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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Análise da ação do tratamento de mobilização neural em pacientes com neuropatia hansênica
(Universidade Federal do Pará, 2014) CABRAL, André dos Santos; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
Historically Leprosy is one of the most disabling diseases in the world. The symptoms of the disease shows a resultant infectious mixed peripheral neuropathy of an insidious inflammatory process involving an ecological relationship between Mycobacterium leprae and man. Clinical disease turns around, both positive signs such as pain, paresthesia and dysesthesia; as negative signals such as sensorimotor loss and autonomic disturbances. Clinic is similarly developed in patients affected by peripheral compressive neurological syndromes. The neural mobilization has proven an effective manual therapeutic resource in controlling the symptoms of these compression syndromes. The inflammatory nature of leprosy neuropathy perform a compressive action and limiting of the mobility of peripheral nerve, impacting negatively with part of the pathology of the disease. This work aimed to investigate the neural mobilization technique is able to improve the symptoms of leprosy neuropathy. Therefore developed a clinical study, longitudinal, non-randomized, self-control, with an experimental analysis of quantitative character, consisting of four different moments, evaluation, experimental intervention period and revaluation 1 and 2. Were examined 12 upper limbs of six patients with high poliquimioterapêutico scheme for multibacillary for clinical form Borderline, who had neurological neurological impairment and remaining neural symptoms. A total of 23 nerve trunks still were symptomatic during the evaluation, taking an average of 3.8 ± 1.8 per patient nerve trunks. Most incidents symptoms to palpation assessment were paresthesia (20) and pain (09). The average intensity of neuropathic pain of each MS was 6.33±3.24. It still has measured grip strength and the sensitivity of the palm side for comparison after the intervention. After 12 sessions of neural mobilization upper limbs there was a slight improvement of sensitivity and grip strength but it was not significant. At the end of the experimental treatment, the number of symptomatic nerve trunks of upper limb decreased significantly. It was also observed analgesia of all upper limbs treated, with maintenance of this benefit after a post-expiration month of the intervention period. With these results we can conclude that the treatment of neural mobilization proved to be effective in controlling leprosy neuropathic pain.
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Análise da variabilidade da frequência cardíaca em pacientes hansenianos: análise linear, simbólica e de complexidade
(Universidade Federal do Pará, 2014) SANTOS, Marcio Clementino de Souza; SOUZA, Givago da Silva; http://lattes.cnpq.br/5705421011644718
Objective: the purpose of this study was to evaluate the heart rate variability (HRV) in patients with multibacillary leprosy clinic history, from dynamic linear and nonlinear analysis. Materials and methods: this is an experimental not randomized, quantitative study with 42 volunteers of both genres, divided into 2 groups of 21. The first group (LG), with 21 leprosy patients, aged 39.14 ±10.58 years, and the second group (CG), with 21 healthy subjects aged 36.24 ± 12.64 years. HR capture was performed by a heart monitor Polar RS800 CX, for a period of 15 min in the supine and 15 min in a sitting position. Analysis of HRV was performed by frequency domain from high frequency spectral indices (HFun), low frequency (LFun) in standard units and reason BF/AF. The nonlinear analysis of HRV was calculated by symbolic analysis (0V indexes%, 1V%, wholesale% and 2ULV%) shannon entropy (SE) and normalized complexity index (NCI). Results: In the spectral analysis of HRV LG presented higher values (p<0.05) of LFun and smaller values (p<0.05) of HFun compared to CG, on bench press position. Both groups showed higher values (p<0.05) of HFun and smaller values (p<0.05) of LFun in supine position in relation to a sitting position. There was no change of reason LF/HF in the comparison between groups and between positions evaluated. Symbolic analysis LG presented higher values (p<0.05) of 0V index% and smaller values (p<0.05) of the 2LV% and 2ULV% index in relation to the CG, in both positions evaluated. The index 1V% was higher (p<0.05) in the LG in relation to the CG just comparing to a sitting position. The CG presented minors values (p<0.05) of 0V index% and higher values (p<0.05) 2ULV% index supine position in relation to a sitting position. The LG presented higher values (p<0.05) 2ULV% index supine position in relation to a sitting position. On the complexity analysis LG presented minors values (p<0.05) of SE and ICN with respect to CG, on bench press position. There were no differences between the groups in SE and NCI analyzed in a sitting position. The CG presented higher values (p<0.05) of ES and ICN on bench press position in relation to a sitting position. Conclusion: The LG present greater sympathetic modulation and less vagal modulation in relation to the CG, indicating less HRV and cardiac modulation with low complexity. In response to postural change, both groups showed increased vagal modulation on position supine, evidencing greater HRV in this condition. Analysis of HRV by linear and non-linear dynamics proved to be a sensitive method and promising for investigation of autonomic dysfunction in patients with multibacillary leprosy.
