NMT - Núcleo de Medicina Tropical
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Item Acesso aberto (Open Access) Avaliação da resposta aos esquemas de tratamento reduzidos para malária vivax(Universidade Federal do Pará, 2001-08) ABDON, Nagib Ponteira; PINTO, Ana Yecê das Neves; SILVA, Rita do Socorro Uchôa da; SOUZA, José Maria deRelapses may occur with long standard treatment of vivax malaria, and these are caused by incomplete patient’s compliance. The use of reduced schedules may further better patient compliance, while maintaining the same efficacy, tolerance and minimal adverse reactions. The objective of this study was to test two schedules with reduced doses of chloroquine for vivax malaria and comparing these with the classical schedule. The authors studied 120 outpatients, with vivax malaria, aged over 12 years, submitted to three therapeutic schemes: scheme I: chloroquine phosphate (150mg) in a dose of 25mg/kg/day for three days (10mg/kg/ day in the first day, 7.5mg/kg/day in the second and third day), plus primaquine (15mg) in a dose of 0.25mg/kg/day for fourteen days; scheme II: chloroquine, in a single dose of 10mg/kg, plus primaquine in a dose of 0.5mg/kg/day for seven days; scheme III: chloroquine, 10mg/kg in a single dose plus primaquine in a dose 0.5mg/kg/ day for five days. The clinical response to all three therapeutic schemes was satisfactory. The disappearance of malarial symptoms occurred after a maximum 96 hours of treatment, while the assexual parasitaemia clearance occurred within 72 hours, in all therapeutic schemes.Item Acesso aberto (Open Access) Canine antibody response to Lutzomyia longipalpis saliva in endemic area of visceral leishmaniasis(Universidade Federal do Pará, 2016-06) BATISTA, Luís Fábio da Silva; MATTA, Vânia Lúcia Ribeiro da; TOMOKANE, Thaise Yumie; PACHECO, Acácio Duarte; SILVEIRA, Fernando Tobias; ROSSI, Claudio Nazaretian; MARCONDES, Mary; LAURENTI, Márcia DalastraIntroduction: Canine exposure to Lutzomyia longipalpis bites and the potential of Leishmania infantum transmissibility for the vector were evaluated. Methods: Immunoglobulin G (IgG) anti-Lu longipalpis saliva and -L. infantum, and blood parasite load were determined in dogs from endemic areas of visceral leishmaniasis. Results: Blood parasitism was similar between symptomatic and asymptomatic dogs. IgG anti-L. infantum was higher in symptomatic dogs, but IgG anti-Lu. longipalpis saliva was mostly observed in higher titers in asymptomatic dogs, indicating vector preference for feeding on asymptomatic dogs. Conclusions: Our data suggest a pivotal role of asymptomatic dogs in L. infantum transmission in endemic areas.Item Acesso aberto (Open Access) Dermatitis after contact with Pheropsophus sp (Coleoptera, Carabidae, Brachininae) in the Pará State, Brazilian Amazon(Universidade Federal do Pará, 2016-12) PARDAL, Pedro Pereira de Oliveira; SILVA, Cristiane Tárcis Cunha da; MONTEIRO, Wuelton Marcelo; GADELHA, Maria Apolonia da CostaDermatitis caused by bombardier beetles is rarely reported. Here, we report a case of beetle-caused dermatitis that occurred in Pará State, the Brazilian Amazon. A female patient while putting on her shoes, felt a burning pain in the right hallux and noticed a beetle inside the shoe. During medical consultation, the physician observed that the injury site was brown and discolored. The patient complained of localized burning pain and blurred vision. The beetle responsible for the injury was identifi ed as Pheropsophus sp. Administered treatment included cleaning with saline, analgesics, and topical hydrocortisone acetate and the patient was discharged without complaints.Item Acesso aberto (Open Access) Donovanose no Pará(Universidade Federal do Pará, 1991-12) SALGADO, Ubirajara Imbiriba; NEVES, Cláudio Domingues das; SILVA, Domingos; MACÊDO, CéliaFrom 1954 to 1990 granuloma inguinale was diagnosed in 259 patients al the dermatology service of the Universidade Federal do Pará in Belém, Brazil. Among them, 56 cases had ocurred in the twenty-year period 1954-1974 and as many as 133 cases were seen during the last five years only. Greater sexual liberty, poor social and economic conditions, and especially increasing homosexual behavior were implicated by the authors as chief determinants for this augmented incidence of the disease.Item Acesso aberto (Open Access) Filariose linfática em Belém, Estado do Pará, Norte do Brasil e a perspectiva de eliminação(Universidade Federal do Pará, 2005-04) FONTES, Gilberto; FRAIHA NETO, Habib; ROCHA, Eliana Maria Mauricio da; BRAUN, Reinaldo F.; VIEIRA, João Batista F.; PADILHA, Saturnino S.; ROCHA, Raimundo CândidoThe objective was to characterize the epidemiological situation of lymphatic filariasis in Belém, state of Pará. Hemoscopic data was analyzed from 1951 through 2003. Information