Dissertações em Doenças Tropicais (Mestrado) - PPGDT/NMT
URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3559
O Mestrado Acadêmico em Doenças Tropicais iniciou em 2004 e pertence ao Programa de Pós-Graduação em Doenças Tropicais do Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA).
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Item Acesso aberto (Open Access) 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/5705421011644718It 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.Item Acesso aberto (Open Access) Adenopatia cervical tuberculosa em crianças: aspectos epidemiológicos, clínicos e laboratoriais(Universidade Federal do Pará, 1998-03-22) FIGUEIREDO, Erika Maria Riebisch de; AYRES, Manuel; http://lattes.cnpq.br/1649810738276000Tuberculosis remains a serious public health problem, and in Brazil, the principal agent for this disease is the Mycobacterium tuberculosis. In infancy, among extrapulmonary forms, one of the most frequent and less studied is that involves the superficial lymph nodes. In order to determine the incidence and to know the epidemiologic, clinical and laboratory features of lymph nodes tuberculosis, between January, 1995 to December, 1996, in the attendance outpatient unit of Hospital Ofir Loiola, it was enrolled 73 children from both sexes, aged 0 to 14 years, with enlargement of the cervical lymph nodes. The samplewas divided in 2 groups: in the first group, it was located 61 patients with adenopathy from etiologies other than tuberculosis, while 12 patients with cervical tuberculosis adenopathy took part in the second group. In this study, concerning tuberculosis adenopathy, for one hundred thousand in habitants,in the metropolitan area of Belem, it was observed an year rate incidence of 1.03 . Regarding adenopathy from other etiologies, the incidence was 4.27 and 6.15, in 1995 and 1996, respectively. The great majority of childhood adenopathy (64.4%) was nonspecific, although, when it was considered just those of known etiology, the relative risk of being tuberculosis was1.17. In both groups, the greatest incidence of cervical adenopathy was observed among preschool male children. However, when it was made a comparative analysis between the groups, there were no statistic significative differences toward age, sex, nutritional status, clinical symptom onset, type and characteristics of the affected lymph nodes. Disturbance in the nutritional status may have played a role to enhance the morbidity in 41.7% of the tuberculosis cases. The evidence of a cervical mass was the main symptom in the 2 studied groups, though, 75.1% of children with lymph node tuberculosis also had a general involvement of other lymph nodes chains. All children with cervical lymph node enlargement, which proved later to be of tuberculosis etiology had at least one month of illness course, and in such circumstances, a cold abscess represented the main symptom in 25% of them. It was possible to identify the sourceof infection in 1/3 of patients. Among children with tuberculosis, 63.6% had a positive tuberculin skin test, with a reaction 210 mm. Considering all bacteriologic procedures performed, culture turned to be the main element to tuberculosis diagnosis, with 100% positive results; while baciloscopy had little importance. Histopatologic exams showed granulomatosis lesions suggesting tuberculosis, in 88.9% of the sample. Concomitant pulmonary involvement was observed in 27.3% of children with lymph node tuberculosis. A good therapeutic response was seen using the pattern scheme adopted by Health Ministery, with out adverse reactions.Item Acesso aberto (Open Access) Alterações clínicas e metabólicas em portadores de hanseníase multibacilares(Universidade Federal do Pará, 2009-12-30) CALIXTO, Sheyla Cristina de Souza; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901Leprosy is an infectious disease caused by Mycobacterium leprae. It is characterized by dermato-neurological damage, ranging in spectrum between two stable poles (tuberculoid and lepromatous), with unstable intermediate forms. An operational classification with treatment purposes, join patients in two groups: the paucibacillary (PB), which represents clinical forms that have 1-5 injuries and smear-negative; the multibacillary (MB) corresponding to clinical forms of 5 or more lesions and with or without positive smear. Although to be treatable, leprosy still represents an important public health problem. Its major morbidity is associated with the reaction state and neural damage that can cause physical disabilities and permanent deformity, compromising significantly the patients quality of life. Clinical consequences with regard to ophthalmology, endocrine and cardiovascular diseases may come from the pathogenesis of both infection and immunopathological process, as by the adverse drug reactions, so such events must to be clarified in order that the health planning can minimize