Acesso aberto (Open Access)
Análise de série temporal da hanseníase no estado do Pará
(Universidade Federal do Pará, 2016) PINHEIRO, Helder Henrique Costa; ARAÚJO, Marizeli Viana de Aragão; http://lattes.cnpq.br/7849256617873180; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
Objective: Analysing a time series of new cases detected of Leprosy in the State of Pará, checking epidemiological trends according to the observated variables of the disease. Methods: Ecological observational design of detection historical series of Leprosy cases with use of secondary data from the National Notifiable Diseases System. The detection rates and the general variables in studies and estimated the trends of the time series were calculated. The State of Pará data were compared to the States of Mato Grosso State and Rio Grande do Sul. Results: The detection rate in Pará in 2014 was 4,84 per 10.000 inhabitants, with 32.177 cases detected in the period 2008-2014, estimating a trend annual growth rate of -12.71%. The proportion of children under 15 years of age was 10.4%, the largest in Brazil. Higher frequency of MB cases (65,2%) and Borderline clinical form (45,2%) was deteceted. Conclusion: The detection of new cases of leprosy is mainly in adult men, poorly educated and living in urban areas. The downward trend in case detection of the disease is different from stationary trend in the State of Mato Grosso. However, the trend of leprosy cases in children and adolescents in the State of Pará is stationary.
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Análise 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.
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Análise molecular de rotavírus tipo G9 de crianças na Região Norte do Brasil
(Universidade Federal do Pará, 2016-10-31) GUERRA, Sylvia de Fátima dos Santos; SOARES, Luana da Silva; http://lattes.cnpq.br/0556695301015859; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435
Group A rotavirus (RVA) is the most viral agent associated with acute gastroenteritis, responsible for about 200,000 deaths among children aged under five years annually. RVA belongs to Reoviridae family, Rotavirus genus, its genome is composed by double-stranded RNA (dsRNA) with 11 segments encoding 12 proteins, six structural (VPs) and six non-structural (NSPs). Each protein designating a specific RVA genotype, being VP7 protein responsible for G genotype and currently there are 32 genetic variants. G9 genotype emerged on a global scale in the 90s, a period before RVA vaccine introduction in Brazil that occurred in 2006, and is continuously detected until present day. This study aimed to describe the frequency and genetic constellation associated with the current G9 genotype in Northern Brazil. It was selected 50 samples collected between 1999 and 2013, being 45 G9P[8], 2 G9P[4] and 3G9P[6], for fecal suspension preparation and dsRNA extraction for further genome amplification and sequencing of nucleotides. It was observed that during pre-RVA vaccine introduction period G9 frequency rate was 43%, while after RVA vaccine introduction the most frequece obtained was 12.5% (2008 to 2010). Phylogenetic analysis of VP7 gene showed that all strains belong to lineage III of G9, observing aminoacidic substitutions in antigenic sites when compared with vaccine strains. It was demonstrated in VP4 gene that P[8] strains gathered in lineage III, whereas P[4] grouped into lineage V and P[6] strains into lineage I. All G9P[6] and G9P[4] samples were associated with DS-1 constellation, genogroup 2, while G9P[8] samples showed Wa constellation, genogroup 1, except for one sample showing NSP3 gene with DS-1 profile. G9 samples from Northern region analyzed were associated with the expected constellations described in other parts of the world, except for one G9P[8] sample that showed a genetic restructuration in NSP3 protein. In the present study the same G9 lineages have circulated during pre and post RVA vaccine introduction periods, and it was described aminoacidic substitutions in relevant antigenic regions, such as it was reported genetic restructuration phenomenon in one sample of this genotype, emphasizing the continuous monitoring of current genetic variants of RVA.
