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Teses em Doenças Tropicais (Doutorado) - PPGDT/NMT

URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3560

O Doutorado Acadêmico em Doenças Tropicais iniciou em 2007 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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Acesso aberto (Open Access)
Avaliação dos marcadores de injúria miocárdica induzida pela exposição ao metilmercúrio em modelos experimentais de primatas do novo mundo (Cebus Apella)
(Universidade Federal do Pará, 2009-07-10) MAGNO, Ismaelino Mauro Nunes; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
This study aimed to examine effects of the mechanisms of injury producing cellular damage in the heart of the monkey Cebus apella exposed for 120 consecutive days, with daily dose of 1.5 methyl Hg, by changes detected in biochemical markers of myocardial injury CK - MB, the histopathological findings as well as the technique of immunolabeling of apoptotic cells. For that, we related to the serum profiles of CK-MB, total CK, AST, ALT, urea, creatinine and total bilirubin with the histopathological and immunohistochemical findings in the involvement of the heart muscle during exposure to methyl Hg, and compared with a control group. The method used for determination and analysis of the serum and the determination of mercury in blood was the kinetic ultraviolet; atomic absorption spectroscopy, respectively; for histopathological analysis used the technique of Hematoxylin and Eosin; and for detection of apoptotic profiles the method APOPTAG. Was obtained information that correlate the biochemical changes, histopathologic profiles and apoptotic mechanism of cardiac involvement in three animals exposed to methyl Hg, when compared with control group. Among all substances of biochemical analysis were found that there was only marked increase of serum CK-MB enzyme, whereas, the histopathologic analysis showed reversible cell damage by accumulation of water in the three organs examined (heart, liver and kidney). It is also the observation of a clear labeling of apoptotic cells in heart, liver and kidney tissues of exposed animals, showing a higher number of positive cells in cells of renal tubules. Emphasizing that there was no inflammatory infiltrate around these tissues described and analyzed, and was there absence of such lesions in tissues of three control animals. It was concluded that the enzyme CK-MB, the hydropic degeneration and the mechanism of apoptosis may be indicators of myocardial injury in acute exposure to methyl Hg whose pathogenesis could be related to mitochondrial decompensation because massive commitment of the Na + / K + and Ca + + pumps. Requiring a greater intake of experimental studies that can clarify the exact pathogenesis, the mechanism of cellular injury and aggression in individuals exposed to toxic doses of methyl Hg.
Acesso aberto (Open Access)
Epidemiologia da infecção genital pelo Papilomavírus humano (HPV) em população urbana e rural da Amazônia Oriental Brasileira
(Universidade Federal do Pará, 2010-04-19) PINTO, Denise da Silva; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
The main cause of the development of precursor lesions and neoplastic processes in the uterine cervix is the genital infection by human papillomavirus (HPV). Cervical cancer is the second largest cause of cancer death among Brazilian women, It is one of the major causes of morbidity and mortality of women in north of Brazil indeed. This research aimed to investigate the epidemiology of genital infection by human papillomavirus (HPV) in women from rural and urban population from two distinct regions of the Western Brazilian Amazon. A Transversal analytic study was taken with 444 females between 13 and 74 years who were volunteers in a preventive examination for cervical cancer, 233 women from an urban primary care unit in Belem Para and 211 women from the right and left side of the Tucurui Lake in Para. It started in January 2008 until March 2010. Uterine cervix samples were collected for a conventional Pap Smears examination and for the detection the DNA of HPV by polymerase chain reaction (PCR) using the universal primers MY9/11. A hundred percent of the volunteers answered a clinical and epidemiological questionnaire. In order to better analyze the epidemiological association between the risky factors and infection by HPV. The samples were divided in three different age groups. Being derived odds ratio of prevalence (ORP) 95% of IC, with its significance verified using the qui-square of Pearson or Fisher exact test, and the final use of multivariate logistic regression model. Among the 444 volunteers, the massive prevalence of genital HPV infection was 14.6%, ranging between 15.0% for the urban sample and 14.2% for the rural ones. The most affected age group was between 13 to 25 years (17.9%), both in the urban sample (19.0%) and rural (17.2%). HPV DNA was found in 13.6% of women with normal cytology and in 41.6% of those with abnormal cytology, this result was more significant for the urban volunteers of the study aged between 26 to 44 years old. Cytological abnormalities, early onset of sexual activity, marital status, number of sex partners recent or old, a premature use of oral contraceptives and condoms, STI’s and genital symptoms, the current smoking in taken, are factors that were associated with genital infections by HPV differently in the three age groups between urban and rural samples of the western Brazilian Amazon.
