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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Acesso aberto (Open Access)
Persistência do Papilomavírus humano (HPV) após tratamento do câncer do colo uterino no norte do Brasil
(Universidade Federal do Pará, 2019-01-28) ORTEGA, Alejandra María Maradiaga; VILLANOVA, Fabiola Elizabeth; http://lattes.cnpq.br/2795981281220026
The cervical cancer is, after breast cancer, the leading oncologic cause of death among women living in developing countries. The cervical cancer is the third most incident cancer in Brazil and without considering non-melanoma skin tumors is the most incident in the northern region of Brazil. Human papillomavirus-HPV is considered the causal agent of cervical cancer and associated with different risk factors inherent to each woman (behavioral, reproductive and socioeconomic), determines the development of this disease. The HPV infection is most often asymptomatic and transient; however, 10-20% of infections caused mainly by genotypes of high oncogenic risk of the virus may persist and lead to invasive cervical cancer. The objective of this study was to investigate the persistence of HPV in cervical specimens in women with invasive cervical cancer after being treated with radiotherapy and / or concomitant chemotherapy in order to determine if the infection with the virus may be a risk factor for recurrence of disease or be associated with a worse prognosis. Forty four patients were selected, from July 2015 to July 2018, with a mean age of 47 years, with cervical cancer (at stages IB1-IVB of disease), attended at Ophir Loyola Hospital, an oncological reference center in the state of Pará. Clinical-epidemiological data and two cervical smear samples (one prior and one post-treatment) were collected, totaling 88 samples for the diagnosis of HPV. Samples were analyzed by Polymerase Chain Reaction (Nested PCR) to detect the presence of HPV DNA; and were genotyped for 9 viral types (two low risk: 6 and 11, and seven high oncogenic risk: 16, 18, 31, 33, 35, 52, 58) by real-time PCR. It was verified that the majority of the patients were treated by epidermoid cancer in stage IIB of the disease; and that prior to treatment HPV was present in 93% (41/44) of the patients, persisting in 75% (33/44) of them, at the end of treatment. Seven viral genotypes were detected (HPV 6, 16, 18, 33, 35, 52 and 58) causing both single and multiple infections, with HPV 16 being the most prevalent genotype. It has been shown that treatment with concomitant radiotherapy / chemotherapy is effective to eliminate the virus, but more studies are needed to determine if the presence of the virus influences the final response to treatment. Making evident the need to implement strategies of prevention and control of this type of cancer, based on the detection of HPV DNA.
Acesso aberto (Open Access)
Perfil epidemiológico de mulheres vivendo com o hiv/aids a partir da perimenopausa no estado do Pará: um estudo através dos instrumentos de monitoramento da epidemia
(Universidade Federal do Pará, 2018-09-20) SANTOS, Eliane Regine Fonseca; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
The great progress in controlling HIV infection through combined antiretroviral therapy (HAART) has transformed AIDS from a fatal into a chronic disease. Women living with HIV/AIDS will experience the climacteric and its events more often, what justifies the necessity to know the female population in order to design an action plan for this phase. This transversal, descriptive study was based on an exploratory documentary analysis of HIV/AIDS registries among women in the 40-64 age group, from 2014 to 2017, in the state of Pará. The Brazilian Notifiable Diseases Surveillance System (SINAN), Mortality Surveillance System (SIM), Logistic and Supply Management System of Drugs (SICLOM), Medical Laboratory Examination Management System (SISCEL), and Hospital Surveillance System of the National Health System (SIHSUS) provided data studied herein. This research aimed at describing the epidemiological profile of women living with HIV/AIDS in the state of Pará to identify the rate of hospital stays for AIDS and its related diseases, the AIDS mortality rates in the state, the number of women in virological failure, and their whereabouts. A total sum of 1.237 cases were reported in the period, with the highest amount in 2017 (37.1%), mainly in the 40-44 age group (30.3%), brown (82.1%), low schooling (41.2%), and urban dwellers (85.2%). The highest hospital mortality rate was in the metropolitan region I (73.9%). The viral load was detectable in 383 women, being the 40-44 age group the one with the highest detectability rate. UREDIPE and CASA DIA are the services where most women were observed in virological failure. It is concluded that brown female urban dwellers, with low schooling, in the 40-44 age group were the ones with the highest number of notification at SINAN. The metropolitan region I had the highest mortality rate.
