Artigos Científicos - NMT

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Hematological changes in human lymphotropic-T virus type 1 carriers
(Frontiers Media S.A., 2022) RIBEIRO, Jairo Falcão; NOBRE, Akim Felipe Santos; COVRE, Louise Canto Ferreira; VIANA, Maria de Nazaré do Socorro de Almeida; SILVA, Ingrid Christiane; SANTOS, Leonardo Miranda dos; ISHIKAWA, Edna Aoba Yassui; COSTA, Carlos Araújo da; SOUSA, Maísa Silva de
The human T-lymphotropic virus type 1 (HTLV-1), isolated in 1980, causes T-cell leukemia/lymphoma in adulthood, a type of lymphoproliferative disease, and chronic HTLV-1-associated myelopathy, a disease that causes paralysis of the lower limbs, which occur in about 5% of cases in this viral infection. This study aimed to establish the hematological profile of patients with HTLV-1 infection in Belém do Pará, describing the hematological parameters under study, estimating the frequency of lymphocytic atypical, and associating the hematological profile with diseases and symptoms. Hematologic data from 202 individuals were analyzed, including 87 HTLV-1 infected individuals and 115 non-HTLV-1 infected individuals as a control group, composed, at a great part, of relatives of the infected. The seroprevalence of HTLV-1 infection was observed in 71.3% of female individuals, with predominance in the group older than 50 years (44.8%). The analysis of hematological parameters showed a significant difference in the counts of the segmented cells (p = 0.0303) and eosinophils (p = 0.0092) in HTLV-1 carriers. Lymphocytic atypical was a finding present only in HTLV-1 carriers (p = 0.0001). There was no high frequency in the leukocyte counts of those infected by HTLV-1 not among them concerning a significant increase or decrease. It is concluded that HTLV-1 infection is prominent in women over 50 years old. The hematological profile of those infected shows a reduction of segmented cells, an increase of eosinophils, and the presence of atypical lymphocytes. The hematological profile of the HTLV-1 carrier should always be evaluated to identify early some diseases associated with the infection.
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Gender, age, endoscopic findings, urease and Helicobacter pylori: all uncorrelated within a sample of a high gastric cancer prevalence population in Amazon
(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades, 2019-09) MIRANDA, Ariney Costa de; CALDATO, Cássio; SAID, Mira Nabil; LEVY, Caio de Souza; TEIXEIRA, Cláudio Eduardo Corrêa; QUARESMA, Juarez Antônio Simões
BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of cor-relation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylo-ri infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser syner-gistic than is usually expected.
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Helicobacter pylori infection and immune profile of patients with different gastroduodenal diseases
(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades, 2018-06) VINAGRE, Ruth Maria Dias Ferreira; VINAGRE, Igor Dias Ferreira; SILVA, Adenielson Vilar e; FECURY, Amanda Alves; MARTINS, Luisa Caricio
The association between infection with Helicobacter pylori and different gastroduodenal diseases is related to bacterial, host and environmental factors. Studies have demonstrated an association between the genetic diversity of H. pylori, especially in the vacA and cagA genes, and the development of digestive diseases such as peptic ulcer and gastric cancer. In addition, the nature of the host inflammatory response may explain these different manifestations of infection caused by this microorganism. In this respect, host factors that regulate the immune and inflammatory responses involving the functional interaction of H. pylori infection with different components of the immune system, particularly T cells, in gastroduodenal diseases still need further investigation. Objective: To characterize the immune response, including immunity induced by infection with H. pylori, especially virulent strains (vacA alleles and cagA gene), by analyzing the cytokine profile and T-cell population present in gastroduodenal diseases in a Brazilian population. Methods: In a prospective study, gastric biopsies were collected from 554 patients with different gastroduodenal diseases for histological analysis and for the determination of bacterial genotype and cytokine production (IL-4, IL-10, IFN-γ and IL-12) by ELISA. Results: The predominant genotype of the H. pylori strains isolated from the patients studied was s1m1cagA+, which was more common among patients with gastric ulcer, duodenal ulcer and gastric cancer. A significant association was observed between the s1m1cagA+ genotype and a higher degree of inflammation, higher neutrophil activity and the development of intestinal metaplasia. The gastric concentrations of IFN-γ and IL-12 were significantly higher in patients infected with H. pylori than in uninfected individuals. Higher levels of these cytokines were detected in patients with gastric ulcer and cancer, while the levels of IL-4 and IL-10 in the gastric mucosa were lower in these patients. In addition, IFN-γ and IL-12 concentrations in gastric biopsies were higher in patients infected with the virulent s1m1cagA+ genotype. In contrast, IL-4 and IL-10 levels were higher in tissue infected with s2m2cagA in gastric biopsies. Conclusion: Our study shows that the interaction between the type of infectious strain and the Th1 immune response can influence and perpetuate gastric inflammation, and thus contributes to the development of the different clinical manifestations of H. pylori infection.