such injuries. An early diagnosis enables an early and effective treatment intending to avoid important clinical changes and sequelae. It was conducted a descriptive study of the kind of serial cases of 68 patients with high treatment of leprosy longer than or equal to 2 years and treatment of reactional states, aiming to describe the clinical, epidemiological and laboratory aspects in multibacillary patients after discharge with a focus on hypertension, diabetes, osteoporosis diagnosis and discuss about the possible relationships with the treatment of reactional leprosy episodes. We observed that most patients were male, aged over 45, comes from Belém, low education and low family income, the prevalent type of leprosy was the virchowian, the reverse reaction was the most prevalent state reaction , corticosteroids have been the most used drug for treatment in reactional states, patients who did not use corticosteroids had a greater percentage of normal densitometry, the co-morbidities: diabetes, hypertension and osteoporosis were more frequent in patients who used corticosteroids and age over 45 years . The level 2 was the most prevalent degree of disability.Item Acesso aberto (Open Access) Alterações endócrinas e metabólicas em pacientes HIV positivos com lipodistrofia(Universidade Federal do Pará, 2007-11-30) YAMANO, Ernesto Yoshihiro Seki; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618Lipodystrophy is one of the complications of highly active antiretroviral therapies (HAART). This study evaluates the metabolic and endocrine changing in patients with lipodystrophy. Forty patients were evaluated and classified as lipoatrophy, lipohypertrophy and mixed syndrome. We analyzed insulin resistance for HOMA-IR (Homeostasis Model Assesment Insulin Resistance), fasten glucose and OGTT, urea, creatinine, TSH, Free T4, cortisol, DHEA, ratio cortisol/DHEA, prolactin, testosterone (in male), FSH, LH and estradiol (in female), total cholesterol, LDL-c, HDL-c, uric acid. Anthropometrics measures (Weight, height, body mass index, waist, hip and skin folds thickness), ultrasonographic exams for evaluate hepatic steatosis and measure of bone density. The isolated lipohipertrophy occurred only in female (p<0,05). The mean of age was similar in the groups, without changing in the distribution by age group. Dyslipidemia occurred in all groups after HAART (lipodystrophy mixed, 100%, lipohypertrophy, 80% and lipoatrophy, 70%). Antropometric data showed waist increased in the female with lipohypertrophy (98+ 13,4) and decreased in female with lipoatrophy (76,8 + 6,1). Patients with lipoatrophy have been eutrophic (82,4%) and patients with lipohypertrophy have overweight or obesity (60%). Male was associated with osteoporosis (p < 0,05). We found elevated prevalence of the dyslipidemia (85%) and metabolic syndrome (37,5%) in all groups. The metabolic syndrome was associated with lipohypertrophy. No significant changes were found in the thyroid, cortisol, cortisol/DHEA ratio, testosterone, FSH, LH and prolactina. Conclusions: Female is associated with isolated lipohypertrophy, metabolic syndrome and insulin resistance. Male is related with Osteopenia and osteoporosis. Hepatic steatosis were common, but is not influenced for a type of lipodystrophy. Hormonal changing were unusual events in lipodystrophy.Item Acesso aberto (Open Access) Análise conformacional da enzima protease do HIV-1 relacionada à resistência ao inibidor Nelfinavir(Universidade Federal do Pará, 2017) HOLANDA, Luiz Henrique Campos; SILVA, Jerônimo Lameira; http://lattes.cnpq.br/7711489635465954; SOUSA, Maisa Silva de; http://lattes.cnpq.br/1775363180781218The Human Immunodeficiency Virus (HIV), which causes acquired immunodeficiency syndrome (AIDS), is a retrovirus that has highly virulent glycoproteins that invade the CD4 + T lymphocyte through its CCR4 and CXCR5 receptors. The biological cycle of HIV is mediated by the protease, transcriptase and integrase enzymes. HIV-1 protease is an enzyme that is present in the final phase of the biological cycle, where virus maturation occurs, and is an important pharmacological target. The main objective of this project is to verify the effects of the D30N, I84A and M46I mutations on the HIV-1 protease enzyme and the complex formation with the nelfinavir inhibitor through molecular dynamics and bioinformatics techniques. The results based on the structural analyzes showed structural differences between the studied systems. The 1OHR system presented a closed conformation, the systems D30N and D30N_I84A_M46I presented semi-open conformation and the D30N_I84A system presented open conformation, in which the latter presented lower free energy value and greater instability in the RMSD analyzes, however the greater flotation of residues Of amino acids. The theoretical analyzes showed the importance in the resistance of the double mutation D30N_I84A and the conformational