for the period from 1951 to 1994 was collected from reports available from the National Health Foundation. Data from 1995 to 2003 was obtained through surveys carried out in 62 city sectors, within the eight administrative districts of the city. An appreciable drop in the microfilaraemic rates was observed over the years. The percentages of parasitized individuals in the decades of 1950, 1960, 1970, 1980 and 1990, were respectively: 8.2%, 2.6%, 0.7%, 0.16% and 0.02%. In 2001, a single microfilaraemic case was diagnosed, interrupting a series of two years without registering positive cases in the city. In 2002 and 2003, hemoscopic and entomological surveys were performed simultaneously revealing no microfilariae positive individuals, nor infected mosquitoes. To maintain this trend, surveillance measures must be conducted in order to detect and promptly treat patients, to prevent the risk of resurgence of a focus apparently now controlled.Item Acesso aberto (Open Access) Genes that encodes NAGT, MIF1 and MIF2 are not virulence factors for kala-azar caused by Leishmania infantum(Universidade Federal do Pará, 2014-10) AGUIAR, Bruno Guedes Alcoforado; COELHO, Daniela Lemos; COSTA, Dorcas Lamounier; DRUMOND, Betânia Paiva; COELHO, Luiz Felipe Leomil; FIGUEIREDO, Lívio Carvalho; ZACARIAS, Danielle Alves; SILVA, Jailthon Carlos da; ALONSO, Diego Peres; RIBOLLA, Paulo Eduardo Martins; ISHIKAWA, Edna Aoba Yassui; GAÍDO, Samara Belchior; COSTA, Carlos Henrique NeryIntroduction: Kala-azar is a disease resulting from infection by Leishmania donovani and Leishmania infantum. Most patients with the disease exhibit prolonged fever, wasting, anemia and hepatosplenomegaly without complications. However, some patients develop severe disease with hemorrhagic manifestations, bacterial infections, jaundice, and edema dyspnea, among other symptoms, followed by death. Among the parasite molecules that might influence the disease severity are the macrophage migration inhibitory factor-like proteins (MIF1 and MIF2) and N-acetylglucosamine-1-phosphotransferase (NAGT), which act in the first step of protein N-glycosylation. This study aimed to determine whether MIF1, MIF2 and NAGT are virulence factors for severe kala-azar. Methods: To determine the parasite genotype in kala-azar patients from Northeastern Brazil, we sequenced the NAGT genes of L. infantum from 68 patients as well as the MIF1 and MIF2 genes from 76 different subjects with diverse clinical manifestations. After polymerase chain reaction (PCR), the fragments were sequenced, followed by polymorphism identification. Results: The nucleotide sequencing of the 144 amplicons revealed the absence of genetic variability of the NAGT, MIF1 and MIF2 genes between the isolates. The conservation of these genes suggests that the clinical variability of kala-azar does not depend upon these genes. Additionally, this conservation suggests that these genes may be critical for parasite survival. Conclusions: NAGT, MIF1 and MIF2 do not alter the severity of kala-azar. NAGT, MIF1 and MIF2 are highly conserved among different isolates of identical species and exhibit potential for use in phylogenetic inferences or molecular diagnosis.Item Acesso aberto (Open Access) HCMV UL97 phosphotransferase gene mutations may be associated with antiviral resistance in immunocompromised patients in Belém, PA, Northern Brazil(Universidade Federal do Pará, 2018-04) SILVA, Dorotéa de Fátima Lobato da; CARDOSO, Jedson Ferreira; SILVA, Sandro Patroca da; ARRUDA, Leda Mani França de; MEDEIROS, Renato Lopes Fernandes de; MORAES, Marluce Matos de; SOUSA, Rita Catarina MedeirosHuman cytomegalovirus is one of the causes of opportunist infections in immunocompromised patients, and is triggered by factors such as state of viral latency, weakened immune responses, and development of antiviral resistance to ganciclovir, the only drug offered by the public health system in Brazil to treat the infection. The goal of this study was to identify mutations that may be associated with antiviral resistance in immunocompromised patients. Methods: Molecular analysis was performed in 82 blood samples and subjected to genomic DNA extraction by a silica-based method. Three sequences of the HCMV UL97 gene, which encodes a phosphotransferase protein required for activation of ganciclovir, were amplified by polymerase chain reaction. Pyrosequencing methods were applied to one external 2096-bp segment DNA and two internal sequences between nucleotides 1087 to 1828 to detect mutations in this gene. Results: Approximately 10% of sequences contained mutations between nucleotides 377 and 594, in conserved regions of the UL97 gene, leading to amino acid changes. Eleven coding mutations were identified, including changes leading to amino acid substitutions, E596K and S604F, which