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Teores de mercúrio em cabelo e consumo de pescado de comunidades ribeirinhas na Amazônia brasileira, região do Tapajós
(Associação Brasileira de Saúde Coletiva, 2018-03) SILVA, Camile Irene Mota da; LIMA, Abner Ariel da Silva; RODRIGUES JÚNIOR, Dario; SILVEIRA, Luiz Carlos de Lima; SOUZA, Givago da Silva; COSTA JÚNIOR, José Maria Farah
Riverine communities are exposed to mercury due to the high ingestion of fish in their diet. In order to evaluate the levels of exposure in the Tapajós region, also assessing the fish ingestion frequency, a study was conducted in adults living in riverine communities in the municipality of Itaituba in the State of Pará. Hair samples were collected for the determination of total mercury and the weekly frequency data of fish ingestion was recorded. The mean concentration of total mercury varied from 7.25μg/g (in 2013) to 10.80μg/g (in 2014), with no significant difference being observed (p = 0.1436). As for fish ingestion frequency, the majority of the individuals evaluated revealed high consumption both in 2013 and in 2014. High levels of total mercury were observed only in those with high consumption of fish in both years. The importance of ongoing monitoring of exposure levels in humans should be stressed, basing itself on indices of tolerance of 6μg/g recommended by the World Health Organization, and investigation about the consumption of fish such that strategies for control and prevention are improved.
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Influence of tramadol on functional recovery of acute spinal cord injury in rats
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2018-12) CHAVES, Rosa Helena de Figueiredo; SOUZA, Celice Cordeiro de; FURLANETO, Ismari Perini; TEIXEIRA, Renan Kleber Costa; OLIVEIRA, Carolina Pinheiro de; RODRIGUES, Emanuelle de Matos; SANTOS, Daniel Arthur Santos dos; SILVA, Renata Cunha; PENHA, Nelson Elias Abrahão da; LIMA, Ana Rita de
Purpose: To evaluate the influence tramadol on functional recovery of acute spinal cord injury in rats. Methods: Ten rats were divided into two groups (n = 5). All animals were submitted by a aminectomy and spinal cord injury at eighth thoracic vertebra. In control group, the rats didn’t receive any analgesic. In tramadol group, the rats received tramadol 4mg/Kg at 12/12h until 5 days by subcutaneous. Animals were following by fourteen days. Was evaluated the Basso, Beattie, Bresnahan scale (locomotor evaluation) and Rat Grimace Scale (pain evaluation) at four periods. Results: There no difference between the groups in locomotor evaluation in all periods evaluated (p>0.05) and in both groups there was a partial recover of function. The tramadol group show a lower pain levels at the first, third and seventh postoperatively days when comparing to the control group. Conclusion: The tramadol as an analgesic agent don’t influence on functional recovery of acute spinal cord injury in rats.
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Hanseníase e atenção primária à saúde: uma avaliação de estrutura do programa
(Centro Brasileiro de Estudos de Saúde, 2017-03) SOUSA, Gutembergue Santos de; SILVA, Rodrigo Luis Ferreira da; XAVIER, Marília Brasil
Objective: to evaluate the structure of the municipal program of leprosy control in Canaã dos Carajás (Pará), in the context of Primary Health Care. Methods: this is an assessment of health programs, focusing on leprosy, targeting managers of the leprosy program and managers of health facilities of primary care. Two different questionnaires, developed specifically for this purpose, were used. Conclusion: the municipality in question has a structure classified between poor and regular, showing several weaknesses in the assessed program for the care of leprosy.
