Artigos Científicos - HUJBB/CHU/UFPA

URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/17066

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GBA mutations p.N370S and p.L444P are associated with Parkinson's disease in patients from Northern Brazil
(Universidade Federal do Pará, 2019) AMARAL, Carlos Eduardo de Melo; LOPES, Patrick Farias; FERREIRA, Juliana Cristina Cardoso; ALVES, Erik Artur Cortinhas; MONTENEGRO, Marcella Vieira Barroso; COSTA, Edmar Tavares da; YAMADA, Elizabeth Sumi; CAVALCANTE, Fernando Otávio Quaresma; SILVA, Luiz Carlos Santana da
Mutations of the GBA gene have been reported in patients with Parkinson's disease (PD) from a number of different countries, including Brazil. In order to confirm this pattern in a sample of PD patients from northern Brazil, we conducted a case-control study of the occurrence of the two most common mutations of the GBA gene (c.1226A>G; p.N370S and c.1448T>C; p.L444P) in a group of 81 PD patients and 81 control individuals, using PCR-RFLP, confirmed by the direct sequencing of the PCR products. In the patient group, three patients (3.7%) were heterozygous for the GBA c.1226A>G; p.N370S mutation, and three (3.7%) for GBA c.1448T>C; p.L444P Neither mutation was detected in the control group (p =0.0284). Patients with the c.1448T>C; p.L444P mutation showed a tendency to have an earlier disease onset, but a larger sample number is required to confirm this observation. Our results suggest an association between the GBA c.1226A>G; p.N370S and c.1448T>C; p.L444P mutations and the development of PD in the population of patients from the Northern Brazil.
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Mediastinite por perfuração e ruptura do esôfago torácico
(Colégio Brasileiro de Cirurgiões, 2006-12) TAVARES, Marco Antônio Franco; AZEVEDO, Ives Uchôa de; MODESTO, Alessandre Santana; JANAHÚ, Ajalce de Jesus Leão; NORMANDO JÚNIOR, Geraldo Roger; FELIZ, Allan Hebert
BACKGROUND: To evaluate the mortality by mediastinitis and sepsis originated from ruptures and perfurations of the thoracic esophagus, according to length of diagnosis. METHODS: A retrospective study of 14 years (1992 to 2006) was carried out including patients with thoracic esophageal ruptures and perforations, stratified according to sex, age, mechanism of injury, evolution and treatment (< 24 hours and > 24 hours). RESULTS: Sample was composed of 44 patients, 10 females > (22,73%) and 34 males (77,27%). Age range was from 2 months to 77 years, mean 33,2 years. 19 cases (43,18%) were penetrating external trauma: stab in five cases and gunshot in 14. Endoscopic instrumentation was detected in nine cases (20,45%). Patients in whom esophagorraphy was carried out(early diagnosis, less than 24 hours) the mortality was occurred in three cases (20%). Patients in whom esophagectomy was carried out (later diagnosis, more than 24 hours), mortality occurred in eight cases (36,36%), without statistical significance (p >0,05). Considering conservative treatment, mortality was 71,4% (five out of seven cases) and the difference was statistically significant when compared with patients treated by surgery. CONCLUSION: Conservative treatment of mediastinitis from esophageal ruptures and Perforations showed a high mortality rate when compared to surgical treatment. Among surgical patients, the difference was not significant, reaffirming the indication of esophagectomy in advanced infection (more than 24 hours) and esophogorraphy in early cases.
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Fatores de risco associados ao agravamento de sepse em pacientes em Unidade de Terapia Intensiva
(Universidade Federal do Pará, 2016-12) BARROS, Lea Lima dos Santos; MAIA, Cristiane do Socorro Ferraz; MONTEIRO, Marta Chagas
Introduction: sepsis is a serious public health problem, leading cause of death in Intensive Care Unit (ICU) worldwide. Objective: this study evaluated the aggravation and mortality of sepsis patients in ICU, relating to risk factors, different etiologies and therapies. Methodology: the study was observational descriptive, and evaluated the cases of sepsis (sepsis, severe sepsis and septic shock) from January 2009 to December 2010. Results: of the 212 patients hospitalized in ICU, 181 presented sepsis at different severities, whose sepsis mortality in the ICU was 63%, especially in patients with septic shock (53%), followed by severe sepsis (8.3%). Moreover, the risk factors associated with the aggravation of sepsis were older than 65 years, longer ICU hospitalization time, high frequency of comorbidities and the use of invasive procedures. The highest consumption of antibiotics was carbapenems, and the main isolated multiresistant strains were MRSA, VRE, P. aeruginosa and A. baumannii resistant to carbapenems. Conclusion: this study showed a high mortality from sepsis patients in the ICU, especially in patients with septic shock with comorbidities, who underwent invasive procedures and longer hospitalization time.
