Objective: Analysing a time series of new cases detected of Leprosy in the State of Pará, checking epidemiological trends according to the observated variables of the disease. Methods: Ecological observational design of detection historical series of Leprosy cases with use of secondary data from the National Notifiable Diseases System. The detection rates and the general variables in studies and estimated the trends of the time series were calculated. The State of Pará data were compared to the States of Mato Grosso State and Rio Grande do Sul. Results: The detection rate in Pará in 2014 was 4,84 per 10.000 inhabitants, with 32.177 cases detected in the period 2008-2014, estimating a trend annual growth rate of -12.71%. The proportion of children under 15 years of age was 10.4%, the largest in Brazil. Higher frequency of MB cases (65,2%) and Borderline clinical form (45,2%) was deteceted. Conclusion: The detection of new cases of leprosy is mainly in adult men, poorly educated and living in urban areas. The downward trend in case detection of the disease is different from stationary trend in the State of Mato Grosso. However, the trend of leprosy cases in children and adolescents in the State of Pará is stationary.
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Análise epidemiológica e caracterização parcial do gene F dos Metapneumovirus Humano detectados a partir de casos de infecção respiratória aguda na Região Norte do Brasil
(Universidade Federal do Pará, 2012-10-30) FERREIRA, Luís Edilson de Azevedo; MELLO, Wyller Alencar de; http://lattes.cnpq.br/1784167608719139; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Diseases of the respiratory tract are the main complaints in health care services, and acute respiratory infections (ARI) the most common manifestations, especially in children under five years of age. In developing countries the ARI are a serious public health problem. Throughout the world is estimated to occur in approximately 2 million deaths each year by ARI. Among the causative agents of ARI, we highlight the human metapneumovirus (HMPV), especially by causing severe illness in children under 5 years. Aiming to generate data on the molecular epidemiology of this virus, we analyzed samples taken from patients with ARI in the period January 2009 to December 2011 arising from the Northern Region (Pará, Amazonas, Acre, Amapá and Roraima). It was used the technique of real time PCR (qRT-PCR) to detect the virus by the N gene and RT-PCR for the gene encoding the F protein, which was then partially sequenced. Within the study period, were tested in 2966 samples, 129 of which were positive for HMPV. The age group of 0-4 years was the one that focused more cases (n = 84, 65.89%) across the North. The identification of viruses was found to co-circulation of subgroups A2 and B2 during the three years of the study. Subgroups A1 and B1 not circulated in the region during the study period. This study represents the first report of data on molecular epidemiology of Human Metapneumovirus in northern Brazil.
Acesso aberto (Open Access)
Análise espacial das condições ecoepidemiológicas para estabelecimento da Esquistossomose mansonica em duas áreas do Distrito de Mosqueiro, Belém-PA
(Universidade Federal do Pará, 2012) PEREIRA, Alba Lúcia Ribeiro Raithy; GONÇALVES, Nelson Veiga; http://lattes.cnpq.br/8811269146444725; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
The dynamics process of Mansonic Schitomiasis endemization is multifactorial, which sometimes retards it’s installation process, but also difficult the control of epidemiological surveillance. The Geo-technologies have brought contributions to the public health, creating thematic maps that make easier understand of dynamic population at space used, and their interrelationship with the water resources and with the sickness process. The proposal of this work was to identify through spatial analysis the eco-epidemiological factors related with the Mansonic Schitosomiasis endemization. It was achieved a descriptive study in two coverage areas from Family Health Strategy, Carananduba and Furo das Marinhas, In Mosqueiro District, Belém-PA, between 2010 and 2012, using geoprocessing Techniques like: Remote Sensing and Geographic Information Systems (GIS), through the tools: ERDAS 8.3.1 and ENVI 4.5, for classification of these satellites images, with the variables: Soil, vegetation cover and hydrography; The Global Positioning System (GPS) for georreferencing at study area and capturing collecting points of breeding sites; and ARCGIS 9.3.1 for manipulation and teatring of the Geographic Data Banks and Kernel estimation for identification of risk zones about high resolution satellite images and cartographic bases. Were analyzed, also, environmental and ecological data through geoprocessing techniques. The geo-technologic tools producing thematic maps of Family Health Strategic abrangency, the work routes, environmental classification, and the localization of breeding sites that generating seven agglomerated Kernel points that identified the risk zones of transmission aggravating in 3 boroughs of Carananduba Zone. This zone has been presenting antrophic characteristics due disordered human occupation and hydro siltation collections. The Furo das Marinhas area still keeps native forest and great quantity of hydro collections yet and not being found Biomphilaria. In both studied areas the structure of sanitation is insufficient, and isn’t still there focus active of transmission from Mansonic Schitosomiasis. However, could be a great vulnerability in a short time to happen this incidence at Caranaduba area. So, the geo-technologies applied have enabling a geographic information system that made feasible the diagnostic of risk on the process of Mansonic Schitosomiasis Endemization in more than one location in Para.