restructuring capacity of the M46I mutation and catalytic capacity.Item Acesso aberto (Open Access) Análise das manifestações emocionais e motoras de ribeirinhos expostos ao mercúrio na Amazônia(Universidade Federal do Pará, 2016-02-19) COSTA JUNIOR, José Maria Farah; SOUZA, Givago da Silva; http://lattes.cnpq.br/5705421011644718; PINHEIRO, Maria da Conceição Nascimento; http://lattes.cnpq.br/6353829454533268Introduction: The investigation of impacts clinico-neurological associated with exposure to mercury levels in exposed populations are necessary in the Amazon. Objective: To analyze the emotional and motor manifestations of riparian exposed by diet in the municipalities of Itaituba/PA and Acara/PA. Method: Hair samples were collected for the determination of total Hg, obtaining of demographic data and emotional symptomatology (depression, anxiety and insomnia) and motors (paresthesia, muscle weakness, imbalance when walking, tremor, pain in the limbs and dysarthria). Results: There was a prevalence of females in both municipalities, as well as a higher frequency of women of reproductive age. The median concentration of total mercury (HgT) in Itaituba was significantly higher (p <0.0001) than in Acará. The emotional manifestations were identified in 26 (26,5%) participants from Itaituba and in 24 (52,2%) in Acará. With regard to the specific motor complaints in Itaituba occurred in 63 (64,3%) volunteers, with pain in the limbs (36,7%), paresthesia (32,6%) and muscle weakness (27,5%) the most frequently mentioned. In Acara, 33 (71,7%) participants had motor manifestations with the highest number of complaining of paresthesia (54,3%), pain in the limbs (52,2%) and tremor (34,8%). The average concentrations of HgT those with emotional manifestations, with motor manifestations and emotional and motor manifestations were above the considered tolerable (6μg/g) by the World Health Organization in Itaituba Conclusion: The results revealed the influence of the exposure levels about the emotional and motor manifestations. The monitoring with the application of qualitative and/or quantitative conventional specific tests are needed to better support and control cases, as well as the investigation of other clinical signs.Item Acesso aberto (Open Access) Análise de polimorfismo na região promotora do gene da Interleucina 18 (-137 G/C e -607 C/A) em pacientes portadores do vírus da hepatite C de Belém, Pará(Universidade Federal do Pará, 2012-03-23) SANTOS, Kemper Nunes dos; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769Since its discovery in 1989, the hepatitis C virus (HCV) has been recognized as a major cause of chronic liver disease worldwide. Considered a public health problem worldwide involving between 170 to 350 million people infected. Host genetic factors have been implicated in the persistence of HCV infection. Studies suggest that two single nucleotide polymorphisms at position -607 C/A (rs1946518) and -137 G/C (rs187238) in the region of the gene IL-18 and have been found associated with the transcriptional promoter activity of IL -18, and potentially of IFN-γ, being associated with delayed viral clearance and persistence of the disease. We conducted a cross-sectional analytical study of the city of Belém-PA in 152 blood samples from patients infected with HCV and 188 uninfected controls. The samples were subjected to RT-PCR (Reverse Transcriptase - PCR) for detection of viral RNA and, subsequently, the PCR-RFLP (Restriction Fragment Length Polymorphism) to evaluate the polymorphism in the promoter region of IL-18 gene at positions -137 G/C and -607 C/A. The results showed no significant difference for IL-18 polymorphisms between patients and control group. But showed a significant difference for homozygous genotypes G/G (39.1%) at position -137 (OR = 3.00, CI [95%] = 1.24 – 7.22, p = 0.02), and A/A (21.7 %), position -607 (OR = 3.62, CI [95%] = 1.25 – 10.45, p = 0.03) among women than men (22.6% and 7.6%). The results showed evidence that among women, the presence of the polymorphism homozygous A/A (-607) acts as a protective factor against HCV infection, genotype as the A/A (-607) have been linked in some studies with liver disease and mild viral clearance.Item Acesso aberto (Open Access) 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/3560941703812539Diseases 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.Item 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/2161704040280760The 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.Item Acesso aberto (Open Access) Análise filogenética de genes de provável origem não humana de rotavírus do grupo A em espécimes fecais de crianças com gastrenterite aguda provenientes de Belém, Brasil(Universidade Federal do Pará, 2012) MAESTRI, Régis Piloni; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435Rotaviruses (RVs) are the main cause of acute viral gastroenteritis in both humans and young animals