Acesso aberto (Open Access)
Caracterização das infecções por norovírus nas hospitalizações pediátricas por gastrenterite na cidade de Belém, Pará
(Universidade Federal do Pará, 2012-04-20) SIQUEIRA, Jones Anderson Monteiro; GABBAY, Yvone Benchimol; http://lattes.cnpq.br/1579859438466504
The Norovirus (NoVs), Caliciviridae family, is related with acute gastroenteritis (AGE) in people of all ages groups. Its importance as cause of outbreaks have been confirmed, which occur mainly indoors. Its transmission is mainly by the fecal-oral route through contaminated water and food, and person to person contact. The disease usually is characterized by diarrhea, vomiting, nausea and abdominal cramps. The aim of this study was to demonstrate the importance of NoVs as pathogen associated with hospital admissions of children with AGE in Belém, Pará. The collection of fecal specimens occurred from May 2008 to April 2011, being only tested the samples with negative results for rotavirus. The enzyme immunoassay (EIA) and the reverse transcription-polymerase chain reaction (RT-PCR) were used for NoVs detection. The samples with positive results by EIA and negative by RT-PCR, were submitted to the semi-nested RT-PCR, and the ones with remain negative, were tested by the real-time PCR. A total of 483 samples were analyzed with a positivity of 35.4% (171/483). Adopting the RT-PCR as the reference method, the EIA had a sensitivity of 85.9% and a specificity of 93.4% with excellent reproducibility between them (kappa = 0.8, p <0.0001). The 22 samples positive only by EIA were tested first by semi-nested RT-PCR and after by real-time PCR, with a positivity of 63.6% (14/22) and 75% (6/8), respectively. The partial nucleotide sequencing of ORF1 region demonstrated the presence of GII.4d (80.8%-42/52), GII.7 (7.7%-4/52) and GII.b (11.5%-6/52) genotypes. Sequencing was performed in 64.3% (9/14) of the samples positive only by semi-nested RT-PCR, also corresponding to ORF1, which 55.6% (5/9) were classified as GII.4d and 44.4% (4/9) as GII.b. Of the six samples classified as GII.b, five were characterized as GII.3 when sequenced with primers specifics for the capsid region, suggesting the possibility of recombinants samples. A higher infection rate was observed in children under 2 years of age (90.1%-154/171) and the main symptoms were vomiting (95.8%-137/143) and dehydration (94.4%-118/25), considering the diarrhea was an inclusion criterion. Most infected children had more than 9 days of diarrhea (41.2%), 4 evacuations per day (43.9%) and more than 5 episodes of vomiting (90%) during hospitalization. Regarding seasonality, three peaks of positivity were observed in September and October 2008 (63.6%), and in February 2010 (62.1%). Any correlation with the climatic parameters of rainfall, humidity and temperature was demonstrated. This study confirmed the importance of NoVs as viral enteropathogen associated with AGE among hospitalized children in Belém, imposing the necessity of an active surveillance, in order to avoid possible morbidity caused by this virus in childhood.
Acesso aberto (Open Access)
Rotavírus do grupo C associado à hospitalização de crianças com gastrenterite aguda em Belém, Pará
(Universidade Federal do Pará, 2014-07-30) LOBO, Patrícia dos Santos; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435
Acute gastroenteritis (AG) is a major cause of morbidity and mortality of children worldwide, being rotavirus one of the causative agents of AG, responsible for about 38.3% of the cases of hospitalization, resulting in 197,000 deaths of children under five years annually, mostly in developing countries. Rotavirus belongs to the family Reoviridae, genera Rotavirus, have genome composed by 11 segments of double-stranded RNA (dsRNA) and are classified into eight groups/different species (A to H).The most commonly found belongs to the group/species A (RVA), however rotavirus group/species C (RVC) has assumed importance in gastroenteritis and usually relate to self-limiting course of childhood diarrhea, with possible transmission from pigs. This study aims to detect the RVC in children less than three years of age hospitalized with acute gastroenteritis in Belém city, Pará state, Amazon region, Brazil. From May 2008 to April 2011, an intensive surveillance for AG was performed in a pediatric hospital of Belém in children with AG, of which 279 samples had negative results for RVA and norovirus. Accordingly, the nucleic acid was extracted from the fecal suspension with silica by the method of reverse transcribed and amplified by polymerase chain reaction (PCR) using primer pairs specific for the VP7 gene G8S/G8A; C1/C4 for VP6; T434/T435 for VP4; and NSP4 (+)/(-) specific for NSP4 gene. The positive control (prototype Cowden) and negative control (water RNAse free) were used in all tests. Automatic sequencing and subsequent phylogenetic analysis were performed. Data were analyzed using statistical chi-square partition, Fisher's exact test and simple logistic regression with p values ≤ 0.05. The positive rate for RVC was 2.1% (6/279) by PAGE and RT-PCR and posteriorly, submitted to automated sequencing and classified in genotypes I2, G4, P[2] and E2 for VP6, VP7, VP4 and NSP4 genes, respectively. The frequency of RVC was higher in the age group between 24 to 36 months (5.7%) (p= 0.0493). Gender more affected by RVC was the male with a frequency of 83.3%. Signs and/or symptoms most frequent in children with RVC were fever (80%), vomiting (83.3%) and dehydration (100%). In summary, in this study it was possible the characterization and phylogenetic analysis of VP6, VP7, VP4 and NSP4 genes, providing important data regarding the presence of these agents in hospitalized children with gastroenteritis in the metropolitan region of Belém, Pará.