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)
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)
Aspectos clínicos e epidemiológicos da infecção pelo HTLV em usuários do Centro de Testagem e Aconselhamento do município de Santarém- Pará
(Universidade Federal do Pará, 2014) BARBOSA, Richelma de Fátima Miranda; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769
Acesso aberto (Open Access)
Aspectos epidemiológicos da infecção pelo vírus da hepatite C em populações ribeirinhas do estado do Pará, na Amazônia brasileira
(Universidade Federal do Pará, 2015-09-24) FECURY, Amanda Alves; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769
The hepatitis C virus (HCV) has large number of infected and may cause hepatocellular carcinoma. Its genetic material RNA presents six different genotypes (1, 2, 3, 4, 5 and 6) and subtypes, related by disease prognosis and response to treatment. The main route of transmission of HCV is the parenteral route, but the vertical and intrafamily transmission and is also reported. Drug use and needlestick share were characterized as risk factors for acquisition of infection and pathways are described and confirmed by literature. Less is known about viral transmission in remote or hard to reach communities such as riverside communities. This study aimed to determine the prevalence of viral infection, evaluate the serological profile and circulating genotype HCV, and trace the epidemiological characteristics, describing the main risk factors for acquisition of HCV infection that different riverside communities living in the State of Pará, in the Eastern Amazon, are exposed. The respondents answered a questionnaire to obtain epidemiologic information and blood samples were collected to carry out the serological, molecular, and genotyping tests. 1.277 samples were collected from Surrounding of the Tucuruí Hydroeletric, Pacuí, Hole of Maracujá and Nazário communities. Predominant age group 18-37 years old, female, married, low education, fishermen or açaí extractor, with up to 1 minimum wage. Respecting the particular characteristics of each local, consumption of alcohol and tobacco ranged between communities, as well as sharing the spiked material and cutting, the manicure kits, surgeries, hospitalization, presence of sexually transmitted diseases and if has any familiar with hepatitis. The Pacuí presented prevalence of HCV infection of 8,84 % having moderate prevalence of infection and Tucuruí was 2,25 %, close to the national average. The genotype 1 was found in 100% of Pacuí samples and 70% of Tucuruí samples, which possessed the remaining 30% of the samples belonging to genotype 3, following the pattern expected genotype distribution. In Maracujá Hole and Nazário Hole, there were no positive samples. The communities seem to have individuals who should be considered for the taking of public health measures, with increased risk of infection through drug use and the sharing of needlestick objects. The viral circulation have intermediate to moderate prevalence, with standard genotypic distribution similar to the Brazilian. The distribution of the infection and its features can vary within the country and even within their own regions, depending on the presence and viral circulation, in addition to the risk factors to which comunities are exposed.
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)
Avaliação bioquímica, hormonal e de parâmetros de crescimento na exposição pós-natal ao metilmercúrio em ratos wistar
(Universidade Federal do Pará, 2016-08-19) XAVIER, Fábio Branches; PINHEIRO, Maria da Conceição Nascimento; http://lattes.cnpq.br/6353829454533268
The effects of methylmercury on growth hormone and its relation to liver function, weight and growth were evaluated in an experimental model of acute and subchronic exposure with mercury. Forty wistar rats were divided into four groups: control, acute, subchronic2 (SB2) and subchronic3 (SB3). Measurements of total mercury (HgT), growth hormone (GH), glucose, ALT and AST enzyme activities, body weight and length of animals were measured in all groups. The results demonstrated that the dose of 25mg/kg was lethal for all animals in this group. The concentrations of mercury measured in the hair’sfrom the SB2 and SB3 groups were significantly higher than in the control group. GH levels were elevated in the acute group and reduced in the subchronic groups. The reduction of glycemia in the subchronic groups was highly significant in relation to the control group (p <0.01). The ALT and AST enzyme activities were altered. These results suggest that methylmercury high doses administered is hepatotoxic, able of to compromise glycemic control and to promote significant alterations in GH levels, which may interfere in the growth of the animals. However, other studies are required to understand the alterations found.