of species such as calves, horses, pigs, dogs, cats, and birds. The genetic diversity of RVs is related to a variety of evolutionary mechanisms, including point mutation, genome reassortment, and reassortment. The objective of this study was realized the molecular charaxterization of the genes that encode structural and nonstructural proteins in unusual RV strains. The clinical specimens selected for this study were obtained from children and newborns with RV gastroenteritis, who participated in research projects on viral gastroenteritis conducted at the Evandro Chagas Institute. Structural (VP1-VP4, VP6, and VP7) and nonstructural (NSP1-NSP6) genes were amplified from stool samples by the polymerase chain reaction and subsequently sequenced. Eight unusual RV strains isolated from children and newborns with gastroenteritis were studied. Reassortments between genes of animal origin were observed in 5/8 (62.5%) strains analyzed. These results demonstrate that, although rare, interspecies (animal-human) transmission of RVs occurs in nature, as observed in the present study in strains NB150, HSP034, HSP180, HST327, and RV10109. This study is the first of its kind conducted in the Amazon region and supports previous data showing a close relationship between genes of human and animal origin, representing a challenge to the large-scale introduction of RV vaccines in national immunization programs.Item Acesso aberto (Open Access) Análise higiênico-sanitária da carne do caranguejo-uçá (Ucides cordatus) beneficiada em dois municípios litorâneos do Estado do Pará(Universidade Federal do Pará, 2002) CÉSAR, Kátia Lamarão Vieira; REZENDE, Manoel Barbosa deAmong the products of animal origin, the crab is held as one of the victuals more susceptible to the deterioration process due to is specific chemical composition, activities of autoliticas enzyme and to the close pH of the neutrality. Beyond of those intrinsic factors related to the crustacean, the process of extraction of its meats is accomplished, in the great majority of the times, in unsatisfactory hygienic-sanitary condition, causing, like this, a high text of contamination of these. With the objective of analyzing the microbiologic, microscopic and parasitical quality of the crabmeat traded in two municipal districts of Pani (Sao Caetano de Odivelas and Braganya), 30 samples were researched, acquired from the meat collectors, in its points of collection. In the microbiologic analysis, presence was observed, in high levels, of fecal coliforms and S. aureus, in both municipal districts, however Salmonella (s. panama: sorogrupo D) was only detected in Braganya/Vila de Caratateua. It is stood out that, great part of collection points presented their samples out of the effective legal patterns in the current Brazilian legislation. The microscopic analysis revealed constant dirt presence (fragments and stick chips, seed, fibber and chips of vegetable origin, for the human, excrement and insect larva). However, the parasitical analysis was negative for the detection of cysts of protozoarius (E. histolytica/E. dispar and G. lamblia). The results reveal the precariousness of the hygienic-sanitary conditions of the researched samples, indicating this way the need of being created, on the part of the competent authorities, a registration of the Ministerio da Agricultura e Secretaria da Agricultura do Estado, so that the manufacturing and the commercialization of this product are made in agreement with Brazilian and state sanitary rules.Item Acesso aberto (Open Access) Análise higiênico-sanitária de polpas de cupuaçu e bacuri comercializadas na cidade de Belém, Pará(Universidade Federal do Pará, 2005-05-30) CAVALCANTE, Rejane Maria Sales; FRAIHA NETO, Habib; http://lattes.cnpq.br/9202245658963683The consuption of fruit pulp and your derivatives have been increased, because of their nutricional properties, flavors variety and aromas, and the increasing search for the products with in natura food characteristics. The pulps are used for direct comsuption or as a raw material for juice, ice cream, yogurt industries. The process to obtain pulp should be done in right hygiene conditions, followed by apropriated storage, to assure integrity and quality of products. The study objective was value sanytary hygienic conditions of cupuaçu and bacuri pulps sold in the city of Belém, considering that the processing involves fruit manipulation, sometimes with not apropriated hands. Your realization counted on the Division of Sanitary Vigilancy of Municipal Health Department, Central Laboratory of the State of Pará (LACEN) and Laboratory of Parasitology on Biological Sciences Center Support. The methods used were microbiological, microscopical, parasitological analysis of 33 samples bought in 11 street markets, with in we easily find these products, the street markets are well distributed in the neighborhoods of Belém Icoaraci small town. 22 