Acesso aberto (Open Access)
Análise multivariada de características clínicas de PET/MAH e níveis de expressão gênica e derivação de modelos de predição diagnóstica em pacientes infectados com o HTLV-1
(Universidade Federal do Pará, 2017) VIRGOLINO, Rodrigo Rodrigues; RODRIGUES, Anderson Raiol; http://lattes.cnpq.br/4030747999301402
Human T-cell lymphotropic virus type 1 (HTLV-1)- associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a debilitating condition resulting from inflammation of the nerve tissue of the spinal cord caused by the action of HTLV-1. The aim of the present study was to evaluate the classification of individuals infected with HTLV-1 and propose a clinical prediction model for the occurrence of HAM/TSP. A database composed of 63 infected individuals was used, 23 of whom were diagnosed with HAM/TSP using the criteria recommended by the World Health Organization. Functional predictors (ordinal variables), gene expression levels (continuous variables) and sex (demographic variable) were also used. A mixed principal component analysis was employed, followed by hierarchical cluster analysis to determine the allocation of individuals into groups in an unsupervised fashion and compare the results to the classifications defined by clinicians. Diagnostic prediction models were then derived based on penalized binary logistic regression, which is suitable when the sample size is small. The unsupervised analysis showed that the patients were arranged into three groups: patients with HAM/TSP, patients without HAM/TSP and an intermediate group composed of individuals with and without the disease. Two models were derived from the statistical modeling – one with a penalization criterion of 0.032 and another with a criterion of 0.1 (more extreme). Both models were evaluated by internal validation using 10-fold crossvalidation. The variables that composed the final models were degree of gait alteration, derived Tinetti score, left and right adductor muscle tone and left triceps surae muscle tone. Statistical prediction methods may constitute a useful tool to support the diagnoses of HAM/TSP, especially in settings with limited resources.
Acesso aberto (Open Access)
Apoptose de células inflamatórias e evolução clínica do Eritema Nodoso Hansênico: ensaio com Azatioprina
(Universidade Federal do Pará, 2008) OLIVEIRA, Miguel Saraty de; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Leprosy is a chronic infectious and contagious disease, affecting mainly skin and peripheral nerves, interrupted by outbreaks reaction, classified as Type I or reverse reaction and the reaction type II or erythema nodosum leprosum, usually accompanied by neuritis.Thalidomide and prednisone are widely used in treat ENL, but are not always fully effective, it needs to be investigate other immunosuppressive drugs to control the reaction. The phenomenon of apoptosis of inflammatory cells occurs in leprosy and ENL, but few studies correlating the phenomenon with clinical improvement or worsening of the ENL reaction are available. This report describes the occurrence of apoptosis of inflammatory cells and clinical progression of erythema nodosum leprosum before, during and after the use of azathioprine to treat ENL. The results obtained with 07 patients enrolled in the study indicate that the drug, azathioprine, is effective in treating cases of ENL difficult to treat. This drug may induce remission of ENL, as well as to further decrease the dose of prednisone in use.The phenomenon of apoptosis could be documented using the immunogold with caspase 3 in all cases. There was no significant variation seen between the number of cells highlighted with caspase 3 before and after treatment with azatioprina.No significant correlation between the number of cells highlighted with caspase 3 before and after treatment with azathioprine and clinical improvement shown could be demonstrated.