Acesso aberto (Open Access)
Avaliação da sensação posicional de articulações dos membros superiores em sujeitos expostos cronicamente ao metilmercúrio
(Universidade Federal do Pará, 2014-11-29) OLIVEIRA, Alexandre Rodrigo Batista; SOUZA, Givago da Silva; http://lattes.cnpq.br/5705421011644718
The Exposure of mercury in some watersheds in the Amazon has chronic character and a mild and moderate intensity. Communities of the basin in the Tapajos River has been monitored about the levels of mercury in the hair over the past 20 years and it was observed that the concentration of mercury in the hair of these people has high levels when compared with other riparian regions, without gold mining activities. In accidents occurred on Minamata in Japan, one of the most common symptoms was the loss of the somestetic function. Proprioception is a somestetic function that can be used to monitor the effects of prolonged exposure to mercury in populations. This work aims to study the sensation of positional joints of upper limb of subjects chronically exposed to mercury and with high levels in the last 3 years and compare the results of this assessment with those obtained in populations with less exposure to methylmercury. Fifty-seven volunteers have agreed to participate in this study, 23 of which belonged to group subjects chronically exposed to mercury from the community of barriers and 34 subjects belonged to the group with lower exposure to mercury from the community of Alter do Chão. Each subject had the positional sensations of joints of the shoulder, elbow and wrist evaluated by 3 times under conditions of open and closed eye. The evaluation consisted of teaching the subject to move a segment of the upper limb (forearm, hand or arm) from a neutral position to a position to articulate target. Each time the subject ended the movement was photographed the final position with digital photo camera of high resolution spatial and temporal. To calculate the articular amplitude at the end of the movement was used the program KINOVEA®, in which allows you to open the photo and use a digital tool to measure the angulation between the proximal and distal segment of the joint in question. Middle articular amplitude values for the open eye condition were statistically higher in the exposed group than in the control group in all the joints, while for the closed eye condition the values exposed group was statistically lower than in the control group only in the wrist joint. There was no statistical difference for the relative difference of angular joint positioning values between the study groups in all joints examined. The exposed group showed lower coefficient of variation for the test condition with the eye open in the joints of the wrist and elbow. The exposed group showed the highest coefficient of variation for the test condition with the eye closed only in the wrist joint. The angular difference values were sequentially higher proximal joints to the distal articulation in the exposed group, however in the control group the angular difference was similar in all the joints. The subjects chronically exposed to mercury showed slight alterations of the joint position sensation when compared with a control group. Proprioceptive evaluation can be an inexpensive tool for the assessment of the effects of mercury on the health of coastal populations exposed to the metal.