cupuaçu and 11 bacuri samples were analysed. The microbiological analysis were made regarding presence of 45ºC coliformes using more probable number (NMP) method, and Salmonella sp., in agreement with RDC nº12/2001/ANVISA. The results were all negatives. The microscopical examination, followed nº1/2000 Instruction of Supplying and Agriculture Department didn’t show any dirty in the samples. The parasitological analysis was made following Faust method and no worms or protozoan were found. Although the street markets observation of sanitary hygienic conditions suggests product cantamination, all 33 samples of cupuaçu and bacuri pulps were considered good for consuption, in agreement with current legislation. These results can be explained by the acid level and the presence of citric acid both products, and because of the freezing process.Item Acesso aberto (Open Access) Análise morfológica das células de Langerhans purificadas da epiderme de camundongo Balb/c, após interação in vitro com Leishania (Viannia) brasiliensis e Leishamania (Leishmania) amazonensis(Universidade Federal do Pará, 2003) QUARESMA, Mariana do Socorro Maciel; SALGADO, Claudio Guedes; http://lattes.cnpq.br/2310734509396125Langerhans Cells (LC) are MHC class II positive antigen-presenting cells that constitute 2-3% of all epidermal cells, which have been demonstrated to stimulate a vigorous T-cell response to Leishmania major. New World cutaneous leishmaniasis is caused by different species, presenting diverse clinical pictures, varying from cutaneous localized to mucous or anergic disease. Using a "panning" technique, murine (Balb/c) epidermal LC were purified to around 95% purity (pLC). The freshly prepared LC (fLC) presented small, delicate dendrites and the classic Birbeck granules. Parasites of the subgenera Viannia and Leishmania, which are genetically very distinct, have been suggested to have a possible species-specific response in cell mediated immunity. In this study, pLC and L. (V.) braziliensis or L. (L.) amazonensis were cultured and their morfology were analyzed after 12h or 36h culture. Using Giemsa stain and scanning electron microscopy, different morphologic changes were detected on LC afier 12h culture on both cultures, LC and L. (V.) braziliensis or LC and L. (L.) amazonensis. After interaction with L. (V.) braziliensis, LC became more dendritic, that were smaller in lenght when compared to LC cultivated alone. In contrast, after interaction with L. (L.) amazonensis, LC became round shaped with a few cells showing some dendrites. Moreover, there was a dose contact between the promastigotes flagelli and LC, but without phagocytosis in 12h or 36h culture, what is different of the observations found in the literature on the interaction between LC and L. major. These results suggest that LC primary response against different species of Leishmania could be distinct upon the species involved in the interaction process.Item 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/4030747999301402Human 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.Item Acesso aberto (Open Access) Anemia, parasitismo intestinal e exposição mercurial em duas comunidades ribeirinhas da Amazônia(Universidade Federal do Pará, 2003) OIKAWA, Teiichi; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098The incidence of anemia, intestinal parasitism and mercurial exposure prevalence in two Amazon riverside communities, São Luiz of Tapajós (Tapajós River) and Igarapé-Mirim (Tocantins River), where social-economics standards are similar. Eighty hair simples, blood and stool were analyzed. The results demonstrated incidence of intestinal parasitism of 42.5% in São Luiz of Tapajós and 75,15% in Igarapé-Mirim. The hematimetrics indexes indicated incidence of anemia of 40% in São Luiz do Tapajós and 25% in Igarapé-Mirim. The medium total mercury concentrations in hair samples of the residents in São Luiz of Tapajós were 14.9 ± 6.6 µg/g in male individuals and 13,4 ± 3,4 µg/g in the females sex, while in Igarapé-Mirim they were of 2,5 ± 1,4 µg/g in the male probant and 3,5 ± 1,6 µg/g in the female one. It was observed in São Luiz do Tapajós, 82,5% of concentrations of total mercury are above the 10 µg/g, value of reference for population no exposed, while in Igarapé-Mirim, any values above these were fround values. It can be concluded that the quality of life of the riverine people analyzed is committed by the appraised factors, becoming necessary the adoption of preventive ways of educative actions in those communities by government authorities sponsor.Item Acesso aberto (Open Access) Aplicação do modelo de acurácia em casos suspeitos de amebíase em uma comunidade rural do nordeste do Estado do Pará, Brasil(Universidade Federal do Pará, 2006) REZENDE, Manoel Antônio Costa de; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872Introduction: The studies on the prevalence of intestinal worms are scarce among