Acesso aberto (Open Access)
Análise molecular dos genes VP4, VP7 e NSP4 de rotavírus do tipo G1 circulantes em Belém e Marituba, Pará, Brasil, de 1982 a 2008
(Universidade Federal do Pará, 2011) SOARES, Luana da Silva; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435; LINHARES, Alexandre da Costa; http://lattes.cnpq.br/3316632173870389
Rotaviruses are major viral agents of acute gastroenteritis and responsible for 36% of hospitalization for diarrhea among children less than five years of age, resulting in 453.000 deaths annually, mostly in developing countries. Rotavirus is a member of Reoviridae family, and its genome consists of 11 double-stranded RNA (dsRNA) which encode 12 proteins. G1 rotavirus is commonly detected in epidemiological investigations, occurring under different prevalence rates. The aim of this study was to analyze the VP4, VP7 and NSP4 diversity genetic of G1 rotavirus circulating in Belém and Marituba, Pará, Brazil, from 1982 to 2008. We selected 83 samples previously characterized as G1 type and submitted to RT-PCR. The samples were from seven studies conducted in IEC. It was possible amplification for 63 (75.9%) specimens. Lineages 1 (8/63, 12.7%), 2 (29/63, 46.0%), 3 (18/63, 28.6%) and 9 (8/63, 12.7%) of VP7 gene were detected. The sublineages 2E and 3A were co-predominant detected in 57.1% (36/63) of samples. Three amino acid substitutions (97 [D→E], 147 [S→N] and 218 [I→V]) were observed in VP7 antigenic regions (A, B and C) in samples of 1, 2 and 9 lineages. All samples showed P[8] specificity for VP4 gene and lineages 2 (21/63, 33.3%) and 3 (42/63, 66.7%) were detected. Two substitutions (35 [I→V] and 38 [S→G]) occurred in antigenic region of VP4 of samples analyzed. For NSP4 gene, all samples belonged to E1 type. Phylogenetic analysis of NSP4 gene revealed that occurred changes in nucleotide positions 47 (C→T) and 101 (T→C), resulting in amino acid substitutions at positions 16 (S→P) and 34 (L → P) in all samples and 9 specimens displayed amino acid substitution in NSP4 toxicity residue (aa 131). This study allowed us to broaden our understanding about genetic diversity and circulation of G1 variants and represents the first molecular epidemiology analyze of this genotype in Brazil corroborating the high heterogeneity of this genotype.
Acesso aberto (Open Access)
Soroprevalência para arboviroses humanas de interesse em saúde pública como marcador de impacto ambiental em comunidades ribeirinhas que vivem sob a influência da usina hidrelétrica de Tucuruí-Pará
(Universidade Federal do Pará, 2011) BRITO, Mioni Thieli Figueiredo Magalhães de; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
The arboviruses are a major public health problem in Brazil, especially in the Amazon for its ability to cause epidemics with considerable rates of morbidity and mortality in both humans and animals. Four, Virus dengue (VDEN), Virus yellow fever (VYF), Virus Mayaro (VMAY) and Virus Oropouche (VORO) has special relevance for the region, particularly in those environments where environmental impacts are imminent. Studies on the prevalence of antibodies to arboviruses in this region are limited. This study aimed to estimate the prevalence of antibodies to arboviruses of the major public health concern in the communities that live under the influence of the Tucuruí dam in the state of Pará. The study was observational, cross-sectional analytical study carried out in individuals of both sexes, aged over 18, resident at the left and right margin of the lake Tucuruí power plant and from the RDS and Alcobaça Pucurui-ararão. The collection of blood samples and filling in the questionnaire were performed at two different times, flood and ebb of the lake. All samples were analyzed by the Evandro Chagas Institute where they were tested with hemagglutination inhibition for detection of antibodies against 19 types of Arboviruses and MAC-ELISA test for detection of IgM antibodies. Data analysis was descriptive and analytical, are used to calculate odds ratio with confidence interval 95% to determine the association between the study variables and chi-square or Fisher exact test to verify the significance statistical relationships between the variables of the study with an alpha level of 0.05. In all, 635 individuals were studied and the antibodies to arboviruses was significantly associated with sociodemographic characteristics of individuals such as sex, ossupation and residence time in study area. No association was found between the presence of antibodies arboviral and other traits.
Acesso aberto (Open Access)
Associação do polimorfismo do gene humano NRAMP1 na susceptibilidade/resistência para hanseníase em áreas endêmicas do estado do Pará
(Universidade Federal do Pará, 2011) SILVESTRE, Maria Perpétuo Socorro Amador; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
Leprosy is a public health problem in the Pará state and a challeng for the Control Programs that aim strategies improvement to elimination of this disease between us. The agreement of the genetic and immunology mechanism to explain maintenc endemic disease can be one of the alternatives for problem resolution. The human gene for natural resistance associated macrophage protein – NRAMP1 is expressed in macrophages and seems to be involved with influence cellular immune responses to mycobacterium leprae infection. We evaluated the polymorphism association of this gene as reported by Buu et al (1995) with leprosy “per se” and clinical forms according to the anti-PGL-1 levels in the population studied. A total of 122 leprosy patients and 110 individual healthy coming from endemic municipalities in Para were genotyped for the polymorphism of NRAMP1. Association was found with leprosy “per se” (p=0.0087) and 3’ untranslated region with insertion/deletion of four base pairs was significantly associated with multibacillary (p=0.025) compared to contacts not cosanguineos. Heterozygotes and haplotypes with four base pairs deletion were more frequent among multibacillary than paucibacillary. The NRAMP1 gene haplotypes seem to have important influence on leprosy clinical presentation also revealed by Mycobacterium leprae anti-PGL-1 positively.