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Equinococose policística na Amazônia oriental brasileira: atualização da casuística
(Universidade Federal do Pará, 2004) SOARES, Manoel do Carmo Pereira; SILVA, Carlos Augusto Moreira; ALVES, Max Moreira; NUNES, Heloisa Marceliano; AMARAL, Ivanete do Socorro Abraçado; MÓIA, Lizomar de Jesus Maués Pereira; CONDE, Simone Regina Souza da Silva; CUNHA, Fernanda Barbosa de Almeida da; SILVA, Rosângela Rodrigues; CRESCENTE, Jose Angelo Barletta
By means of epidemiological and clinical-laboratorial approaches was consolidated an update of polycystic echinococcosis in the Eastern Brazilian Amazon, period from 1962 to 2003, including unpublished cases and those already published. In that way, they were identified 40 cases of the disease in referred period, understanding cases coming from the States of Pará and Amapá, Brazil. The width of the ages went from 10 to 72 years and 47,5% belonged to the masculine sex. The liver was the attacked organ (82,5% of the cases). The Echinococcus vogeli (Rausch and Bernstein, 1972), comes as the main agent involved. Starting from the recognition of the importance and of the implications of the handling of the echinococcosis for the tropical area, it is believed that should happen an improvement of the diagnosis, appropriate treatment and of a better registration of the disease.
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Evaluation of frailty, functional capacity and quality of life of the elderly in geriatric outpatient clinic of a university hospital
(Universidade Federal do Pará, 2016-02) FREITAS, Crislainy Vieira; SARGES, Edilene do Socorro Nascimento Falcão; MOREIRA, Karlo Edson Carneiro Santana; CARNEIRO, Saul Rassy
Objective: To investigate the occurrence of frailty and analyze the functional capacity and quality of life in the elderly in a department of geriatrics and gerontology in Belém-PA. Method: Cross-sectional, descriptive and analytical study.103 elderly people were assessed as the socio-demographic and clinical aspects, frailty, according to the phenotype of Fried, history of falls, self-perceived health, functional capacity (FC) and quality of life (QOL). The elderly were classified as frail (FR), pre-frail (PF) and non-frail (NF). The groups were compared using the binomial test, Kruskal-Wallis test and ANOVA test, and the relationship between FC and QOL through Pearson correlation. Results: The mean age was 73.39(±6.42) years; 23.0% of the elderly were FR, 57.0%were PF and 20.0% were NF. The highest criteria of phenotype were muscle weakness and physical inactivity. Was no difference in FC between FR and PF ( p<0.01) and FR and NF ( p<0.01). The FR elderly had lower QOL and the highest scores were intimacy (15.33±2.26) and death and dying (14.88±3.26). There were correlation between FC and QOL in groups PF ( p=0.0273) and NF ( p=0.0017). 62.1% of seniors pointed to health as regular and 34.0% had a history of falling. Conclusion: Muscle weakness and physical inactivity were most striking in the development of frailty, which was associated with worse QOL and FC, despite most seniors be independent. These data are important for early detection of determinants of frailty, since the criteria discussed here are reversible.