us, most of them were performed in sample of populational basis not very well defined, like users of health service and public school students. Objective: Quantify the Entamoeba hystolitica prevalence in a rural population of Pará state. Methods: feces study using the ferric hematoxilina method in 124 people from the rural part of Tailândia, arbitrarily selected in order to establish prevalence and accuracy, the positive and negative predictive values, as well as sensitivity and specificity. Results: from the populational sample, 56,5% belonged to male sex, 60,5% out of these were ranging between 18 to 43 years old. In the scholarship study, 64,5% had at least 3 years of school and 63,7% earned less than R$300,00. The Entamoeba hystolitica prevalence reached 24,2%. Conclusion: the accuracy, which is the measurement of global value of the performed test, shows that 73,4% of the patients were correctly classified. The 70,0% sensitivity test defined positive for the infection and a specificity of 74,5%.Item 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/0548879430701901Leprosy 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.Item Acesso aberto (Open Access) Apresentação clínica, etiologia e distribuição geográfica da Leishmaniose tegumentar no município de Santarém, estado do Pará, Brasil(Universidade Federal do Pará, 2012-12-27) MARTINS, Nádia Vicência do Nascimento; GARCEZ, Lourdes Maria; http://lattes.cnpq.br/1949154423200138; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901American tegumentary leishmaniasis (ATL) is an infectious disease affecting skin and mucosa, which has shown a significant increase in incidence in recent decades, has an overall prevalence of approximately 1.5 million cases annually worldwide. The present study is an analytic approach, descriptive, cross-sectional profile with the objective of establishing clinical and epidemiological correlations etiologies of cutaneous leishmaniasis in a series of cases in western Pará In the survey included 102 individuals presenting clinical manifestations of ATL, selected in from October 2009 to November 2011, attended the Center for Zoonosis Control in the city of Santarém, state of Pará variables were analyzed from the application of the chi-square tack and presented through figures and tables. The results demonstrate that prevailed infections in males 85.29%, aged 30 to 40 years 32.35%, workers and residents of rural areas engaged in occupations mostly peasants 21.57%, showed single lesions 63.72%, 77.45% ulcerated type, located in the lower limbs in 58.82% of cases, with time to disease progression of 02 months on average 74.50%. Conclusion: Six Leishmania species were identified, and the subgenus Viannia more prevalent and predominant species E (V). braziliensis.Item Acesso aberto (Open Access) Arbovírus Morumbi (Phlebovirus : Bunnyaviridae) - estudo histopatológico e imuno-histoquímico do fígado na infecção experimental em camundongos: comparação entre as vias cerebral, intraperitoneal e subcutânea(Universidade Federal do Pará, 2000) BARROS, Vera Lúcia Reis Souza de; ROSA, Amélia Paes de Andrade Travassos da; ALVES, Venâncio Avancini Ferreira; http://lattes.cnpq.br/8923271345704795Morumbi virus is a member of Phlebotomus Fever serogroup (Bunyaviridae family, Phlebovirus genus), native from the Brazilian Amazon region. It'svector is unknown, but is supposed to be, transmitted by phlebotomine sandflies. It was isolated in 1988 from a human presenting an acute febrile illness. When inoculated in the brain of Newborn Swiss mice, this arbovirus showed visceral tropism, including liver damage. In order to establish the anatomopathological and immunohistochemical characteristics in the liver of albino Swiss suckling mice experimentally infected with Morumbi virus; to assess the differences of tropism of the virus in the liver following the intra cerebral, intra peritoneal or subcutaneous routes of inoculation; to detail the sequence of anatomical and pathological events in the liver; to demonstrate the location of the viral antigen in the hepatic tissue during the experimental assay; and to study the possible relationship between the anatomopathological and immunohistochemical findings, an experimental study was conducted with 71 Newborn Swiss mice (two or three days of age), distributed as follows: 21 received intra cerebral inoculation (IC), 21 received intraperitoneal inoculation (IP) and 29 received subcutaneous inoculation (SC). 0.02ml of virus suspension was used as the infectious dose. The control was comprised of 30 mice that were not inoculated. Subgroups of 8 mice (6 inoculated, 2 controls) were euthanized daily, at intervals of 24 - 96 hours in the IC and IP groups, and until 120 hours in the SC group. Liver specimens from all mice were fixed in a 10% neutral formalin solution, then embedded in paraffin wax to obtain 5f.lm sections that were stained with haematoxylin/eosin for morphological analysis. Immunohistochemical technique (Envision System, DAKO, USA) was employed in additional sections, using alkaline phosphatase and hyper-immune anti-Morumbi virus serum prepared into suckling mice, to detect the viral antigen. 