Acesso aberto (Open Access)
Interferentes bio-sócio-ambientais na exposição ao mercúrio em crianças ribeirinhas de diferentes regiões da Amazônia
(Universidade Federal do Pará, 2011-06-27) AMORAS, Walter Wanderley; SILVEIRA, Luiz Carlos de Lima; http://lattes.cnpq.br/9383834641490219
The present study examined possible bio-socio-environmental factors interfering in mercury exposure in children riverside. 103 children participated in the regions of the Tapajos and Acará Rivers and Marajó Island. The type of study was performed cross-sectional analysis. Hair samples were collected for analysis of the Hgtotal levels, blood (hemoglobin and hematocrit analysis) and faeces. Anthropometric indices were used to analyze children's growth. In the evaluation of psychomotor development test was applied modified Denver II screening. The highest average of Hgtotal levels in hair samples of children was in the Tapajós region (5.58 mg / g) and 0.65 g / g in other locations. The prevalence of Hgtotal> 10 mg / g was 25% and 7.5% in São Luiz do Tapajós and Barreiras. Daily consumption of fish by the families of the children as it relates to levels of Hgtotal p (value) was <0.05. The prevalence of breastfeeding duration in the groups of children under 12 months and greater than 6 months for locations in the Tapajos River, when Hgtotal related contents in hair of children with p (value) <0.05. The prevalence of anemia in the Tapajós region was 46.7% and when related to Hgtotal levels p (value) <0.0001. The parasitological tests indicated that 68.3% were multiinfested frequent when related Hgtotal p (value) <0.05. The profile of growth observed through the nutritional indicators status was 82.6% normal weight for age and 14.5% with very low weight and low. Psychomotor performance assessed by the Denver II screening test had changed five children as suspicions of developmental delays. It was concluded that in locations around the gold mining activities riverine children are at risk of mercury contamination. Bio-social- environmental factors interfering in exposure to mercury such as daily consumption of fish, length of breastfeeding, anemia, intestinal parasites showed significant statistical relationships with Hgtotal in the children's hair.
Acesso aberto (Open Access)
Análise proteômica da resposta ao arsênio e do exoproteoma de Chromobacterium violaceum
(Universidade Federal do Pará, 2011-07-06) CIPRANDI, Alessandra; SILVA, Artur Luiz da Costa da; http://lattes.cnpq.br/7642043789034070
Chromobacterium violaceum is a Gram-negative beta-proteobacterium found in tropical ecosystems and it is an opportunistic pathogen for animals and humans. C. violaceum infection is associated with a high mortality rate, but little is known about the molecular basis of pathogenicity mechanisms. As an environmental microorganism, C. violaceum is exposed to diverse external conditions, which require great adaptability and effective protection systems. C. violaceum possesses an arsenic resistance operon arsRBC. Arsenic is a toxic metalloid associated with skin lesions, neurological diseases and cancer. The aim of this study was to investigate changes in protein pattern in presence of arsenite and characterize secreted proteins of C. violaceum ATCC 12472. The proteins from C. violaceum were analyzed by twodimensional electrophoresis and mass spectrometry. Proteomic analysis revealed that arsenite induces an increase of proteins involved in oxidative stress response, DNA repair and energetic metabolism. Among the secreted proteins were identified virulence factors (metallopeptidases, collagenase and toxins), transporters, and proteins involved in stress response and potentially useful. The results show novel insights into the adaptive response of C. violaceum.