Acesso aberto (Open Access)
Avaliação da vulnerabilidade do potencial de endemização da esquistossomose mansônica no Distrito de Mosqueiro Belém, Pará
(Universidade Federal do Pará, 2014) PINTO, Sônia Claudia Almeida; PINHEIRO, Maria da Conceição Nascimento; http://lattes.cnpq.br/6353829454533268; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Schistosomiasis mansoni (SM) is an endemic parasitic disease that occurs in at least 74 countries with illness of 25 million people, including Brazil. It is related to socioeconomic and environmental factors, with emphasis on migratory movements that contribute to the spread of this disease. In northern Brazil only the state of Para has focus of this disease, the main in the city of Belem.The urban sprawl through the occupation of peripheral areas of the metropolitan area of Belem has generated significant social and environmental impacts, reaching areas of environmental preservation.From an ecosystemic perspective, the study assessed the possibility of expansion of SM in the insular area of the one administrative districts of Belem, in Mosqueiro (DAMOS), where there was the environmental characterization, malacological, parasitological and population surveys. Georeferencing techniques were used for spatial analysis of the study area, interview questionnaire at home and collection of material for parasitological examination. The approach adopted for determining the sample size calculation was based on the territory coverage of the family health strategy of the Belem Municipal Health Department. Thus, was realized the zoning of the study area, where Biomphalaria sp. breeding places were found. And was adopted a 50m radius buffer (north, south, east, west), from each breeding. Inside this area size, with the help of GPS technology, has set up a sample of 491 households with an estimate of 5.31 residents per household, with the exclusion of closed or abandoned households obtained the sample of 283 households for visitation with 421 participants. It was necessary to create the schistosomiasis vulnerability index (SVI) for better information with regard the interpretation of the data. The results showed that the DAMOS presents all environmental and population characteristics of the different endemic areas of Brazil; the malacological survey identified 30 breeding of planorbids; presence of the species B. straminea not infected with S. Mansoni; very low sewage network coverage, water and increase the migratory process in disordered occupation areas with populations from endemic areas for SM.The majority of study participants reside in areas considered of medium vulnerability, however 16% are in areas of high vulnerability; the area of Carananduba was considered the highest susceptibility and increased risk potential for entry of SM in Mosqueiro district.The spatial analysis of vulnerability to schistosomiasis in the study area, has led not only support the hypothesis of endemicity of SM in DAMOS, but to show where the first outbreak may occur, what and where the major risk factors are.This study may help in the management processes in public health with the implementation of preventive measures of health education, epidemiological and environmental surveillance.
Acesso aberto (Open Access)
Avaliação do dano neural periférico sensitivo e motor em pacientes hansenianos, com HIV/AIDS e co-infectados Hanseníase/HIV utilizando-se a avaliação neurológica simplificada e técnicas complementares
(Universidade Federal do Pará, 2015) ACÁCIO, José Augusto Bastos; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
According to the Ministry of Health, in 2014 Brazil had 24,612 new cases of leprosy. The number of individuals living with HIV increased by 11% in Brazil between 2005 and 2013. Leprosy and HIV infection are two chronic infectious diseases that have important geographical overlap in our country. Therefore, co-infection of these two diseases, it became also important in terms of public health. However, recent studies have shown that the overlap of these two conditions does not alter the clinical course (immunological or histological) thereof, and that the incidence of leprosy is not increased in HIV-infected patients. Mycobacterium leprae shows no increase in prevalence in co-infection with HIV, as well as the generalized immunosuppression of AIDS does not affect the manner of presentation of leprosy. This study aims to evaluate the peripheral nerve damage in leprosy patients with HIV / AIDS and co-infected with leprosy / HIV using the evaluation protocol of the Ministry of Health and an additional assessment to check for possible interference related factors will infection HIV neurological evaluation of the co-infected patient leprosy / HIV. It was developed through an analytical cross-sectional study comparing three groups: (1) 20 patients with leprosy; (2) 20 patients with HIV / AIDS and (3) with 18 patients with co-infection leprosy / HIV. The simplified neurological assessment when used in the HIV virus carriers group and of patients with co-infection leprosy / HIV could not identify, when present, nerve damage from the HIV infection or the use of ART in the groups in question, it does not investigate important neuromuscular disorders and characteristics of peripheral neuropathies affecting the patient with HIV / AIDS, but not carrier of leprosy. Evaluation complement the present study was important to detect important changes that could go unnoticed among the three groups. Especially for people with HIV where there doesn’t seem to be a guide that guides the neurological assessment regarding the impairment of the peripheral nervous system in this group. What would enable early detection and subsequent treatment that would enable preventive measures or treatment for the frame found, thus preventing the possible worsening and the installation of after-effects that might reasonably interfere with the welfare bio-psycho-social that individual.