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Aspectos clínicos e epidemiológicos da infecção genital pelo Papilomavírus humano (HPV) em adolescentes da região metropolitana de Belém
(Universidade Federal do Pará, 2012-05-10) CAMPOS, Ana Carla Araújo; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973
Adolescence is a period of a woman’s life marked by biological and psychological transformations that intensely influence future health. These women are more susceptible to STD. HPV infection is one of the most frequent STD, it is important to evaluate its prevalence because its link to uterine cancer. This study evaluated the prevalence of the HPV genital infection in the adolescent female population in Belém. These data were correlate to sociodemographic factors including social conduct, and reproductive behavior. A transversal study was conducted between August 2009 and August 2011 with 134 women between 13 and 19 years of age who visited the Maternal Unit for Children and Adolescents of Belém for Pap screening tests. The selected patients answered a questionnaire on sociodemographic data, behavioral and reproductive. Cervicovaginal material was collected for conventional cytology and for DNA HPV test by polymerase chain reaction (PCR) technique. The association of HPV infection and selected risk factors was assessed using the chi-square 2χ and/or the Fisher exact test, all with an alpha level of 0.05. The HPV genital infection had a prevalence of 22%, HPV 58 being the most prevalent with 31% and the least common HPV 11 with 3.4%. Among the HPV positive adolescents, there were 51% HPV infections that were not included in the quadrivalent vaccine (6, 11, 6, and 18). 72,2% had infection with at least one of the HPVs in the high risk group. There were cytological changes in 6.2% of pap smears. Risk factors associated with genital HPV infection in this study were schooled for more than eight years, with first sexual intercourse after 14 years, use of oral contraceptives for more than a year, and current use of oral contraceptives, pregnancy at 14 years or less, and abnormal cytological findings. The study results showed the prevalence of high risk HPV in non-immune-preventable cervical samples, demonstrates the need for new policies for primary and secondary prevention involving adolescents through instruction and guidance thus motivating them to actively participate in promoting their own health.
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Aspectos clínicos e epidemiológicos da infecção pelo HTLV em usuários do Centro de Testagem e Aconselhamento do município de Santarém- Pará
(Universidade Federal do Pará, 2014) BARBOSA, Richelma de Fátima Miranda; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769
Acesso aberto (Open Access)
Aspectos clínicos, epidemiológicos, microbiológicos e terapêuticos da candidemia nosocomial em unidades neonatal e pediátrica em um hospital geral em Belém/ Pará
(Universidade Federal do Pará, 2006-06-13) PAES, Andréa Luzia Vaz; LEÃO, Raimundo Nonato Queiroz de; http://lattes.cnpq.br/2956764853618778; SOUZA, Rita Catarina Medeiros de
The fungals infections have been emerging as responsible for nosocomial infections, particularly when associates with morbities as prematureness, blood diseases, hospitable stay for more than 15 days, come in another. With the purpose of evaluating candidemia occurrence in patients of neonates and of the pediatrics put into hospital in public hospital in Belém / Pará, Fundação Santa Casa of Misericórdia from Pará (FSCMP), was accomplished a retrospective study having as investigation base all the cultures accomplished in hospital from January 1999 to December 2004. Of a total of 2.622 cultures, just five with C. albicans isolation of pediatrics and neonates patients. It is worth stress that it was not identified no other species of Candida. The children had between 0 until 9 months, and all of them were submitted for surgical procedures. Occurring other concomitant hospitable infections to candidemias. Among signals and symptoms introduced at the moment of the isolation of Candida note that respiratory disfunction and fever were the most frequent. Anemia and leukocytoses were the laboratories alterations predominant. Some risk factors for candidemia development were identified as antibiotics therapy, surgeries, blood transfusion, and use of blocking of H2, central veined catheter, probe pray-gastric. Among antibiotics used note that antibiotic of wide spectrum, like ceftazidime, imipenem, vancomycin, were used in most cases (4/5). The average time of hospitable stay belonged to 55 days, and three patient remained put into hospital in ICU. This work reflects a Candida's low isolation in children put into hospital in FSCMP, suggesting an improvement in the tests employees for mushrooms cultures.