Acesso aberto (Open Access)
Caracterização da resposta imune citocínica na infecção humana pelo vírus oropouche e sua relação com o padrão de soroconversão e a presença de sintomas
(Universidade Federal do Pará, 2011-12-19) OLIVEIRA, Euzébio de; VASCONCELOS, Pedro Fernando da Costa; http://lattes.cnpq.br/0973550817356564
This thesis is the first global study that researches and analyzes the immune response of cytokine in human infections by Orthobunyavirus Oropuche virus. The study used 320 samples of human serum. Sixty were from the Blood Bank (negative control) and 260 were obtained from two outbreaks of the Oropouche virus in the State of Pará and Amapá (Brazil). The latter was divided into 8 subgroups for better data accuracy. The collected samples were analyzed for clinical data/symptoms with serologic testing by titration of antibodies by the hemagglutination inhibition (IgM/IgG) and the detection cytokines plasma levels by flow cytometry. This allowed for the technical description of cytokine. The data obtained allowed for the observation of the characteristics and the behavior of the cytokines signatures expressed by patients by the presence or not of the virus. This also allowed for the observation of changes to serum through the presence of specific symptoms such as fever, chills, headache and dizziness. This led to the following conclusions a) there is a pattern in the synthesis of pro-inflammatory and regulatory cytokines; b) there is a balance in the profile of the immune response between pro-inflammatory cytokines (Th1) and modulators (Th17); c) an infection by the Oropouche virus alters the production of cytokines in individuals; d) the results also show that whem comparing individuals no responders with early responders, there was an increase of IL-1β and decreased IL- 12; no responders with late responders, there was a decrease of IL-8, and increased IFN-α, IL-23 and IL-17; No responders occurred early responders compared with the increase IL-4 and IFN-g; However, when compared early responders and late responders, decreased IFN-α and IL-6; early responders generally showed a decrease in IL-10 and late responders showed an increase in IL-5; e) The results also show the expression of IL-5 in patients who showed symptoms specific for Oropouche infection (fever, chills, headache and dizziness), suggesting this signal to be directly associated with pathogenesis of the virus; f) there is a need to complement this research with more studies such as those related to the expression of chemokines.
Acesso aberto (Open Access)
Perfil de anticorpos anti-pgl-1 em indivíduos sadios de áreas endêmicas em hanseníase do estado do Pará, método de Elisa
(Universidade Federal do Pará, 2012) CUNHA, Maria Heliana Chaves Monteiro da; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Acesso aberto (Open Access)
Avaliação do polimorfismo genético das apolipoproteínas A1 e A5 em pacientes HIV positivos com síndrome lipodistrófica no estado do Pará
(Universidade Federal do Pará, 2012-06-13) DUTRA, Claudia Daniele Tavares; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
Introducion: Dyslipidemia is one of the metabolic changes caused by using antiretroviral therapy (ART) in HIV patients with lipodystrophy syndrome. Objective: To evaluate the genetic polymorphisms of apolipoproteins A1 and A5 in HIV patients with lipodystrophy in use of antiretroviral therapy and its association with dyslipidemia. Methods: It´s a cross-sectional and analytical study. We used a research protocol which studied conditions sociodemographic, clinical risk factors (physical activity, smoking, drinking, food frequency) for dyslipidemia, and biochemical assessment of the apolipoproteins A1 and A5 polymorphisms. Results: Of the 105 HIV-positive patients studied, 63.8% were men, mean age of 44.5 (± 9.4) years, 70.5% reported being single and having a family income of up to three minimum wages (77,1%). The risk factors were: smoking (21%), alcohol use (43.8%), physical inactivity (69.5%), diabetes mellitus (16.2%), overweight (22.9%) and cardiovascular risk (39.1%). The most prevalent form of lipodystrophy syndrome was mixed (51.4%). Food frequency intake observed of fruits (60.8%) and vegetables (36.3%), milk and dairy products (75%) were daily. While candy and sweets (31.4%), sausages (11.7%) and fatty snacks (26.4%) were more than twice a week. And the habit of eating meat with fat apparent was common (56.9%). The observed dyslipidemia classification revealed most patients with isolated hypertriglyceridemia (30.5%) and mixed hyperlipidemia (32.4%). It was observed that the isolated hypertriglyceridemia associated with the apolipoprotein A5 gene (rs3135506, rs619054 and rs662799), and not being influenced by clinical forms of lipoatrophy. There was no presence of the apolipoprotein A1 polymorphism (Lys107-0must2) in the patients studied. Conclusion: The main factors for hypertriglyceridemia were being man and had apolipoprotein A5 gene polymorphisms (rs3135506, rs619054 and rs662799).