Acesso aberto (Open Access)
Avaliação do hemograma, da velocidade de hemossedimentação (VHS) e da proteína C reativa (PCR) como preditores diagnósticos da síndrome febril de caráter infeccioso
(Universidade Federal do Pará, 2022-02-22) RAMOS, Francisco Lúzio de Paula; RODRIGUES, Anderson Raiol
Fever is the oldest and most frequent sign/symptom in the entire field of medicine. It is present in all ages and comprises all medical specialties. Currently, are known more than 200 causes of fever, being the etiology infectious the most common. The fever can be short term – more related to viral etiology -, and long-term, more frequently caused by bacteria, protozoa and, fungi. When excessively prolonged, it is more linked to structural factors, such as autoimmune diseases and neoplasms. The extension of etiology poses fever as a challenge most of the time. The hemogram, in turn, is the most requested exam in the medical routine due to its wide utility, since it can provide more than 20 parameters for analysis, enabling to perform a broad clinical evaluation and monitor the evolution of cases. Hemogram is very useful in the assessment of fever syndrome, as it shows a reactional state in response to infectious diseases, mainly if added to the evaluation of inflammatory tests, including the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). This study aimed to evaluate the application of the hemogram, ESR and CRP combined with clinical-epidemiological factors and time of illness as diagnostic predictors of infectious fever syndrome. We evaluated 319 patients with fever syndrome of infectious origin, being 77 of bacterial causes, 113 of viral causes, and 129 parasitic etiology, aged between 18 and 60 years old, who were attended at the Unified Medical Care Sector of Evandro Chagas Institute, between the period from 02/2018 to 01/2020. Another 213 healthy individuals were included in the study as control group. For data analysis, we used Microsoft Office Excel (2007), Biostat 5.0 (2007), SPSS Statistics 17.0 (2010), GraphPad Prism 9.0.0 Release Notes (2020), and Rv 3.5.2 (2018) software. We applied the Odds ratio (OR) to assess chances; Kruskal-Wallis for variance; Youden index for the cutoff points between variables, and ROC curve (AUROC) for accuracy. The p-value < 0.05 was considered statistically significant. The results revealed that the bacterial diseases have as characteristics in hemogram the increase in the number of neutrophils, which reflects in the numerical increase of leukocytes; In contrast, the viral diseases are characterized by the numerical reduction of lymphocytes, mainly of neutrophils, with reflection on the total number of leukocytes defined as leukopenia; the parasitic diseases assumed an intermediate profile between bacterial and viral, marked by the numerical normality of white blood cells, thus resembling the control group. However, the mean of lymphocytes was higher than in the other diseases, including the control group. In general, in bacterial diseases, there is an increase in ERS, and especially in CRP, which are also increased in parasitic diseases; but in viral diseases, these tests tend to be numerically normal, being similar to the control group in this aspect. Therefore, the inflammatory tests are increased in bacterial and parasitic diseases, but mainly in the first-mentioned, and are normal in viral diseases. Diseases such as malaria, visceral leishmaniasis, typhoid fever, HIV, and Epstein-Barr virus infections can be identified by findings peculiar to them observed in hemogram. We concluded that the numerical values of the hemogram, as well as the levels of ESR and CRP, combined with clinical and epidemiological factors and to the time of illness can predict groups of diseases and even predict specific diseases causative of infectious fever syndrome.
