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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Dissertação Acesso aberto (Open Access) Atenção em saúde aos casos de coinfecção hiv/hanseníase em uma área hiperendêmica para hanseníase na Amazônia(Universidade Federal do Pará, 2016-07-01) ALBUQUERQUE, Nahima Castelo de; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901This study aimed to evaluate the primary health care to patients co-infected patients with HIV/leprosy in hyperendemic area for leprosy in the Amazon. This is a descriptive, exploratory study, evaluation of health services, with quantitative and qualitative approaches. They were interviewed twenty people diagnosed with HIV and leprosy who were followed up at the clinic of Center Tropical Medicine. It was used an adaptation of the assessment instrument of primary health care performance, containing sociodemographic and clinical informations, gateway, health services used, integration of care actions, Free Association of Words Test and stories of feelings related to the diagnosis of co-infection. The quantitative evaluation was conducted by the description of frequencies. Qualitative evaluation was categorized by the free association of data words according to the stimuli to HIV, leprosy and quality of health care. The results of the subjective questions of the interviews were analyzed based on thematic content. The study was approved by the Research Ethics Committee of the Center Tropical Medicine of Pará State University, under the CAEE Nº 49477115.1.0000.5172. It was identified a predominance of males, aged 40 to 59 years old, brown race, low socioeconomic level and derived from the city of Belem-Para. There was a predominance of patients diagnosed with Aids and antiretroviral therapy. In relation to leprosy there was parity between the clinical forms and, consequently, of paucibacillary and multibacillary cases. Regarding the health services used, coinfected patients were attend essentially by specialized services and have no link with the PHC. Unfamiliarity has been observed about the health services available in the network. In interpreting evocations and discourses prevail speeches related to feelings of death, fear, sadness, concern and questions related to diagnosis of HIV and leprosy. About the changes in daily life, stand out the inability to work and the largest health care. The results shows the need for strengthening PHC in the context of public policies for HIV/Aids and leprosy control, to make it the main gateway for patients, regardless of cases of co-infection, ensuring access on a expanded health perspective. We conclude that despite the satisfaction of users and the services provided in secondary care, the current health care model does not consider the singularities co-infection users of HIV/leprosy.Dissertação Acesso aberto (Open Access) Incidência de infecção hospitalar em portadores do HIV: estudo comparativo com pacientes não-HIV(Universidade Federal do Pará, 2008) SARAIVA, Danielle de Lima; NEVES, Dilma Costa de Oliveira; http://lattes.cnpq.br/7230812534416350; MARSOLA, Lourival Rodrigues; http://lattes.cnpq.br/9393259046010911; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539HIV/AIDS patients may be exposed to the same risks for acquisition of nosocomial infections than non-HIV/AIDS patients, however, factors related to the immune suppression of former patients represent important paper in the pathogenesis for the development of nosocomial infections. This study investigated and compared the incidence of infections between HIV infected inpatients and non-infected inpatients in the Infectious Diseases Service of Hospital Universitário João de Barros Barreto. Nosocomial infections were related to invasive procedures (mechanical ventilation, urinary and central vascular catheter). It was an analytical, observational and prospective study, accomplished from February to December, 2007. Daily visits were performed by infection control team and the researcher from the first day in the Hospital to his discharge. There were reported 1.130 exits and 20.276 patients-day; 40 patients developed nosocomial infections and 17 (42,5%) non-HIV patients had 19 (39,6%) infections and 23 (57,5%) HIV patients developed 29 (60,4%) infections; eleven (55%) of these 23 patients had T4 cells counts less than 100cells/mm3 and 15 (65,22%) deaths were related to nosocomial infections. Hospital infections rates in HIV patients were higher than in non-HIV patients (3.09 versus 1.74 infections by 1000 patients-day). Pneumonia was the most frequent infection site an its incidence was 1,6 episodes for 1000 patients-day. Urinary tract infection in non-HIV patients was 12,11 episodes by 1000 urinary catheters-day compared to 4,41 episodes by 1000 urinary catheters-day in HIV positive patients. In conclusion, HIV patients are more susceptible to acquire nosocomial infections probably because of immune suppression related to HIV infection and invasive procedures and preventive and control measures should be directed to this patient population.Dissertação Acesso aberto (Open Access) Perfil epidemiológico dos usuários do Centro de Testagem e Aconselhamento no município de Belém, Pará com sorologia positiva para HIV(Universidade Federal do Pará, 2011) NASCIMENTO, Rodolfo Gomes do; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539The pandemic of HIV and aids represent a global phenomenon, dynamic and unstable. One of the main achievements in controlling the epidemic was the creation and expansion of Counseling and Testing Centers (CTC) in several regions of the country. These centres represent the input port of the individual is infected in the health system and provide specialist services in diagnosis, guidance on HIV transmission and prevention. The overall objective of the survey was to describe the epidemiological profile, as well