Acesso aberto (Open Access)
Detecção, epidemiologia e análise molecular de rotavírus, picobirnavírus e reovírus em aves de corte criadas em granjas na mesorregião metropolitana de Belém, Pará, Brasil
(Universidade Federal do Pará, 2012-08-29) SILVA, René Ribeiro da; SILVA, Artur Luiz da Costa da; http://lattes.cnpq.br/7642043789034070; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435
This study aimed to investigate the occurrence of avian rotavirus (AvRV), picobirnavirus (PBV) and avian reovirus (ARV) in chickens raised on farms located in the Metropolitan mesoregion of Belém, Pará state, in the period of 2008 to 2011. For this purpose, 85 pools of fecal samples were collected from 37 farms belonging to eight counties. Viral RNA was extracted from fecal suspensions and subjected to polyacrylamide gel electrophoresis (PAGE) followed by RT-PCR. At least one sample was selected of each municipality wich positive result for nucleotide sequencing of the genes NSP4 (AvRV), RdRp (PBV) and S2 (ARV), and in the case of the PBV samples were cloned before sequencing. PAGE showed positive in 0/85 (0%) samples for AvRV group A, 13/85 (15.3%) samples for PBV and 01/85 (1.2%) samples for ARV. In the case of RT-PCR positive results was observed in 35/85 (41.2%), 42/85 (49.4%) and 28/85 (32.9%) of the samples for AvRV, ARV and PBV, respectively. Of the eight counties studied, seven showed positivity to PBV, and six for AvRV and ARV. Of the 37 farms studied the presence of these viral infections was observed in 19 (51.4%) to AvRV and ARV and 21 (56.8%) to PBV. NSP4 gene sequences had a similarity between 86.3 and 90.5% at the nucleotide level (nt) with prototypes from chicken and 93.5 and 100% similarity at the nt level when compared among them. RdRp sequences showed a high genetic heterogeneity with gene variants resulting between 56.1 and 100% similarity at the nt level with prototypes belonging to different species and sources of contamination and between 50.3 and 100% similarity at nt level when compared among them. S2 gene sequences analysis showed between 90.9 and 94.4% similarity at the nt level with chicken prototypes and 90.1 and 100% similarity at the nt level when compared each other. AvRV, ARV and PBV were detected in broiler farms of the Metropolitan mesoregion of Belém, being the detection by RT-PCR more efficient to detect at least one type of virus in the eight counties surveyed. Except for the PBV, which showed heterogeneous relationship with the prototypes used, the AvRV and ARV of this study related specifically to the samples obtained in birds. This is the first study involving the genomic sequencing of the AvRV, ARV and PBV in broilers in northern Brazil.
Acesso aberto (Open Access)
Caracterização genética de micobactérias não tuberculosas isoladas de espécimes clínicos pulmonares no estado do Pará
(Universidade Federal do Pará, 2012-11-29) COSTA, Ana Roberta Fusco da; LIMA, Karla Valéria Batista; http://lattes.cnpq.br/9795461154139260
In recent years have been seen increased reports of nontuberculous mycobacteria (NTM) infections in the world. However, data on frequency and NTM species associated with pulmonary infections are still limited in Brazil, especially in states of Northern Brazil. The knowledge of species associated with NTM lung infections has clinical and epidemiological importance, being molecular techniques efficient tools to provide diagnostic species-specific, which is necessary for choice of appropriate therapy. This study describes the diversity of NTM isolated from respiratory specimens at the Evandro Chagas Institute between 1999 and 2011. The NTM were initially characterized by PCR-restriction analysis (PRA-hsp65) and reidentificated by sequencing of 16S rRNA, hsp65, rpoB and ITS1 targets. According to ours findings, the PRA-hsp65 method proved to be a convenient tool for identifying NTM, allowing distinction of a variety of species quickly, simply and inexpensively, as compared to the sequencing. Moreover, as suggested in this study, according to local species diversity, this method can be subject to modifications to provide greater discriminatory power. Sequence analysis of the rpoB gene of Mycobacterium avium complex (MAC) revealed that this target is not a suitable alternative for discrimination of isolates from State of Para, because it generated discrepant results with low taxonomic resolution. M. chelonae, M. avium and M. simiae complexes were the most frequent NTM. Two potential species were detected, M. paraensis sp. nov. and M. amazoniensis sp. nov., being proposed as new members of the M. simiae complex. Among the patients with NTM disease, the main characteristics found were women older than 50 years, pardo ethnic group and previous tuberculosis. Although this study does not show the real magnitude of NTM lung infections in State of Para, it describes the diversity of species and clearly reveals the importance of this group in the region, which has accounted 13.5% of mycobacterial isolates in a reference laboratory. The findings highlight the need for bacteriological confirmation of cases presumptively diagnosed as TB with primary resistance to therapy for TB.