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)
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)
Avaliação epidemiológica, clínica e molecular de enteropatógenos causadores de diarreia aguda em crianças e adultos residentes na comunidade Quilombola do Abacatal, Ananindeua, Pará
(Universidade Federal do Pará, 2015) KAIANO, Jane Haruko Lima; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435
Acute diarrheal disease is a major cause of morbidity and mortality in developing countries and one of the factors that contributes to the worsening of the nutritional status of children. This study aimed to evaluate the clinical, epidemiological and molecular profile of infections by viral and parasitic agents in children aged 0-10 years and those over 10 years of quilombo of Abacatal in the 2008-2010 period. Fecal samples from 294 children were collected in the age group 0-10 years and 81 individuals over 10 years, residents of the community Abacatal, Ananindeua, Pará, which had acute diarrhea board or without diarrhea (controls). The viral diagnosis was made by immunochromatographic and molecular tests and parasitological by Faust and Hoffman method. A total of 375 fecal samples were obtained from 177 individuals. The frequency of viral agents in this study were rotavirus group A rotavirus C and picobirnavirus group by 6.4% (24/375), 0.3% (1/375) and 1.3% (5/375 ), respectively.The polyacrylamide gel electrophoresis confirmed the presence of rotavirus in 23 of 10 samples (43.48%) having short profile of 13 (56.5%) long profile. The presence of intestinal parasites was observed in 272 (77.94%) samples, and the most common were Ascaris lumbricoides detected in 13.18% (46/349) of the samples, followed by Trichuris trichiura with 10.88% (38 / 349), hookworms with 4.01% (14/349) and Strongyloides stercoralis 1.72% (6/349). Of the 24 samples positive for rotavirus group A the following genotypes were detected: G2P [4] (12.50%, 3/24); G1P [8] (25.00%, 6/24), G3P [9] (29.20%, 7/24) and G12P [6] (33.33%, 8/24). Two new genotypes were detected for VP6 genes (I18) and NSP1 (A19) of rotavirus A. Nutritional assessment of 38 children was conducted, showing that 18 4% (7/38) presented malnourished. This study highlights the need to implement preventive actions in the community, including education measures for health, vaccination against rotavirus, and even the implementation of programs to control parasitic infestations.
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)
Avaliação temporal e genética do rotavírus genótipo G2 circulante na Região Norte do Brasil antes e após a introdução da vacina contra rotavírus
(Universidade Federal do Pará, 2016-10-31) OLIVEIRA, Alessilva do Socorro Lima de; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435
Rotavirus group A (RVA) is the most important cause of diarrhea, accounting for about 40% of morbidity and mortality related to this disease in children around the world before the introduction of the vaccine. After the introduction of the vaccine against the RVA in Brazil in 2006 genotype G2RVA he rose again, being detected in up to 82% of children under five years of age performed post vaccination studies, leading to questions about the protection afforded by the vaccine facing the G2 type, as well as the occurrence of a selective pressure vaccine. Little is known about the evolution and diversity of G2 genotype and the possible influence of the vaccine on this. To provide a better understanding of the flow and genetic diversity of RVA genotype G2, we perform the time of circulation analysis of genotype over 31 years and analysis of structural and non-structural genes from samples that have circulated over 20 years in northern region of Brazil. The temporal assessment of movement of different genotype circulating in this region has observed that the G2 type RVA presented over the years a cyclical pattern of occurrence that did emerge in a post deployment of the vaccine scenario, suggesting a natural fluctuation due to variations natural occurring over time. Phylogenetic analyzes showed that for VP7 lines G2 there is a continuous, responsible for a movement of rotation in the lines being detected two lines and three sublineages over 20 years. Three important substitutions in antigenic regions of VP7 (A87T, D96N and S213D) were identified in samples that circulated from the 90. These changes may have increased the capacity of the circulating strains in environments where there is vaccine coverage for RVA. All G2P[4] strains analyzed revealed a DS-1-like genome constellation: I2-R2-C2-M2-A2-N2-T2-E2-H2. However, several viral variants circulated during the study period. No differences were observed in the antigenic sites of the VP8 * and VP7 proteins between samples that circulated in the period before and after the introduction of the vaccine. For VP2 and VP3 genes was evident in some samples a strong correlation with animal genes. This study provides evidence of genetic diversity in G2 genotype RVA, suggesting that this type has natural characteristics fluctuation and its emergence after the implementation period of the vaccine is more directly associated with ecological characteristics of the virus than a vaccine pressure.