Acesso aberto (Open Access)
Avaliação clínica e epidemiológica do papilomavírus humano em mulheres idosas em unidades de saúde em Belém –Pará -Brasil
(Universidade Federal do Pará, 2014-08-27) FREITAS, Wiviane Maria Torres de Matos; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973
Aging is a real phenomenon that brings individual and social changes. Among these current modifications is the permanence of the elderly population in the field of sexual activity. Once this event was particularly the young, the elderly today and are sexually active still increasingly exposed to sexually transmitted diseases (STDs), including infection with the human papillomavirus -HPV, not to adopt safe habits such as condom use. The STD rates in the elderly are of concern when associated with increasing number of cervical cancer in this population. The study aimed to evaluate clinically and epidemiologically HPV in older women to health facilities in Belém / PA. It is a cross-sectional, analytical and quantitative study. Information was collected through clinical and epidemiological questionnaire containing variables on first sexual intercourse, sexual partners, alcohol consumption and smoking habits, etc. Cells of the uterine cervix for performing Pap smear, DNA extraction and detection of HPV DNA were collected. The HPV detection was performed by PCR and subtyping of the real-time PCR. The collections are given after approval of the Center for Tropical Medicine / UFPA Research Ethics Committee under the number 401.991 and analyzed by means of the construction of the database and the Chi-square and Fisher exact tests applied level of significance accepted of α ≤ 0.05. For data analysis, counted with 159 samples of older, averaged 67.98 years of age, widows and with incomplete primary education most. Registered a 6.28% prevalence of HPV infection in these elderly surveyed, there was a significant relationship between infection with multiple partners (p≤0,006) and the habit of smoking in the life (p≤0,03) . Another important fact is older in sexual activity as a higher prevalence of HPV (14.28%) than those without activity (2.72%). Added the event of an elderly infected with viruses having a subtype of high oncogenic risk (HPV16), in addition to all older received cytology within the normal range. It is concluded that despite the prevalence is decreasing in this present age, the elderly are exposed to risk factors that may contribute to increased rates of cervical cancer, highlighting the importance of this research and the constant screening in these women.
Acesso aberto (Open Access)
Malária em mulheres na idade reprodutiva: análise dos aspectos clínico-epidemiológicos na região de Itaituba, 2005 a 2007
(Universidade Federal do Pará, 2010) MELO, Wilson Franco de; PINHEIRO, Maria da Conceição Nascimento; http://lattes.cnpq.br/6353829454533268
A malária na gestação representa uma ameaça à vida da mãe e do concepto além de influenciar na evolução da gravidez. Visando esclarecer aspectos da malária que acomete gestantes de áreas hiperendêmicas na Amazônia, este estudo se propõe avaliar aspectos clínico-epidemiológicos da doença em mulheres na idade reprodutiva, com ênfase em gestantes internadas em hospital público de referencia para a região de Itaituba. O estudo foi conduzido no HMI de Itaituba no período de 2005 a 2007, através do levantamento de prontuários de mulheres hospitalizadas e com diagnóstico de malária confirmado pela gota espessa, e da análise documental baseada nos dados do SIVEP-Malária. Os resultados evidenciaram que no Pará, em 2007, mais de 51% dos casos notificados foram oriundos de apenas nove municípios, dois deles (Itaituba e Jacareacanga), pertencentes à microrregião de Itaituba, área onde foi registrada maior Incidência Parasitária Anual (IPA). Os dados dos prontuários de 30 pacientes (sete, gestantes) revelaram, em sua maioria, que eram procedentes da área rural do município de Itaituba e haviam sido infectadas por P. falciparum; que as gestantes eram as mais jovens (p<0,05); e que o tempo de internação foi similar entre gestantes e não-gestantes. As intercorrências sobre o curso gestacional foram um óbito fetal (malária por P. vivax, segundo trimestre) e um parto prematuro (malária por P. falciparum, terceiro trimestre). Concluiu-se, a partir dessas observações, que casos graves de malária podem ocorrer tanto associados à espécie vivax como falciparum fazendo-se necessário constante vigilância epidemiológica, especialmente no município de Itaituba, onde está concentrado o maior número de casos da doença. As medidas de vigilância epidemiológica a serem adotadas devem privilegiar o diagnóstico precoce e tratamento imediato das pacientes, sobretudo das gestantes, já que estão sujeitas a maior risco de complicações com sérias conseqüências para o concepto.