Acesso aberto (Open Access)
Reações hansênicas em pacientes coinfectados com HIV/Hanseníase: Clínica e ibmunopatologia
(Universidade Federal do Pará, 2013) PIRES, Carla Andréa Avelar; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Brazil is one of the few countries remaining endemic for infection for human immunodeficiency virus (HIV) and leprosy, and these diseases have a major impact on social costs and on quality of life. Although it is recognized the importance of this co-infection, various aspects are not fully understood yet. This study aims to describe the clinical, histopathological and immunopathological aspects of reactional states of patients coinfected HIV/leprosy, comparing them to leprosy patients without HIV. Were followed two groups: (1) 40 patients coinfected with HIV/leprosy, (2) consists of 107 leprosy patients. Prevailed male subjects in both groups. In Group 1, the majority were paucibacillary (70%), as borderline tuberculoid (45%) and with less risk of having lepra reaction in relation to non-coinfected. All of coinfected who had lepra reaction (n = 15) were taking antiretroviral therapy (ART), and most in the aids status (n = 14), being Immune Reconstitution Syndrome (IRS) a clinical condition markedly important in many of these patients (n=7). In the group of non-coinfected, the pattern of infection was the majority multibacillary (80.4%), type borderline-borderline (40.2%), and higher relative risk of presenting lepra reactions (p = 0.0026). The reversal reaction was the most common in both groups. In the coinfected group were observed skin lesions with aspect according to expected for each clinical form, in general, erythematous infiltrated with similar evolution to non-coinfected. The dermal edema was the most common histopathological findings in both groups. In group 1, giant cells were found in all histopathological and in greater quantity (2 +) and large size. The morphology of erythema nodosum leprosum no presented significant differences between groups, as well as the expression of IL-1􀈕 and IL-6. This study confirms the hypothesis that clinical and immunopathological aspects of reactions in these patients is an inflammatory active status, not of anergy, similar to that found in non-coinfected.
Acesso aberto (Open Access)
Análise do dano neural em pacientes hansenianos e na coinfecção HIV/ Hanseníase através de duas coortes clínicas
(Universidade Federal do Pará, 2013) BATISTA, Keila de Nazaré Madureira; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
In Brazil where leprosy is endemic and where HIV infection continues to expand and internalizing, if expected to find an increased prevalence of individuals living with both leprosy and HIV / AIDS, but there are few reports on the neurological damage that can cause overlapping. The aim of this study was to investigate nerve damage in leprosy leprosy patients coinfected with human immunodeficiency virus, compared with leprosy coinfected not at the beginning of treatment and at discharge, through two clinical cohorts. The sample consisted of 99 patients of whom 46 had coinfection MH / HIV and only 53 leprosy, these patients were seen at the outpatient clinic of the Center for Tropical Medicine and evaluated by the Simplified Technique. As a result there was a predominance of males, aged between 15 and 45 and the origin of the Metropolitan Region of Belém In group coinfection MH / HIV were prevalent in these paucibacillary patients and the presence of neuritis , abnormal sensitivity , motor abnormalities, presence of disability and neural damage was higher in this group than in the MH. In group predominated MH multibacillary patients and the presence of these neuritis, abnormal sensitivity, motor abnormalities, presence of disability and nerve damage was higher in this group than in coinfected MH / HIV. Monitoring of patients coinfected MH / HIV there was a small reduction in the presence of failure and nerve damage while in the MH group monitoring the presence of disability remained increased and nerve damage. In the Kaplan-Meier survival analysis was found that in patients MH was maintaining the chance of the patient remains without nerve damage, while in the coinfected patients group, was observed a reduction in the chance of the patient to keep without nerve damage the end of treatment. Thus it is concluded that the neural damage behaves differently in the two groups manner, predominantly in the paucibacillary group coinfected patients coinfected and not in multibacillary patients, but with the same gravity, which is troubling since diagnosing this damage at the beginning of the appearance of leprosy is still a problem for public health.
Acesso aberto (Open Access)
Caracterização genotípica do Vírus Varicela-Zoster em casos de varicela e Herpes zoster em Belém-Pará, Brasil
(Universidade Federal do Pará, 2013) COSTA, Marcos Rogério Menezes da; MONTEIRO, Talita Antônia Furtado; http://lattes.cnpq.br/4592027736583434; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Varicella zoster virus (VZV) can cause chickenpox during primary infection, subsequently establishing a latent infection. In case of reactivation of the virus, the herpes zoster may occur. Analysis of the presence of IgG and IgM is critical to determine the prevalence of this virus in the Metropolitan Region of Belém. The study of specific nucleotide polymorphisms is used to define the genotypes of VZV. Analysis of ORFs 22, 38 and 54 identified genotypes of VZV according to the classification established in conference July 25, 2008 in Whitechapel, London / UK, where the strains of VZV detected and characterized by sequencing of SNPs were grouped into classes 1 through 5. To evaluate the prevalence of antibodies and describe the circulating genotypes was the aim of this study. The frequency of IgM and IgG antibodies in cases of chickenpox was 68.2% and 48.2%, respectively. Cases of herpes zoster showed prevalence of anti-VZV IgG and IgM of 87.5% and 12.5%, respectively. The genotypes 1 or 3 and 5 were present in 13 samples sequenced, and the European strain (class 1 or 3) was found in samples from all the cities studied. The identification of strains circulating VZV is extremely important because of the association of specific genotypes with clinical harshest and to assess the implementation of the vaccine in the National Immunization Program.