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Extranodal nasal NK/T-Cell Lymphoma: a rare oral presentation and FASN, CD44 and GLUT-1 Expression
(2013) PONTES, Hélder Antônio Rebelo; PONTES, Flávia Sirotheau Corrêa; SILVA, Brunno Santos de Freitas; FONSECA, Felipe Paiva; ANDRADE, Bruno Augusto Benevenuto de; RIZO, Victor Hugo Toral; ROMAÑACH, Mário José; LEÓN, Jorge Esquiche; ALMEIDA, Oslei Paes de
Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignant tumor with distinctive clinicopathological features, characterized by vascular invasion and destruction, prominent necrosis, cytotoxic lymphocyte phenotype and a strong association with Epstein-Barr virus. Here is reported an extranodal nasal NK/T-cell lymphoma case, involving the maxillary sinus, floor of the orbit, and interestingly extending to the oral cavity through the alveolar bone and buccal mucosa, preserving the palate, leading to a primary misdiagnosis of aggressive periodontal disease. Moreover, this work investigated for the first time the immunohistochemical expression of fatty acid synthase (FASN) and glucose transporter 1 (GLUT-1) proteins in this neoplasia. FASN showed strong cytoplasmatic expression in the neoplastic cells, whereas GLUT-1 and CD44 were negative. These findings suggest that the expression of FASN and the loss of CD44 might be involved in the pathogenesis of the extranodal nasal NK/T-cell lymphoma, and that GLUT-1 may not participate in the survival adaptation of the tumor cells to the hypoxic environment. Further studies with larger series are required to confirm these initial results.
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Environmental influences on antibody-enhanced dengue disease outcomes
(2012-12) DINIZ, Daniel Guerreiro; FÔRO, César Augusto Raiol; TURIEL, Maíra Catherine Pereira; SÓSTHENES, Márcia Consentino Kronka; DEMACHKI, Samia; GOMES, Giovanni Freitas; REGO, Carla M Damasceno; MAGALHÃES, Marina Cutrim; PINHO, Brunno Gomes; RAMOS, Juliana Pastana; CASSEB, Samir Mansour Moraes; BRITO, Maysa de Vasconcelos; SILVA, Eliana Vieira Pinto da; NUNES, Márcio Roberto Teixeira; DINIZ JUNIOR, José Antônio Picanço; CUNNINGHAM, Colm; PERRY, Victor Hugh; VASCONCELOS, Pedro Fernando da Costa; DINIZ, Cristovam Wanderley Picanço
Because an enriched environment (EE) enhances T-cell activity and T-lymphocytes contribute to immunopathogenesis during heterologous dengue virus (DENV) infections, we hypothesised that an EE increases dengue severity. To compare single serotype (SS) and antibody-enhanced disease (AED) infections regimens, serial intraperitoneal were performed with DENV3 (genotype III) infected brain homogenate or anti-DENV2 hyperimmune serum followed 24 h later by DENV3 (genotype III) infected brain homogenate. Compared AED for which significant differences were detected between the EE and impoverished environmental (IE) groups (Kaplan-Meyer log-rank test, p = 0.0025), no significant differences were detected between the SS experimental groups (Kaplan-Meyer log-rank test, p = 0.089). Survival curves from EE and IE animals infected with the AED regimen were extended after corticoid injection and this effect was greater in the EE than in the IE group (Kaplan-Meyer log-rank test, p = 0.0162). Under the AED regimen the EE group showed more intense clinical signs than the IE group. Dyspnoea, tremor, hunched posture, ruffled fur, immobility, pre-terminal paralysis, shock and death were associated with dominant T-lymphocytic hyperplasia and presence of viral antigens in the liver and lungs. We propose that the increased expansion of these memory T-cells and serotype cross-reactive antibodies facilitates the infection of these cells by DENV and that these events correlate with disease severity in an EE.