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Aspectos epidemiológicos da infecção pelo vírus da hepatite C em populações ribeirinhas do estado do Pará, na Amazônia brasileira
(Universidade Federal do Pará, 2015-09-24) FECURY, Amanda Alves; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769
The hepatitis C virus (HCV) has large number of infected and may cause hepatocellular carcinoma. Its genetic material RNA presents six different genotypes (1, 2, 3, 4, 5 and 6) and subtypes, related by disease prognosis and response to treatment. The main route of transmission of HCV is the parenteral route, but the vertical and intrafamily transmission and is also reported. Drug use and needlestick share were characterized as risk factors for acquisition of infection and pathways are described and confirmed by literature. Less is known about viral transmission in remote or hard to reach communities such as riverside communities. This study aimed to determine the prevalence of viral infection, evaluate the serological profile and circulating genotype HCV, and trace the epidemiological characteristics, describing the main risk factors for acquisition of HCV infection that different riverside communities living in the State of Pará, in the Eastern Amazon, are exposed. The respondents answered a questionnaire to obtain epidemiologic information and blood samples were collected to carry out the serological, molecular, and genotyping tests. 1.277 samples were collected from Surrounding of the Tucuruí Hydroeletric, Pacuí, Hole of Maracujá and Nazário communities. Predominant age group 18-37 years old, female, married, low education, fishermen or açaí extractor, with up to 1 minimum wage. Respecting the particular characteristics of each local, consumption of alcohol and tobacco ranged between communities, as well as sharing the spiked material and cutting, the manicure kits, surgeries, hospitalization, presence of sexually transmitted diseases and if has any familiar with hepatitis. The Pacuí presented prevalence of HCV infection of 8,84 % having moderate prevalence of infection and Tucuruí was 2,25 %, close to the national average. The genotype 1 was found in 100% of Pacuí samples and 70% of Tucuruí samples, which possessed the remaining 30% of the samples belonging to genotype 3, following the pattern expected genotype distribution. In Maracujá Hole and Nazário Hole, there were no positive samples. The communities seem to have individuals who should be considered for the taking of public health measures, with increased risk of infection through drug use and the sharing of needlestick objects. The viral circulation have intermediate to moderate prevalence, with standard genotypic distribution similar to the Brazilian. The distribution of the infection and its features can vary within the country and even within their own regions, depending on the presence and viral circulation, in addition to the risk factors to which comunities are exposed.
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Aspectos epidemiológicos, clínicos e evolutivos da tuberculose em idosos de um hospital universitário de Belém - Pará
(Universidade Federal do Pará, 2016-02-29) CHAVES, Emanuele Cordeiro; SANTOS, Maria Izabel Penha de Oliveira; http://lattes.cnpq.br/9592128667013030; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163
Physiological changes, especially the immune, make the most vulnerable elderly to infections such as tuberculosis, a disease that this group is specific both in clinical presentation and in its therapeutic management. The objective was to evaluate the epidemiological, clinical and evolutionary aspects of tuberculosis in elderly patients at a university hospital in Belém - Para. It is a study of a retrospective cohort study, conducted at the University Hospital João de Barros Barreto, where 82 records were analyzed of cases of tuberculosis in elderly patients diagnosed from 2009 to 2013, and as a complementary way of obtaining information was obtained from the database of the National System for Notifiable Diseases of the State Department of Public Health. For statistical analysis we used the electronic program Statistical Package for Social Sciences (SPSS) version 22.0, and applied the test G, assuming level α = 0,05 (5%) and value P≤0,05. The study was approved by the Research Ethics Committee of the Tropical Medicine Center under Opinion No. 1.081.347. Most elderly were male (n = 53; 64,6%), aged 60-69 years, both among men (n = 34; 64,2%) and among women (n =13; 44,8%), with a statistically significant difference (p=0,009), new cases of tuberculosis (n = 78; 95,1%), with pulmonary clinical form (n = 62; 75,6%), associated diseases (n = 57; 69,5%) and length of stay greater than 21 days (n = 38; 46,3%). Fever (n = 55; 67,1%), dyspnea (n =53; 64,6%), weight loss (n =50; 61,0%), productive cough (n = 49; 59,8%) and chest pain (n=42; 51,2%) were the primary signs and symptoms evidenced. Regarding treatment, there was a high percentage of adverse events (n=41; 50%), especially gastrointestinal symptoms (n = 29; 70,7%). Most seniors evolved with cure (n = 49; 59,8%), but emphasizes that death from tuberculosis was considerable in the study group (n=13; 15,9%), mainly occurring during hospitalization up 7 days. As for the exposure variables and outcome for healing and death from tuberculosis, there was a statistically significant difference in the age range of variables (p = 0,017), length of stay (p = 0,000) and adverse reactions (p = 0,018). We conclude that the clinical presentation and therapeutic management of tuberculosis in the elderly is different, so it is necessary to strengthen strategies that facilitate early identification of TB suspects elderly in the community, which should take place mainly through Primary.