Acesso aberto (Open Access)
Epidemiologia espacial e sorológica da hanseníase no estado do Pará
(Universidade Federal do Pará, 2013) BARRETO, Josafá Gonçalves; KITRON, Uriel; http://lattes.cnpq.br/4693583802608442; SALGADO, Claudio Guedes; http://lattes.cnpq.br/2310734509396125
Leprosy remains a severe public health problem in the State of Pará, Brazil. Over 80,000 cases were detected during the last 20 years in Pará, and currently, the annual case detection rate (50/100,000 inhabitants) is three-fold higher than the Brazilian average. The main objective of this study was to develop a method combining anti-PGL-I serology and spatial epidemiology as a tool for reducing the leprosy disease burden in Pará. An initial cross-sectional survey was conducted in eight municipalities of Pará at the residences of people reported to be affected by leprosy during the last five to six years. A group of researchers with experience treating leprosy patients, including dermatologists, nurses, physical therapists and lab technicians, performed a dermatoneurologic clinical examination and collected blood samples to test for anti-PGL-I IgM in 1,945 household contacts (HHC) of the 531 reported cases. Additionally, 1,592 school children (SC), aged 6-20 years, from 37 randomly selected elementary and secondary public schools underwent the same clinical and serologic evaluation. The residential addresses of reported leprosy cases and the residences of the examined SC were georeferenced to determine the spatial distribution pattern of leprosy. Two years later, based on the previous serological data, we returned to two cities to re-examine the same subjects. To evaluate the significance of geographic information in detecting new cases, we also selected two new public schools located in high-risk areas for leprosy. High-risk areas were determined by the spatial analysis of the distribution of cases in one municipality. During the initial survey, 156 (8%) HHC and 63 (4%) SC were diagnosed as new leprosy cases; 806 (41.4%) HHC and 777 (48.8%) SC tested positive for anti-PGL-I. Spatial analysis of one selected municipality demonstrated heterogeneity in the distribution of leprosy cases, with spatial clusters of high and low detection rates in specific regions of the city (p<0.01). Additionally, 94.7% of the initially examined SC lived within less than 200 meters of a leprosy case registered during the six years prior to this study. During follow-up, the incidence of leprosy was significantly higher among seropositive individuals (22.3%) when compared to seronegative individuals (9.4%) (OR = 2.7; 95%CI = 1.29 – 5.87; p = 0.01); leprosy rates were also significantly higher among dwellers of residences with at least one seropositive subject (17.4%), compared with dwellers of residences with no seropositive subjects (7.4%) (OR = 2.6; 95%CI = 1.18 – 5.91; p = 0.02). Selecting schools located in areas of the city at high-risk of leprosy increased the efficiency of detecting new cases among SC (8.2%) when compared to randomly selected schools (4%) (p = 0.04). The data indicate a high rate of undiagnosed leprosy cases and of subclinical infection with M. leprae in the State of Pará. Anti-PGL-I serology and spatial epidemiology are effective tools to increase the early detection of new cases, and these methods should be used by the municipalities of Pará to help reach leprosy control targets.
Acesso aberto (Open Access)
Correlação entre o câncer bucal e de laringe e a presença do Papilomavírus Humano (HPV) e do vírus Epstein-Barr (EBV) no estado do Pará
(Universidade Federal do Pará, 2013) ARAÚJO, Marizeli Viana de Aragão; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
The oral and laryngeal cancer represents a growing public health problem in Brazil. Smoking and alcohol are the main causes of oral cancer and larynx, but a part of the population develops the disease without being exposed to these risk factors, suggesting the existence of other causes such as genetic predisposition, alteration of tumor suppressor genes, diet and viral agents, particularly human papillomavirus (HPV) and Epstein-Barr virus (EBV). The proposition of this study was to verify prevalence of HPV and EBV in normal oral mucosa, cancer of oral cavity and larynx, and what types are most prevalent in these two situations. For this study we established two groups: one consisting of 70 specimens embedded in paraffin, with a confirmed diagnosis of oral and larynx cancer and other with 166 individuals without lesions in the oral cavity. Laboratory analysis for the viral detection and typing HPV and EBV (EBV type 1 or 2) were performed by conventional PCR (Polymerase Chain Reaction). The typing of samples positive for HPV types (6, 11, 16, 18, 33, 35, 38, 52 and 58) was performed by real time PCR using probes specific for each type. The EBV and HPV prevalence found in the oral and laryngeal cancers was 78.6% for HPV and 84.3% for EBV and 24.1% and 45.8% for EBV and HPV, respectively, in individuals without oral lesions. The most prevalent HPV types were HPV 58 (50.9%), HPV 6 (9.1%) and HPV 16 (9.1%) in cancer group and HPV 18 (12.5%), HPV 6 (7.5 %) and HPV 58 (2.5%) in the group with no lesions. The EBV 2 was more prevalent in both the cancer lesions than subjects without lesions, with a frequency of 94.9% and 82.9%, respectively. There was no association of HPV infection with EBV and sex, the prevalence being similar for men and women. Association was observed between the prevalence of HPV and EBV and its co-infections with the group that developed cancer. The prevalence of HPV and EBV and the odds ratio in the occurrence of cancer was 8.86 (p <0.0001) in individuals infected with HPV and 4.08 (p = 0.0004) in patients infected by EBV. The probability value estimated for prevalence of HPV and EBV co-infection and the occurrence of cancer has shown that individuals infected by both viruses have 65.72% likelihood of developing cancer, while infected with HPV has 31.94% and infected with EBV 17.79%. The results of this study may suggest that viral agents (HPV and EBV) are important risk factors for the development of carcinogenesis, and HPV is more effective than EBV in triggering the disease.