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HCV infection through perforating and cutting material among candidates for blood donation in Belém, Brazilian Amazon
(Universidade Federal do Pará, 2014-12) VALOIS, Rubenilson Caldas; PEREIRA, Luciana Maria Cunha Maradei; CRESCENTE, Jose Angelo Barletta; OLIVEIRA FILHO, Aldemir Branco de; LEMOS, José Alexandre Rodrigues de
This study evaluated epidemiological factors for HCV infection associated with sharing perforating and cutting instruments among candidates for blood donation (CBD) in the city of Belém, Pará, Brazilian Amazon. Two definitions of HCV infection cases were used: anti-HCV positivity shown by EIA, and HCV-RNA detection by PCR. Infected and uninfected CBD completed a questionnaire about possible risk factors associated with sharing perforating and cutting instruments. The information was evaluated using simple and multiple logistic regressions. Between May and November 2010, 146 (1.1%) persons with anti-HCV antibodies and 106 (0.8%) with HCV-RNA were detected among 13,772 CBD in Belém. Risk factors associated with HCV infection based on the EIA (model 1) and PCR (model 2) results were: use of needles and syringes sterilized at home; shared use of razors at home, sharing of disposable razors in barbershops, beauty salons etc.; and sharing manicure and pedicure material. The models of HCV infection associated with sharing perforating and cutting instruments should be taken into account by local and regional health authorities and by those of other countries with similar cultural practices, in order to provide useful information to guide political and public strategies to control HCV transmission.
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Evolução do estado nutricional de menores de 5 anos em aldeias indígenas da Tribo Parakanã, na Amazônia oriental brasileira (1989-1991)
(Universidade Federal do Pará, 1994-02) MARTINS, Sandro José; MENEZES, Raimundo Camurça de
Acesso aberto (Open Access)
Avaliação da resposta aos esquemas de tratamento reduzidos para malária vivax
(Universidade Federal do Pará, 2001-08) ABDON, Nagib Ponteira; PINTO, Ana Yecê das Neves; SILVA, Rita do Socorro Uchôa da; SOUZA, José Maria de
Relapses may occur with long standard treatment of vivax malaria, and these are caused by incomplete patient’s compliance. The use of reduced schedules may further better patient compliance, while maintaining the same efficacy, tolerance and minimal adverse reactions. The objective of this study was to test two schedules with reduced doses of chloroquine for vivax malaria and comparing these with the classical schedule. The authors studied 120 outpatients, with vivax malaria, aged over 12 years, submitted to three therapeutic schemes: scheme I: chloroquine phosphate (150mg) in a dose of 25mg/kg/day for three days (10mg/kg/ day in the first day, 7.5mg/kg/day in the second and third day), plus primaquine (15mg) in a dose of 0.25mg/kg/day for fourteen days; scheme II: chloroquine, in a single dose of 10mg/kg, plus primaquine in a dose of 0.5mg/kg/day for seven days; scheme III: chloroquine, 10mg/kg in a single dose plus primaquine in a dose 0.5mg/kg/ day for five days. The clinical response to all three therapeutic schemes was satisfactory. The disappearance of malarial symptoms occurred after a maximum 96 hours of treatment, while the assexual parasitaemia clearance occurred within 72 hours, in all therapeutic schemes.
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HCMV UL97 phosphotransferase gene mutations may be associated with antiviral resistance in immunocompromised patients in Belém, PA, Northern Brazil
(Universidade Federal do Pará, 2018-04) SILVA, Dorotéa de Fátima Lobato da; CARDOSO, Jedson Ferreira; SILVA, Sandro Patroca da; ARRUDA, Leda Mani França de; MEDEIROS, Renato Lopes Fernandes de; MORAES, Marluce Matos de; SOUSA, Rita Catarina Medeiros
Human cytomegalovirus is one of the causes of opportunist infections in immunocompromised patients, and is triggered by factors such as state of viral latency, weakened immune responses, and development of antiviral resistance to ganciclovir, the only drug offered by the public health system in Brazil to treat the infection. The goal of this study was to identify mutations that may be associated with antiviral resistance in immunocompromised patients. Methods: Molecular analysis was performed in 82 blood samples and subjected to genomic DNA extraction by a silica-based method. Three sequences of the HCMV UL97 gene, which encodes a phosphotransferase protein required for activation of ganciclovir, were amplified by polymerase chain reaction. Pyrosequencing methods were applied to one external 2096-bp segment DNA and two internal sequences between nucleotides 1087 to 1828 to detect mutations in this gene. Results: Approximately 10% of sequences contained mutations between nucleotides 377 and 594, in conserved regions of the UL97 gene, leading to amino acid changes. Eleven coding mutations were identified, including changes leading to amino acid substitutions, E596K and S604F, which were observed in 100% of samples and are described for the first time in Brazil. In addition, one mutation (A594V) that is associated with ganciclovir resistance was detected in a kidney transplant patient. Conclusions: Further studies to detect mutations associated with HCMV resistance to antiviral drugs are required to demonstrate the need to increase the variety and availability of drugs used to treat viral infections in the public health care system in Brazil.