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Atenção em saúde aos casos de coinfecção hiv/hanseníase em uma área hiperendêmica para hanseníase na Amazônia
(Universidade Federal do Pará, 2016-07-01) ALBUQUERQUE, Nahima Castelo de; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
This study aimed to evaluate the primary health care to patients co-infected patients with HIV/leprosy in hyperendemic area for leprosy in the Amazon. This is a descriptive, exploratory study, evaluation of health services, with quantitative and qualitative approaches. They were interviewed twenty people diagnosed with HIV and leprosy who were followed up at the clinic of Center Tropical Medicine. It was used an adaptation of the assessment instrument of primary health care performance, containing sociodemographic and clinical informations, gateway, health services used, integration of care actions, Free Association of Words Test and stories of feelings related to the diagnosis of co-infection. The quantitative evaluation was conducted by the description of frequencies. Qualitative evaluation was categorized by the free association of data words according to the stimuli to HIV, leprosy and quality of health care. The results of the subjective questions of the interviews were analyzed based on thematic content. The study was approved by the Research Ethics Committee of the Center Tropical Medicine of Pará State University, under the CAEE Nº 49477115.1.0000.5172. It was identified a predominance of males, aged 40 to 59 years old, brown race, low socioeconomic level and derived from the city of Belem-Para. There was a predominance of patients diagnosed with Aids and antiretroviral therapy. In relation to leprosy there was parity between the clinical forms and, consequently, of paucibacillary and multibacillary cases. Regarding the health services used, coinfected patients were attend essentially by specialized services and have no link with the PHC. Unfamiliarity has been observed about the health services available in the network. In interpreting evocations and discourses prevail speeches related to feelings of death, fear, sadness, concern and questions related to diagnosis of HIV and leprosy. About the changes in daily life, stand out the inability to work and the largest health care. The results shows the need for strengthening PHC in the context of public policies for HIV/Aids and leprosy control, to make it the main gateway for patients, regardless of cases of co-infection, ensuring access on a expanded health perspective. We conclude that despite the satisfaction of users and the services provided in secondary care, the current health care model does not consider the singularities co-infection users of HIV/leprosy.