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Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário
(2013-12) FAVACHO, Bernard Costa; COSTA, Carleno da Silva; MAGALHÃES, Thamer Costa; ASSUMPÇÃO, Paulo Pimentel de; ISHAK, Geraldo
Gastric neoplasia is a heterogeneous and multifactorial disease and its incidence and mortality vary widely based on geographic location. Approximately 60% of the diagnoses of patients from occidental countries were made on the stages III and IV. The best treatment still is to realize a surgical procedure. AIM: Identify the epidemiological aspects of the patients diagnosed with T4b gastric adenocarcinoma. METHODS: The study was observational, transversal and retrospective; it was also based on secondary sources from patients diagnosed with T4b gastric adenocarcinoma, through pathologic stages. A total of 815 charts were analyzed and 27 patients studied. The variables were: demographic aspects, main symptoms, risk factors, access to health system, surgical aspects, morbidity, mortality and survival. RESULTS: Were included 22 men (81,5%) and five woman (18,5%), in the age group between 38 and 87 years old - median age of 58. The time, in months, to access the health system varied from one to 120, average of 12,5 months. The most prevalent signs and symptoms were: weight loss 23 (85,2%), epigastric pain 22 (81,5%), vomit 16 (59,3%) and gastric fullness 12 (44,4%). The frequency of the affected adjacent body structures was: pancreas 8 (29,6%), liver 7 (25,9%), transverse colon 6 (22,2%), small intestine 6 (22,2%), mesocolon 3 (11,1%), spleen 1 (3,7%) and gallbladder 1 (3,7%). Postoperative morbidity occurred in 51, 85% of the patients. There were a significative association between surgical mortality and the occurrence of fistula/ dehiscence, septic shock and bleeding. The survival rate after six months was 63,27%. CONCLUSION: The mean time between onset of symptoms and access to specialized health services was high. More than half of the patients had postoperative morbidities. Patients who had fistula / dehiscence, bleeding and septic shock were significantly associated with surgical mortality. The survival rate after six months was 63.27%.
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Acidentes por centopéia notificados pelo "Centro de Informações Toxicológicas de Belém", num período de dois anos
(2001-12) BARROSO, Eduardo; HIDAKA, Alexandre Shigemi Vicente; SANTOS, Amanda Xavier dos; FRANÇA, Joana D'arc Matos; SOUSA, Adriana Maria Brito de; VALENTE, Jorgianne Rodrigues; MAGALHÃES, Andréa Franco Amoras; PARDAL, Pedro Pereira de Oliveira
Centipedes are arthropods of the class Chilopoda. The objective of this work was to study the incidence of accidents involving centipedes at "Centro de Informações Toxicológicas de Belém" (CIT-Belém) over a two-year period. Seventy-six patients were studied from March 30, 1998 until March 30, 2000. Centipede accidents occurred in 16.8% of all accidents by venomous animals at Centro de Informações Toxicológicas de Belém; compared to snake accidents, 44.4 % and scorpion accidents, 20.5%. The majority of cases occurred in the residence (86.8%). The most important age group was 20-49 years old (64.4%). The part of human body mostly affected was the superior members (47.4 %). Local pain and edema were found in 95.8% and 52.1% of the patients, respectively. Treatment was symptomatic. Healing occurred in 94.7%, although the outcome of 5.3% of cases was unknown. Centipede accidents are a benign accident, occurring within the residence and treatment consists of measures to decrease the pain.
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Criptococose em crianças no Estado do Pará, Brasil
(1999-10) CORRÊA, Maria do Perpétuo Socorro Costa; OLIVEIRA, Eliseth Costa; DUARTE, Rosineide Roseli Barros Seixas; PARDAL, Pedro Pereira de Oliveira; OLIVEIRA, Flávio de Mattos; SEVERO, Luiz Carlos
Relatam-se 19 casos de criptococose em crianças, diagnosticados em Belém, PA. Em nove pacientes a variedade do agente etiológico foi estudada e identificada como Cryptococcus neoformans var. gattii. A média de idade destes pacients foi 7,8 anos (variação, 5-13 anos). Havia 5 meninas e 4 meninos (razão, 1,25:1). Cinco foram a óbito em três meses apesar do tratamento com anfotericina B (associada com fluconazol 3 ou fluocitosina 1). São comentados a existência de áreas de alta endemia da infecção por var. gattii no Pará e a gravidade da doença causada por essa variedade fúngica.
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Paracoccidioidomicose em crianças em Belém do Pará
(1999-02) FONSECA, Eliane Regine de Souza da; PARDAL, Pedro Pereira de Oliveira; SEVERO, Luiz Carlos
During the period from January/85 to July/96, 102 cases of paracoccidioidomycosis were observed in a hospital in Belém, PA. Thirteen of these cases were children between 3 and 13 years of age, with a predominance of females (8:5). All patients presented the disseminated subacute form of the mycosis. The high prevalence of the mycosis in children in endemic areas of the Amazon region is discussed.