Acesso aberto (Open Access)
Incidence of congenital toxoplasmosis in the city of Belém, State of Pará, Northern Brazil, determined by a neonatal screening program: preliminary results
(Universidade Federal do Pará, 2012-02) BICHARA, Cléa Nazaré Carneiro; CANTO, Giselle Acácia de Cristo; TOSTES, Camila de Lima; FREITAS, Jofre Jacob da Silva; CARMO, Ediclei Lima do; PÓVOA, Marinete Marins; SILVEIRA, Eliete da Costa
Introduction: The aim of this study was to determinate the incidence of congenital toxoplasmosis among a group of newborns (NBs) from Belém using neonatal screening. Methods: Among the 6,000 newborns referred for investigation of genetic and metabolic diseases, 1,000 were selected for screening for congenital toxoplasmosis by determining the amount of IgM in the eluates of blood collected on filter paper. Positive tests were confirmed using paired serology of the NB and his mother. Results: Out of the 1,000 NBs assessed, one had a positive screening result that was confirmed by paired serology. Conclusions: The incidence of congenital toxoplasmosis in Belém was 10/10,000 live NBs.
Acesso aberto (Open Access)
Canine antibody response to Lutzomyia longipalpis saliva in endemic area of visceral leishmaniasis
(Universidade Federal do Pará, 2016-06) BATISTA, Luís Fábio da Silva; MATTA, Vânia Lúcia Ribeiro da; TOMOKANE, Thaise Yumie; PACHECO, Acácio Duarte; SILVEIRA, Fernando Tobias; ROSSI, Claudio Nazaretian; MARCONDES, Mary; LAURENTI, Márcia Dalastra
Introduction: Canine exposure to Lutzomyia longipalpis bites and the potential of Leishmania infantum transmissibility for the vector were evaluated. Methods: Immunoglobulin G (IgG) anti-Lu longipalpis saliva and -L. infantum, and blood parasite load were determined in dogs from endemic areas of visceral leishmaniasis. Results: Blood parasitism was similar between symptomatic and asymptomatic dogs. IgG anti-L. infantum was higher in symptomatic dogs, but IgG anti-Lu. longipalpis saliva was mostly observed in higher titers in asymptomatic dogs, indicating vector preference for feeding on asymptomatic dogs. Conclusions: Our data suggest a pivotal role of asymptomatic dogs in L. infantum transmission in endemic areas.
Acesso aberto (Open Access)
Genes that encodes NAGT, MIF1 and MIF2 are not virulence factors for kala-azar caused by Leishmania infantum
(Universidade Federal do Pará, 2014-10) AGUIAR, Bruno Guedes Alcoforado; COELHO, Daniela Lemos; COSTA, Dorcas Lamounier; DRUMOND, Betânia Paiva; COELHO, Luiz Felipe Leomil; FIGUEIREDO, Lívio Carvalho; ZACARIAS, Danielle Alves; SILVA, Jailthon Carlos da; ALONSO, Diego Peres; RIBOLLA, Paulo Eduardo Martins; ISHIKAWA, Edna Aoba Yassui; GAÍDO, Samara Belchior; COSTA, Carlos Henrique Nery
Introduction: Kala-azar is a disease resulting from infection by Leishmania donovani and Leishmania infantum. Most patients with the disease exhibit prolonged fever, wasting, anemia and hepatosplenomegaly without complications. However, some patients develop severe disease with hemorrhagic manifestations, bacterial infections, jaundice, and edema dyspnea, among other symptoms, followed by death. Among the parasite molecules that might influence the disease severity are the macrophage migration inhibitory factor-like proteins (MIF1 and MIF2) and N-acetylglucosamine-1-phosphotransferase (NAGT), which act in the first step of protein N-glycosylation. This study aimed to determine whether MIF1, MIF2 and NAGT are virulence factors for severe kala-azar. Methods: To determine the parasite genotype in kala-azar patients from Northeastern Brazil, we sequenced the NAGT genes of L. infantum from 68 patients as well as the MIF1 and MIF2 genes from 76 different subjects with diverse clinical manifestations. After polymerase chain reaction (PCR), the fragments were sequenced, followed by polymorphism identification. Results: The nucleotide sequencing of the 144 amplicons revealed the absence of genetic variability of the NAGT, MIF1 and MIF2 genes between the isolates. The conservation of these genes suggests that the clinical variability of kala-azar does not depend upon these genes. Additionally, this conservation suggests that these genes may be critical for parasite survival. Conclusions: NAGT, MIF1 and MIF2 do not alter the severity of kala-azar. NAGT, MIF1 and MIF2 are highly conserved among different isolates of identical species and exhibit potential for use in phylogenetic inferences or molecular diagnosis.