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Avaliação antropométrica e a concentração plasmática de dapsona em pacientes com hanseníase na cidade de Belém-Pará
(Universidade Federal do Pará, 2011-08-31) MOURA, Fernanda Maria Lima; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098
Hanseniasis is a serious problem of public health in the state of Pará, with high incidence and prevalence rates. This paper aimed to evaluate the nutritional status of patients bearing multibacillary hanseniasis relating them to their plasma concentration of dapsone. It is a transversal epidemiological study performed with 29 individuals of both sexes with multibacillary hanseniasis referred to the Ambulatório do Núcleo de Medicina Tropical da Universidade Federal do Pará. Social-demographic, anthropometric, plasma concentration of dapsone and use of prednisone indicators were evaluated. It was evaluated the nutritional status through the body mass índex and percentage of body fat. Plasma determination of dapsone was performed through high efficiency liquid chromatography. Other data were obtained through a semi-structured interview form which was answered by the patients. The results have pointed out that most patients were male, average age of 41.73 (±13.14) and living in the municipality of Belém (58.6%).They have lived into an unfavorable social situation, minimum wage family income (65.6%) and low schooling to the elementary level (51.7%). The nutritional status, according to the body mass index has indicated that 48.3% of the patients were eutrophic. However, 51.6% presented overweight and 13.8% out of them were obese. As for the percentage of body fat, 48.3% were obese. It was observed that 37.9% of the patients have already presented a hansenic reaction, with predominance of type 1 reaction (RR) and 34.5% used prednisone. From the patients using prednisone, 60.0% were overweight and 50.0% were obese, according to the body mass index and percentage of body fat, respectively, though without any statistical significance (p>0.05), when compared to the ones who did not. The plasma average concentration of dapsone in the patient was 0.56 μg/mL. As for the body mass index, it was verified that as the weight of the patient raised, the plasma concentration of dapsone reduced. Eutrophic, pre-obese and obese patients presented plasma concentrations of 0.56 μg/mL, 0.54 μg/mL and 0.44 μg/mL, respectively. Considering the percentage of body fat, it was observed that the average plasma concentration of dapsone was 0.54 μg/mL in eutrophic and obese patients. It was not evidenced any statistical significance between the plasma concentration of dapsone and the nutritional status (p>0.05). Conclusion: The nutritional status did not interfere in the plasma concentration of dapsone, independently from the nutritional parameter, body mass index or percentage of body fat used as well as the use of prednisone was not related to the gain of weight.
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/1799493244439769
The 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.
Acesso aberto (Open Access)
Avaliação da vulnerabilidade do potencial de endemização da esquistossomose mansônica no Distrito de Mosqueiro Belém, Pará
(Universidade Federal do Pará, 2014) PINTO, Sônia Claudia Almeida; PINHEIRO, Maria da Conceição Nascimento; http://lattes.cnpq.br/6353829454533268; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Schistosomiasis mansoni (SM) is an endemic parasitic disease that occurs in at least 74 countries with illness of 25 million people, including Brazil. It is related to socioeconomic and environmental factors, with emphasis on migratory movements that contribute to the spread of this disease. In northern Brazil only the state of Para has focus of this disease, the main in the city of Belem.The urban sprawl through the occupation of peripheral areas of the metropolitan area of Belem has generated significant social and environmental impacts, reaching areas of environmental preservation.From an ecosystemic perspective, the study assessed the possibility of expansion of SM in the insular area of the one administrative districts of Belem, in Mosqueiro (DAMOS), where there was the environmental characterization, malacological, parasitological and population surveys. Georeferencing techniques were used for spatial analysis of the study area, interview questionnaire at home and collection of material for parasitological examination. The approach adopted for determining the sample size calculation was based on the territory coverage of the family health strategy of the Belem Municipal Health Department. Thus, was realized the zoning of the study area, where Biomphalaria sp. breeding places were found. And was adopted a 50m radius buffer (north, south, east, west), from each breeding. Inside this area size, with the help of GPS technology, has set up a sample of 491 households with an estimate of 5.31 residents per household, with the exclusion of closed or abandoned households obtained the sample of 283 households for visitation with 421 participants. It was necessary to create the schistosomiasis vulnerability index (SVI) for better information with regard the interpretation of the data. The results showed that the DAMOS presents all environmental and population characteristics of the different endemic areas of Brazil; the malacological survey identified 30 breeding of planorbids; presence of the species B. straminea not infected with S. Mansoni; very low sewage network coverage, water and increase the migratory process in disordered occupation areas with populations from endemic areas for SM.The majority of study participants reside in areas considered of medium vulnerability, however 16% are in areas of high vulnerability; the area of Carananduba was considered the highest susceptibility and increased risk potential for entry of SM in Mosqueiro district.The spatial analysis of vulnerability to schistosomiasis in the study area, has led not only support the hypothesis of endemicity of SM in DAMOS, but to show where the first outbreak may occur, what and where the major risk factors are.This study may help in the management processes in public health with the implementation of preventive measures of health education, epidemiological and environmental surveillance.