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Anna Turan Machado Falcão (1862-1940): a pioneira médica esquecida da Amazônia
(2012-03) MIRANDA, Aristóteles Guilliod de; ABREU JUNIOR, José Maria de Castro
This article outlines a biography of Anna Turan Machado Falcão. Born in 1862 in Igarapé-Miri, Pará State, Brazil, Dr. Anna Turan was Para's first physician. She graduated in the United States of America in 1887. After returning to Brazil and validating her diploma at the Faculdade de Medicina da Bahia, she worked in the states of Pará, Acre and São Paulo, where she died in 1940.
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A medicina no Estado do Pará, Brasil: dos primórdios à Faculdade de Medicina
(2010-09) MIRANDA, Aristóteles Guilliod de
The practice of medicine, the organization of health services and the start of medical education in Pará State, Brazil, are presented from a chronological perspective, from the first accounts after the arrival of Francisco Caldeira Castelo Branco in 1616 to the establishment of the Faculdade de Medicina e Cirurgia do Pará (Pará School of Medicine and Surgery), in 1919. Some historic facts are highlighted and contextualized, and certain individuals who effectively participated in the events described are mentioned. Aspects related to the teaching of medicine are also described, both at the national level and in Pará State, and its importance to the Amazon Region and part of northeastern Brazil is discussed.
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As expedições da Liverpool School of Tropical Medicine e a Amazônia Brasileira
(2011-06) MIRANDA, Aristóteles Guilliod de; ABREU JUNIOR, José Maria de Castro
This paper describe the early years of the Liverpool School of Tropical Medicine, and the expeditions to Brasilian Amazon, to the Cities of Belém and Manaus describing also what happened with the reserchers involved Herbert Durhan, Walter Myers and Harold Wolferstan Thomas.
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Câncer de vesícula biliar: experiência de 10 anos em um hospital de referência da Amazônia
(2011-04) ISHAK, Geraldo; RIBEIRO, Felipe Soares; COSTA, Daniel Souza da; BAHIA, Leandro Augusto Costa; DIAS, Everton Mesquita; ASSUMPÇÃO, Paulo Pimentel de
Objective: To evaluate the epidemiological aspects of surgical patients with gallbladder cancer (GC) enrolled in a University Hospital in Belém (State of Pará – PA), in the period 1999-2009. Methods: observational, retrospective, descriptive and analytical study of secondary sources of patients with GC in the period 1999-2009. We analyzed 75 medical records, with 34 patients studied. The information collected was used for the TNM tumor staging of GC and to characterize the clinical and surgical population. Results: 79% were female, mean age 66.2 ± 11 years and duration of symptoms was 10.8 ± 17.2 months, with no statistical relationship with the stage of disease. Pain in right upper quadrant, nausea and jaundice prevailed as signs / symptoms. Gallstones were present in 91% of cases and were positive in 100% of patients with stage I / II. The sensitivity of ultrasound to preoperatively suggest GC was 14.28%. The simplest operation performed was cholecystectomy, with the predominant intraoperative finding being hepatic invasion. Adenocarcinoma was the predominant histologic type, especially for stages III and IV. Conclusion: The present study showed high incidence of gallstone disease. Advanced stage adenocarcinoma was the most prevalent. This resulted in a low rate of operations with curative intent, in 30% of the patients, and a mortality rate of 21%. The appreciation of symptoms and early investigation by imaging could facilitate treatment in early stages of GC, providing a better prognosis for patients.
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Aneurisma venoso no pé: relato de casos e revisão da literatura
(2006-12) DOURADO, Octavio Cascaes; MIRANDA, Aristóteles Guilliod de; PINHEIRO FILHO, Antonio; DOURADO, Luciana Oliveira Cascaes
We report two cases of venous aneurysms of the foot, presented as a nonpulsatile, painless mass on the back of the foot, with no history of trauma. Doppler ultrasonography showed an anechoic, oval mass communicating with the vein and venous signal suggestive of venous aneurysm. The diagnosis was confirmed by histopathologic analysis, with aneurysmal dilatation involving the three layers of the venous wall. The treatment consisted of ligation and surgical excision. Venous aneurysms are relatively rare, and their presence has been reported in many locations, particularly in the lower limbs. Any venous aneurysms of the foot were found in the review of the literature.

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