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Donovanose no Pará
(Universidade Federal do Pará, 1991-12) SALGADO, Ubirajara Imbiriba; NEVES, Cláudio Domingues das; SILVA, Domingos; MACÊDO, Célia
From 1954 to 1990 granuloma inguinale was diagnosed in 259 patients al the dermatology service of the Universidade Federal do Pará in Belém, Brazil. Among them, 56 cases had ocurred in the twenty-year period 1954-1974 and as many as 133 cases were seen during the last five years only. Greater sexual liberty, poor social and economic conditions, and especially increasing homosexual behavior were implicated by the authors as chief determinants for this augmented incidence of the disease.
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Filariose linfática em Belém, Estado do Pará, Norte do Brasil e a perspectiva de eliminação
(Universidade Federal do Pará, 2005-04) FONTES, Gilberto; FRAIHA NETO, Habib; ROCHA, Eliana Maria Mauricio da; BRAUN, Reinaldo F.; VIEIRA, João Batista F.; PADILHA, Saturnino S.; ROCHA, Raimundo Cândido
The objective was to characterize the epidemiological situation of lymphatic filariasis in Belém, state of Pará. Hemoscopic data was analyzed from 1951 through 2003. Information for the period from 1951 to 1994 was collected from reports available from the National Health Foundation. Data from 1995 to 2003 was obtained through surveys carried out in 62 city sectors, within the eight administrative districts of the city. An appreciable drop in the microfilaraemic rates was observed over the years. The percentages of parasitized individuals in the decades of 1950, 1960, 1970, 1980 and 1990, were respectively: 8.2%, 2.6%, 0.7%, 0.16% and 0.02%. In 2001, a single microfilaraemic case was diagnosed, interrupting a series of two years without registering positive cases in the city. In 2002 and 2003, hemoscopic and entomological surveys were performed simultaneously revealing no microfilariae positive individuals, nor infected mosquitoes. To maintain this trend, surveillance measures must be conducted in order to detect and promptly treat patients, to prevent the risk of resurgence of a focus apparently now controlled.
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Dermatitis after contact with Pheropsophus sp (Coleoptera, Carabidae, Brachininae) in the Pará State, Brazilian Amazon
(Universidade Federal do Pará, 2016-12) PARDAL, Pedro Pereira de Oliveira; SILVA, Cristiane Tárcis Cunha da; MONTEIRO, Wuelton Marcelo; GADELHA, Maria Apolonia da Costa
Dermatitis caused by bombardier beetles is rarely reported. Here, we report a case of beetle-caused dermatitis that occurred in Pará State, the Brazilian Amazon. A female patient while putting on her shoes, felt a burning pain in the right hallux and noticed a beetle inside the shoe. During medical consultation, the physician observed that the injury site was brown and discolored. The patient complained of localized burning pain and blurred vision. The beetle responsible for the injury was identifi ed as Pheropsophus sp. Administered treatment included cleaning with saline, analgesics, and topical hydrocortisone acetate and the patient was discharged without complaints.
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Soroprevalência de anticorpos contra o antígeno CagA do helicobacter pylori em pacientes com úlcera gástrica na região Norte do Brasil
(Universidade Federal do Pará, 2002-08) MARTINS, Luisa Caricio; CORVELO, Tereza Cristina de Oliveira; OTI, Henrique Takeshi; BARILE, Katarine Antônia dos Santos
Helicobacter pylori is a pathogenic agent with a worldwide distribution and is involved in the development of many gastrointestinal diseases. Nowadays infection with the virulent strain CagA+ of H. pylori is considered one of the main etiological factors in the development of gastric ulcer. Based on this information, we investigated the seroprevalence of virulent strains among patients with gastric ulcer from one region, using serologic tests to detect antibodies against H. pylori and CagA protein. Infection by the virulent strain was found in 82% (40/55) of the patients, and among these, 89% (40/45) presented an increased degree of inflammation in the gastric mucosa, with a dense infiltration of leukocytes in the tissue, which probably favored the formation of gastric ulcer. We concluded that the presence of the virulent strain is related to the development of an increased inflammation in the gastric mucosa.