were observed in 100% of samples and are described for the first time in Brazil. In addition, one mutation (A594V) that is associated with ganciclovir resistance was detected in a kidney transplant patient. Conclusions: Further studies to detect mutations associated with HCMV resistance to antiviral drugs are required to demonstrate the need to increase the variety and availability of drugs used to treat viral infections in the public health care system in Brazil.Item Acesso aberto (Open Access) Incidence of congenital toxoplasmosis in the city of Belém, State of Pará, Northern Brazil, determined by a neonatal screening program: preliminary results(Universidade Federal do Pará, 2012-02) BICHARA, Cléa Nazaré Carneiro; CANTO, Giselle Acácia de Cristo; TOSTES, Camila de Lima; FREITAS, Jofre Jacob da Silva; CARMO, Ediclei Lima do; PÓVOA, Marinete Marins; SILVEIRA, Eliete da CostaIntroduction: The aim of this study was to determinate the incidence of congenital toxoplasmosis among a group of newborns (NBs) from Belém using neonatal screening. Methods: Among the 6,000 newborns referred for investigation of genetic and metabolic diseases, 1,000 were selected for screening for congenital toxoplasmosis by determining the amount of IgM in the eluates of blood collected on filter paper. Positive tests were confirmed using paired serology of the NB and his mother. Results: Out of the 1,000 NBs assessed, one had a positive screening result that was confirmed by paired serology. Conclusions: The incidence of congenital toxoplasmosis in Belém was 10/10,000 live NBs.Item Acesso aberto (Open Access) Severe visceral leishmaniasis in children: the relationship between cytokine patterns and clinical features(Universidade Federal do Pará, 2013-12) GAMA, Mônica Elinor Alves; GOMES, Claudia Maria de Castro; SILVEIRA, Fernando Tobias; AURENTI, Márcia Dalastra; GONÇALVES, Eloisa da Graça do Rosario; SILVA, Antônio Rafael da; CORBETT, Carlos Eduardo PereiraIntroduction: The relationship between severe clinical manifestations of visceral leishmaniasis (VL) and immune response profi les has not yet been clarifi ed, despite numerous studies on the subject. This study aimed to investigate the relationship between cytokine profi les and the presence of immunological markers associated with clinical manifestations and, particularly, signs of severity, as defi ned in a protocol drafted by the Ministry of Health (Brazil). Methods: We conducted a prospective, descriptive study between May 2008 and December 2009. This study was based on an assessment of all pediatric patients with VL who were observed in a reference hospital in Maranhão. Results: Among 27 children, 55.5% presented with more than one sign of severity or warning sign. Patients without signs of severity or warning signs and patients with only one warning sign had the highest interferon-gamma (IFN-γ) levels, although their interleukin 10 (IL-10) levels were also elevated. In contrast, patients with the features of severe disease had the lowest IFN-γ levels. Three patients who presented with more than two signs of severe disease died; these patients had undetectable interleukin 2 (IL-2) and IFN-γ levels and low IL-10 levels, which varied between 0 and 36.8pg/mL. Conclusions: Our results showed that disease severity was associated with low IFN-γ levels and elevated IL-10 levels. However, further studies with larger samples are needed to better characterize the relationship between disease severity and cytokine levels, with the aim of identifying immunological markers of active-disease severity.Item Acesso aberto (Open Access) Soroprevalência de anticorpos contra o antígeno CagA do helicobacter pylori em pacientes com úlcera gástrica na região Norte do Brasil(Universidade Federal do Pará, 2002-08) MARTINS, Luisa Caricio; CORVELO, Tereza Cristina de Oliveira; OTI, Henrique Takeshi; BARILE, Katarine Antônia dos SantosHelicobacter pylori is a pathogenic agent with a worldwide distribution and is involved in the development of many gastrointestinal diseases. Nowadays infection with the virulent strain CagA+ of H. pylori is considered one of the main etiological factors in the development of gastric ulcer. Based on this information, we investigated the seroprevalence of virulent strains among patients with gastric ulcer from one region, using serologic tests to detect antibodies against H. pylori and CagA protein. Infection by the virulent strain was found in 82% (40/55) of the patients, and among these, 89% (40/45) presented an increased degree of inflammation in the gastric mucosa, with a dense infiltration of leukocytes in the tissue, which probably favored the formation of gastric ulcer. We concluded that the presence of the virulent strain is related to the development of an increased inflammation in the gastric mucosa.