Acesso aberto (Open Access)
Avaliação das funções neurológicas do hanseniano: a queixa clínica e os achados sensitivo-motores em membros superiores e inferiores
(Universidade Federal do Pará, 2016) BORGES, Mariana Garcia Lisboa; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Although curable, leprosy is still a major public health problem. This is a chronic infectious disease caused by Mycobacterium leprae and characterized by dermatological and neurological involvement. If not treated, this disease can lead to serious disability. The evaluation of the neurological function of the patient is very important for the early dignosis and treatment of nerves damage. The exams in neurological evaluation of leprosy are too subjective. This study, worrying about the consistency of neurological evaluation in showing in a reliable manner the situation of patients, aims to correlate the clinical complaints from leprosy patients with sensory and motor findings in upper and lower limbs. For this, an analytical cross-sectional study was conducted in two steps. The first stage included 97 leprosy patients treated at the service between the years 2014 and 2015, in them was applied the simplified neurological evaluation, which was made the examination of nerve palpation, voluntary muscle strength test, tactile sensitivity test at hand and feet with Semmes-Weinstein, in addition to the collection of clinical complaints. For the second stage were randomly selected 14 patients who were submitted to surface sensitivity tests (thermal, painful and tactile) in the path of the most commonly affected nerves. Data analysis was performed using the chi-square test, G test and t test, when relevant to the comparison with the population or between groups. For correlation ordinal variables the Spearman correlation test, considering the alpha significance level of 0.05. Of the 97 leprosy patients, 77 (79.4%) had complaints, the most common being those related to sensory fibers, including pain and numbness were the most mentioned. On palpation, the ulnar nerve and tibial were the most affected and multibacillary patients had higher averages of affected nerves and most sensitive damage. Engine damage was not very common among patients, but low levels of muscle strength found were related to higher sensory damage stages, higher degree of disability and greater amount of affected nerve. When compared to the occurrence of complaint, the complainants patients had more advanced stages of sensory damage, higher degree of disability in the lower limbs and motor damage occurring more frequently, but the type of complaint did not influence these results. In the evaluation of the surface sensitivity in the nerve pathway, there was a higher incidence of sensory changes also among the plaintiffs, and the heat the most affected. It is clear, then, that the complainants patients are more sensitive to sensory and motor damage, the high degree of disability, and the sensitivity of changes in nerve path. Therefore, health professionals should be alert to this patient group, allocating more attention at the time of evaluation in order to avoid the dreaded disabilities.
Acesso aberto (Open Access)
Avaliação do grau de melhora da força de preensão palmar, por meio do dinamômetro Jamar®, em pacientes em tratamento para neuríte hansênica nos membros superiores
(Universidade Federal do Pará, 2011-11-08) FRAZÃO, Rogério Augusto Mendes; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Leprosy is a disease that causes important social consequences for resulting from nerve damage, leading a contingent of people with deformities and unable to perform activities of daily life and work. In order to assess the degree of improvement in hands force (FPP) using the JAMAR ® dynamometer in patients with leprous neuritis in the use of corticosteroids, there was designed a case series study, consisting of a sample obtained for convenience of 20 patients with acute leprous neuritis, treated as outpatients and the Center for Tropical Medicine (NMT), Federal University of Pará, where the first measurement was performed the day of diagnosis and early treatment for neuritis and the second measurement thirty days after the first evaluation. The ulnar neuritis was prevalent and the FPP values in non-dominant hand had an average of 20.25 ± 13.16 kgf. And 18.50 ± 11.70 kgf. in the first and second measurement respectively. In leprosy patients with neuritis, FPP was reduced compared to the average population (in males obtained 79.86% and 86% of the reference values, the dominant and nondominant hands respectively. In females the values 53.49% and 65.05% in the dominant and nondominant hand, respectively). With respect to leprosy reaction, it was observed that the type I leprosy reaction was obtained force values of 27.40 ± 9.57 kgf. in the dominant hand and 32.40 ± 8.21 kgf. in the non-dominant hand in the first measurement. In the second measurement were recorded average values of 30.90 ± 12.90 kgf. in the dominant hand and 34.00 ± 9.29 kgf. in the non-dominant hand. The type II leprosy reaction presented with values lower grip strength, although not significant (p ≥ 0.06). Patients who had an improvement in neuritic expressed by the regression of pain showed a significant increase in grip strength in dominant hand (p <0.02) Thus we conclude that the PPF can collaborate in the monitoring of patients with leprous neuritis in use of corticosteroids, but further studies should be conducted to obtain information to assist its use.