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Prevalence of human papillomavirus infection and cervical cancer screening among riverside women of the brazilian Amazon
(Universidade Federal do Pará, 2017-07) DUARTE, Daniel Valim; VIEIRA, Rodrigo Covre; BRITO, Elza Baía de; PINHEIRO, Maria da Conceição Nascimento; MONTEIRO, Jeniffer do Socorro Valente; VALENTE, Mário Diego Rocha; ISHIKAWA, Edna Aoba Yassui; FUZII, Hellen Thais; SOUSA, Maísa Silva de
Purpose: the aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed. Methods: cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection. Results: the mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% (n = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% (n = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions (p = 0.026). Conclusions: the infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.
Acesso aberto (Open Access)
Epidemiological, clinical and evolutionary aspects of tuberculosis among elderly patients of a university hospital in Belém, Pará
(Universidade Federal do Pará, 2017-02) CHAVES, Emanuele Cordeiro; CARNEIRO, Irna Carla do Rosário Souza; SANTOS, Maria Izabel Penha de Oliveira; SARGES, Nathália de Araújo; NEVES, Eula Oliveira Santos das
Objective: To evaluate the epidemiological, clinical and evolutionary aspects of tuberculosis in elderly patients of a university hospital in Belém, Pará. Method: A cross-sectional study was conducted in a university hospital, where 82 records of cases of tuberculosis in elderly patients were analyzed. The data was analyzed by applying the G-test, assuming a level of α=0.05 (5%) and a value of p=0.05. Results: Most of the elderly patients were male (64.6%), aged 60-69 years, especially among men (64.2%). Most were new cases of tuberculosis (95.1%), with a pulmonary clinical form (75.6%), associated diseases (69.5%) and a length of stay exceeding 21 days. Fever (67.1%), dyspnea (64.6%), weight loss (61.0%), productive cough (59.8%), chest pain (51.2%) were the main signs and symptoms. Regarding treatment, there was a high percentage of adverse reactions (50%), predominantly gastrointestinal events (70.7%). Most patients were cured (59.8%), but mortality from tuberculosis was considered high (15.9%). In terms of the exposure variables and outcome, there was a statistically significant difference for the age group (p=0.017), length of stay (p=0.000) and adverse reactions (p=0.018) only. Conclusion: The clinical presentation and therapeutic management of tuberculosis among the elderly has characteristics peculiar to this group, making it important to strengthen strategies that facilitate early identification of suspected cases of TB among elderly persons in the community, which should take place mainly through the primary care system.
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Manifestações emocionais e motoras de ribeirinhos expostos ao mercúrio na Amazônia
(Universidade Federal do Pará, 2017-06) COSTA JÚNIOR, José Maria Farah; LIMA, Abner Ariel da Silva; RODRIGUES JÚNIOR, Dario; KHOURY, Eliana Dirce Torres Khoury; SOUZA, Givago da Silva; SILVEIRA, Luiz Carlos de Lima
Introduction: The investigation of clinical and neurological impactations associated with exposure to mercury levels in exposed populations is necessary in the Amazon. Objective: To analyze emotional and motor symptoms of riverside dwellers exposed by diet in the municipalities of Itaituba and Acará, in Pará, Brazil. Methods: Hair samples were collected to assess the total mercury (HgT). Demographic data as well as emotional (depression, anxiety and insomnia) and motor (paresthesia, muscle weakness, loss of balance when walking, tremors, limb pain and dysarthria) symptomatology data were obtained. Results: Mean levels of HgT in Itaituba were significantly higher (p < 0.0001) than in Acará. Emotional symptoms were identified in 26 (26.5%) participants from Itaituba and in 24 (52.2%) from Acará. Specific motor complaints in Itaituba occurred in 63 (64.3%) volunteers; the most frequently mentioned afflictions were limb pain (36.7%), paresthesia (32.6%) and muscle weakness (27.5%). In Acará, 33 (71.7%) participants had motor symptoms, the majority of which complained of paresthesia (54.3%), limb pain (52.2%) and tremors (34.8%). Average HgT levels in Itaituba in those with emotional and motor symptoms were above the tolerable levels (6 μg/g) determined by the World Health Organization. Conclusion: Results showed that mercury levels in emotional and motor symptoms in Itaituba are higher than in riverside dwellers in Acará. Further studies, including the application of specific qualitative and/or quantitative standard tests, as well as the investigation of other clinical signs are necessary.