6 patterns of portal lesion and 9 patterns of lobule lesion were studied in a scale from zero (0) to three (+++), where zero represented absence of lesion and three represented severe lesion. Light microscopy examination revealed that Morumbi virus was able to produce hepatic lesions in the portal and lobular areas when inoculated in mice in three different routes, raising an acute hepatitis, in which bodies similar to Councilman - Rocha Lima bodies were observed, irregularly distributed in the lobules. The appearance of those bodies occurred 24 hours post-inoculation (pi), with a peak at 72 hours pi in miceis inoculated. The immunohistochemical technique showed mild presence of viral antigen from 24 hours after inoculation in IC group and from 48 hours after in IP and SC groups, showing a certain parallelism between the detection of viral antigens and the morphological lesions. Maximum detection of the viral antigen was observed in IP rout, specially those mice euthanized at 72 hours pi. General distribution of the antigen was concentrated in the hepatic lobules, in the cytoplasm of normal and necrotic hepatocytes, as well as inside the Kupffer cells, without any preference for the three lobule areas. The following conclusions are made: i) experimentally infected mice model was excellent to study the Morumbi virus-induced lesions, with preference to IP rout; ii) in all inoculated routes (IP, IC and SC) there were evidence of Morumbi virus infection, with a remarkable detection of its antigen in the hepatic tissue of Swiss mice; iii) Morumbi virus antigen detected in the liver of Swiss mice was associated with acute hepatitis and with focal necrosis; iv) an intense acute hepatitis occurred in the liver of euthanized mice 72 hours pi with Morumbi virus by the intraperitoneal route but was not observed in the other two used routes; v) in this experiment, acute hepatitis was limited, showing a clear tendency to disappear in the follow up in the majority of inoculated animals; vi) cholestasis was not very often observed in the experimental hepatitis due to Morumbi virus; vii) Morumbi virus antigen was detected predominantly in the cytoplasma and was exhibiting a granular pattern in hepatocytes and Kupffer cells; viii) Morumbi viral antigen was detected as early as 24 hours in hepatic tissue in IC route and 48 hours after IP and SC routes.Item Acesso aberto (Open Access) Aspectos clínicos e a prevalência de doenças infecto-parasitárias juntamente com a exposição ao mercúrio metálico em duas comunidades garimpeiras na Amazônia(Universidade Federal do Pará, 2006) MIRANDA, Antonio Marcos Mota; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098The evaluation of the health conditions in two “goldwashers” communities in the Amazon region, goldmines of São Chico and Creporizinho, it was verified the prevalence of clinical and neurological symptoms and the parasitic occurrence of infectious illness, associate to the concentration of total mercury in the urine of the “goldwashers”. At the São Chico, 104 “goldwashers” were investigated, while as Creporizinho 169, it was used the socio economic, epidemiological and laboratorial condition as diagnostic methodologycal and it was used sentable statistical tests for significance verification. The results demonstrated that the average of the metal in “goldwashers” urine of Sao Chico is superior to those of Creporizinho 9.29 μg creatinina Hg/g and 5.64 μg creatinina Hg/g, respectively. Where the distribution of Hg in urine of the São Chico and of the Creporizinho population, below 93% - 96% of the IBMP and above 7%-4%, respectively. There is predominance of the masculine sex in both miners and the occurrence of STD’s in the two goldminers, whose sequence was identical, where the intestinal parasitism and malaria are themost prevalent, however both are below of the IBMP. The clinical evaluation of São Chico presents prevalence of to osteomuscular, dermatological and digestive 32%, 30% and 23% symptoms, respectively. While in the Creporizinho occurred change in the sequence to osteomuscular, digestive and dermatological 51%, 44% and 39%, respectively. Amongst the most prevalent neurological symptoms the tremors, parestesias and chronic headache were present in the group of São Chico and Creporizinho the following sequence, respectively, 38% - 58%, 32% - 53% and 28% - 48%. The health conditions are more precarious in São Chico miner, than Creporizinho however the “goldwashers” are occupationally injured in the two studied populations, nevertheless there are not safe parameters to affirm the presence of the chronic mercurial illness, taking into consideration the variable analyzed in this study.