Acesso aberto (Open Access)
Avaliação imunohistoquímica da densidade de vasos e expressão de moléculas de adesão celular da microvasculatura de lesões na doença de Jorge Lobo
(Universidade Federal do Pará, 2013-03-27) BRITO, Maysa de Vasconcelos; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
Jorge Lobo's disease is a rare mycosis of chronic inflammation that causes injury to the skin without visceral dissemination. This disease is caused by the fungus Lacazia loboi. Its occurrence is prevalent in regions of hot and humid, with most cases reported in the Brazilian Amazon region. The histopathological findings showed lots of fungi at the site of injury, with a rich macrophages infiltrate with giant cells and limited presence of lymphocytes. The migration of leukocytes to the inflammatory site induced Lacazia loboi is supposedly co-ordinated by cytokines and chemokines that aided by blood and lymph vessels influence cell migration inducing the expression of adhesion molecules. In this paper we investigate possible microvascular changes associated with infection by Lacazia loboi at the site of injury that may interfere with the clinical evolution of patients. Therefore, we assessed the density of blood vessels and lymphatic vessels, as well as expression of molecules ICAM-1, VCAM-1 and E-selectin. Our results showed that in Jorge Lobo's disease, there is a reduced amount of blood and lymph vessels, when compared to control skin. There was a larger number of vessels expressing ICAM-1, being also higher number of vessels expressing the molecule VCAM-1, although in much less prominent ICAM-1. There were no differences in the expression of E-selectin. Together the results point to a change in the local microvasculature which may interfere with the development of an effective cellular immune response and justify the presence of the fungus confined to the injury site.
Acesso aberto (Open Access)
Perfil epidemiológico, letalidade e caracterização molecular de Pseudomonas aeruginosa multirresistentes, produtoras de metalobetalactamases de isolados clínicos em Unidade de Terapia Intensiva na região Norte
(Universidade Federal do Pará, 2014) MATOS, Eliseth Costa Oliveira de; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163; LIMA, Karla Valéria Batista; http://lattes.cnpq.br/9795461154139260
The bacterial resistance is responsible for major concerns about the great problems on health systems. The proposal of this study was to determine the epidemiological, lethality and molecular characteristics of Pseudomonas aeruginosa isolated from patients admitted to the Intensive Care Unit (ICU) in a teaching hospital in city of Belem, Pará, Brazil and analyze the performance of susceptibility testing for P. aeruginosa in automated VITEK -2 to study the antimicrobial resistance. The target people of this study consisted of 54 patients with P. aeruginosa infection at the adult , pediatric and neonatal ICUs from January 2010 to March 2012. For the epidemiological research, demographic data, comorbidities, length of stay were collected. Episodes of Healthcare-associated infections were defined in accordance to Center for Disease Control and Prevention (CDC), use of invasive procedures, previous therapy and patient outcome, Jackson MacCabe score, APACHE II score and Charlson score were documented. The bacterial identification was performed by biochemical tests and VITEK-2 system. The sensitivity test was performed with the application of the method of broth microdilution , and detection of metallo-beta-lactamase by the double disc and PCR method. The test of Genotyping was made by amplification throug DiversiLab system. The P. aeruginosa was the second most common pathogen in the hospital and this occurrence was higher in the adult ICU. The respiratory infection was predominant in the adult ICU, while bloodstream infection was prevalent in pediatric and neonatal ICU. The multidrug resistance was higher in the adult ICU, the average age of patients was 28 years, with an average length of stay of 87.1 days, the diseases were potentially fatal and major risk factors for acquisition of PaMR infection were the use of mechanical ventilation and urinary catheterization. Through the meta-analysis study, we found that infections caused by MR strains showed higher mortality rate, and were twice as likely to death occurs, multidrug resistance a factor of poor prognosis in patients with infection PaMR. Four isolates producers blaSPM-1 variant was detected and genotyping figured the presence of genetic similarity greater than 97%, the changes observed may be related to selective pressure existing in the adult ICU, coupled with inadequate therapy. This study demonstrated the importance of investigations of infections with multidrug-resistant pathogens in critical care units, contributing to these data the possibility of better monitoring and control of these infections.
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.