Acesso aberto (Open Access)
Avaliação do risco cardiovascular em pacientes com lipodistrofia secundária a terapia antirretroviral: critérios de framingham, índice tornozelo-braço e medida da espessura da camada medio-intimal da carótida
(Universidade Federal do Pará, 2011-12-16) KOURY JUNIOR, Adib; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
The use of combination antiretroviral therapy has significantly reduced mortality and morbidity in patients infected by HIV virus. However, this treatment may cause metabolic alterations such as dyslipidemia, glucose intolerance, insulin resistance and lipodystrophy. The clinical and laboratorial consequences that follow these alterations may raise the risk for cardiovascular diseases. This research aimed to investigate the epidemiological, clinical and laboratorial aspects of patients with lipodystrophy associated to raise cardiovascular risk, ankle-brachial index (ABI) and measurement of the carotid intima-media thickness (cIMT). For so, it was performed a Transversal analytical study with 62 patients with lipodystrophy using highly active antiretroviral therapy (HAART) with ages varying from 29 to 68, followed up in the outpatient unit of lipodystrophy of João de Barros Barreto University Hospital. The patients were submitted to anamnesis with clinical examination, blood collection for laboratorial tests with glycemia dosage, total cholesterol and its fractions, triglycerides and ultrasensitive PCR, measurement of the ankle-brachial index and measurement of the carotid intima-media thickness through mode B ultrasonography. The patients were classified according to their cardiovascular risks through the criteria of the Framingham Score. The variables were analyzed by the study of the measurements of central trend and the hypotheses were analyzed by the chi-square Test and/or the Fisher exact Test. The prevalence of alteration of the ABI in the studied sample was 21% and of the patients with a increase of the cIMT was 48.4%. According to the Framingham score, 53.2% of the patients presented low risk to a cardiovascular event in a 10 year range, 16.1% of moderate risk and 30.7% of high risk. A patient with a increase of the cIMT presented a larger cardiovascular risk through the Framingham score. Male, age, increase of the abdominal circumference have presented a significant association with the carotid intima-media thickness cIMT.
Acesso aberto (Open Access)
Avaliação dos fatores de risco associados à transmissão do HTLV-1 e do HTLV-2, em doadores de sangue, na cidade de Belém do Pará
(Universidade Federal do Pará, 2006-04-10) LOPES, Bruna Pedroso Tamegão; LEMOS, José Alexandre Rodrigues de; http://lattes.cnpq.br/0820294977759092
In order to define the epidemiological profile of the Human T-cell Lymphotropic Virus (HTLV-1 and HTLV-2) among inapt blood donors population, at the HEMOPA Foundation, in Belém, state of Pará, we analyzed 113 epidemiological forms, related with risk factors associated with these retrovirus transmission, among carriers and noncarriers of HTLV. We observed that 76% (n=50) of the inapt blood donors were infected by HTLV-1 and 24% (n=16) by HTLV-2; 62% (n=70) of the carriers were male and 38% (n=43) were female, with a tendency of infection in this gender (p=0,007). The risk factors which exhibited significant results were: have received blood transfusion (p=0,0003), more specifically to HTLV-2 (p=0,02); have been breastfeeding from non-mother (p=0,006), more specifically to HTLV-1 (p=0,04); have been submitted to surgery (p=0,01), discriminately to HTLV-1 (p=0,03) and HTLV-2 (p=0,04); share blades/shavers (p=0,02), more specifically to HTLV-1 (p=0,02); do not use condoms during sexual intercourse (p=0,0003), discriminately to HTLV-1 (p=0,001) and HTLV-2 (p=0,002). Despite of the diverse stages existing in the process of selection of blood donors, which the main objective is to eliminate potentials candidates carrying transmissible blood diseases, in special of chronic and asymptomatic course, exist bias that disable an exempt process of fails.