as the risk of users behaviors that were serviced in CTA-Belém, between January 2008 and December 2010 with positive serology for HIV. For this purpose was held an active pursuit and confidentially in medical records archived respecting the anonymity of users and all ethical precepts that involve the manipulation of information. Were analyzed the data of 547 users with HIV of CTA-Belém during the study period (prevalence 6,09%). The results of the survey clarified the profile of users with AIDS, who were in the majority of the general population and were not part of any group more vulnerable to viral infection and sought service have been exposed to some risk and forwarded by other services/health professionals. Regarding the risky behavior, 98.5% reported sexual exposure and results warn not to use condoms in sex with both fixed and with possible partners, being the main reasons for this behavior trust in partnerthe non-availability of condoms during sexual intercourse and others. It is concluded that although there are similarities in relation to other studies developed in the country and with the current trend of HIV/AIDS epidemic, there are peculiarities in our region who deserve better targeting of preventive intervention on the part of public health such as providing free condoms and guidance campaigns for use in stable relationships, including in the population with higher education and professional situation stable.Dissertação Acesso aberto (Open Access) Perfil metabólico e nutricional de pacientes HIV positivos com lipodistrofia submetidos à terapia anti-retroviral: orientação nutricional(Universidade Federal do Pará, 2008-04-24) DUTRA, Cláudia Daniele Tavares; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618Adverse effects of the lipodystrophyca syndrome is common in patients submitted to the use of highly active anti-retroviral therapy (HAART). This study evaluates the effectiveness of nutritional guidance on the metabolic changes in patients with lipodystrophy secondary to TARV, in the city of Belém - PA, in the period October 2006 to December 2007. We evaluated 29 patients, aged from 20 to 60 years, of both sexes, HIV positive, with lipodystrophyca syndrome, use of HAART and analyzed the metabolic and nutritional alterations before and after the intervention clinical-nutrition. The results were analyzed through programmes BioEstat 4.0 with p<0.05 and Virtual Nutri 1.0. We analyzed total cholesterol and fractions (LDL and HDL), triglycerides, insulin resistance, anthropometric measurements, measure of bone density, assessment of hepatic steatosis and cardiovascular risk. There was greater prevalence of patients retirees, male, aged 41 to 50 years and income from zero to three minimum wages. There were no significant differences between the sexes as to alcoholism and smoking, while 72% of patients not practiced physical activity. The association between lipoatrophy and lipohypertrophy and time of use of HAART, was significant, regardless of sex. There is total cholesterol and high triglycerides, low HDL and LDL normal. The analysis of the metabolism of carbohydrates, 48% of patients had changes glicêmicas and 34% resistance to insulin. It was observed that 52% of patients had hepatic steatosis and 79% change in bone mineral density, with greater prevalence for men. The syndrome presented lipoatrófica global measures smaller than the syndrome and mixed lipohipertrófica. After intervention clinical and nutritional changes significant decrease in levels of triglycerides and glucose and increase of HDL. As for cardiovascular changes, 31% of patients reduced the absolute risk of heart attack and death in 10 years, with reduction of total cholesterol and HDL. The nutritional intervention had a significant decrease in food intake of calories, proteins and lipids. Nutrition treatment minimized the metabolic changes of HAART, providing a better prognosis and quality of life of these patients.Dissertação Acesso aberto (Open Access) Prevalência das dermatoses infecciosas e correlação com o estado imunológico de pacientes com HIV atendidos em Centro de Referência em Belém – Pará, Brasil(Universidade Federal do Pará, 2012) SANTOS, Josie Eiras Bisi dos; BRITO, Arival Cardoso de; http://lattes.cnpq.br/0563291980190339Skin disorders affect about 90% of patients infected with human immunodeficiency virus (HIV) in some stage of their disease. The skin manifestations are broad and include viral, bacterial and fungal infections and noninfectious inflammatory diseases. Some of these skin conditions are considered markers of HIV infection and acquired immunodeficiency syndrome (AIDS), they reflect the current state of the patient's immune, due to the occurrence more prevalent in patients with low CD4 cell count serum. Even with the technological evolution of laboratory methods, dermatological signs are still a basic index of the presence and the clinical course of HIV infection. The present study aims to assess the prevalence of skin diseases of infectious etiology in patients with HIV assisted in the Specialized Reference Unit in Special Infectious and Parasitic Diseases in Belém-Pará, Brazil, from March 2011 to October 2011. We conducted a cross-sectional study by clinical and laboratory evaluation of 210 patients with HIV. Serology, cytologic, mycological and skin biopsy with histopathologic examination were performed according to need. The overall prevalence of skin diseases was 49% Dermatological diseases identified were superficial mycoses, onychomycosis, scabies, viral warts, bacterial infections, genital warts, candidiasis, herpes simplex, herpes zoster, leprosy, syphilis, Kaposi's sarcoma and disseminated histoplasmosis skin. The median CD4 cell count in patients with infectious dermatoses was 298 cells/mm3, significantly lower (p=0.0158 *) compared to the median of the patients without infectious dermatoses (384 cells/mm3). The median CD4/CD8 ratio in patients with infectious skin disease was 0.30, significantly lower (p=0.0138 *) compared to the median of the patients without infectious skin disease (0.41). The median viral load in patients with infectious dermatoses was 173 cópias/mm3 and those without infectious skin disease was 25 cópias/mm3, there is no real difference between the groups (p=0.0741). The occurrence of infectious skin diseases according to CD4 cell count showed that there is significant association between viral warts and herpes simplex virus with the CD4 cell count below 350 cells/mm3 (p= 0.0182* and p=0.0428*, respectively). The variation in the prevalence of infectious dermatoses as time of use of antiretroviral therapy (HAART) showed that only superficial mycoses showed a significant increase in the prevalence when compared to patients who did not perform HAART. In the literature, studies of prevalence vary widely between services due to the type and location of the selected sample. The results found in this study characterize patients from the State of Pará, Brazil, sometimes agreeing with the information contained in other prevalence studies in the literature.Dissertação Acesso aberto (Open Access) A qualidade de vida de pacientes com Síndrome lipodistrófica associada ao HIV(Universidade Federal do Pará, 2016) GUIMARÃES, Débora Suellen de Oliveira; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618The HIV lipodystrophy syndrome is characterized by changes in body fat distribution, or anatomical changes, such as lipoatrophy in the face region; loss of limb fat, apparently leaving the venous network of members; the loss of fat from the buttocks with or without the accumulation of fat in the abdomen and can occur in both sexes; and metabolic changes characterized by increased serum lipids; by peripheral insulin resistance, which results in diabetes mellitus. These changes are related to ART - antiretroviral therapy, chronic infection caused by HIV, genetic factors and the wearer's lifestyle (ABBATE, 2006). The purpose of this research is to investigate the quality of life of patients with lipodystrophy syndrome associated with HIV. Data collection was conducted through interviews with patients with lipodystrophy syndrome associated with HIV / AIDS in the age groups above 18 years, who agree to participate. The questionnaire was: A characterization questionnaire of adults with HIV / AIDS and for evaluating the quality of life questionnaire will be used the World Health Organization Quality of Life in HIV Infection, abbreviated version (WHOQOL-HIV-Bref). For statistical analysis we used the electronic program Statistical Package for Social Sciences (SPSS) version 22.0, and the chi-square test of Pearson (X2), assuming level α = 0.05 (5%) and value p≤0,05. Most respondents were male (66%), with age range between 29 and 73 years, as the level of education, 44% had completed high school. Were predominantly of low socioeconomic status, and family income around 1 to 3 minimum wages (88%). Regarding marital status, only 14% were married. Among the respondents, 28 (56%) had a final score for quality of life, so that 22 (44%) had a score to bad quality life. research The conclusion has implications for professional practice, with the realization of the importance of observing, improve and step in to the demands of the users of the services can be met, with a view to further actions directed to their resolution and strengthening the patient's bond with the health team, watching the patient holistically in their various fields of this study, because in general, the majority of patients were dissatisfied with other external services to outpatient endocrinology, showing that this link needs to be strengthened in services of health.Dissertação Acesso aberto (Open Access) Soroepidemiologia da hepatite C em pacientes HIV/AIDS do serviço ambulatorial especializado do Programa DST/AIDS de Imperatriz-Maranhão(Universidade Federal do Pará, 2012) SOUSA, Alda Emídia Barroso Pinheiro de; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769The co-infection of hepatitis C virus (HCV) in people with human immunodeficiency virus (HIV) is frequently observed because these viruses present in their similarity transmission routes, particularly in relation to the parenteral route. In Brazil, the frequency depends on the geographical area in question, ranging from 8.9% to 54%. In co-infected patients, the progression of HCV disease is usually more aggressive and has a high level of viremia, but there is an increased risk of association with HCV cirrhosis and / or liver cancer. The aim of this study was to estimate the prevalence of HCV and risk factors associated with coinfection in HIV-positive individuals in the city of Imperatriz Maranhão. Participants 249 HIV positive patients seen at the SAE Program Municipal STD / AIDS Imperatriz of Maranhão. Was collected from each volunteer 10 mL of peripheral blood for routine HIV testing, where research was done HCV IgG antibodies specific tests and Molecular Biology (RT-PCR) to investigate the viral RNA and genotyping. Among the patients there was similarity between the frequency of genera, 49% male and 51% female, mean age 40 years. It was observed that 98% have low literacy and 63% have an income of up to one minimum wage. The seroprevalence of anti-HCV was 2.4% (6/249). In comparing the risk factors studied among patients in the reactive and non reactive serologic test for HCV-specific antibodies demonstrated that the presence of tattoos and piercing was the only factor that was significant, being more frequent in the reactants. This was the first study that investigates the HIV and HCV coinfection in the city of Imperatriz, Maranhão and identification of coinfected patients was of fundamental importance for the service since then will follow up these patients.