Acesso aberto (Open Access)
Infecção humana por Leishmania (Leishmania) chagasi em área endêmica de leishmaniose visceral no estado do Pará, Brasil: uma abordagem epidemiológica, clínica e imunológica
(Universidade Federal do Pará, 2010) ROSAS FILHO, Mário de Souza; SILVEIRA, Fernando Tobias; http://lattes.cnpq.br/8106158306299969
A transeccional study was carried out in a cohort of 946 individuals of both sexes, from one year old and upwards, living in endemic area of American visceral leishmaniasis (AVL), municipality of Barcarena, northeast Pará, Brazil. The major aim of this study was to identify individuals with the symptomatic and/or asymptomatic infection due to Leishmania (L.) chagasi, and to study the two types of infection, both clinically and immunologicall. For diagnosis of infection there were used the indirect fluorescent antibody test (IFAT) and the leishmanin skin test (LST) with amastigotes and promastigotes antigens of Leishmania (Leishmania) chagasi, respectively. Results were scored as + to ++++: for the IFAT, serological titres (IgG) of 80-160 and 320-640 were given + and ++, with those of 1.280-2.560 and 5.120- 10.240 as +++ and ++++ respectively. For the LST, exacerbated reactions (³16mm) were regarded as ++++, strongly positive (13-15mm) as +++, moderately positive (9- 12mm) as ++, and weakly positive (5-8mm) as +. Analysis of the difference among the clinical-immunological profiles of infection was based on the programme BioEstat 4.0 and the X2 and Binomial tests with confidence of 95%. During the study, 12 infected persons showed high serological titres (1.280 to 10.240 IgG) with negative LST reactions: 5 children and 2 adults developed of AVL with IFAT titres ³ 2.560 (IgG) and a negative LST, and 2 children and 3 adults developed subclinical infections with IFAT titre of 1.280 (IgG) and a negative LST. In addition, the two tests enabled the identification of 5 different clinical-immunological profiles within the total of 231 cases of infection diagnosed, as follows: 1. 77% with asymptomatic infection (AI), with LST ranging from +/++++ and a negative IFAT; 2. 2% with symptomatic infection (SI = AVL) and 3. 1.3% with subclinical oligosymptomatic infection (SOI), both groups with a negative LST and IFAT ranging from +++/++++; 4. 9.9% with a subclinical resistant infection (SRI), showing both LST and IFAT with +/++, and 5. 9.8% with an indeterminate initial infection (III), with a negative LST and IFAT +/++. Regarding evolution of infection, the major observation was that only a single case of SI (= AVL) evolved from the profile III (23 cases), from which most infections evolved to the profiles SRI (9 cases) or SOI (5 cases) while the lastly 8 cases remained as III.
Acesso aberto (Open Access)
Avaliação das funções neurológicas do hanseniano: a queixa clínica e os achados sensitivo-motores em membros superiores e inferiores
(Universidade Federal do Pará, 2016) BORGES, Mariana Garcia Lisboa; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Although curable, leprosy is still a major public health problem. This is a chronic infectious disease caused by Mycobacterium leprae and characterized by dermatological and neurological involvement. If not treated, this disease can lead to serious disability. The evaluation of the neurological function of the patient is very important for the early dignosis and treatment of nerves damage. The exams in neurological evaluation of leprosy are too subjective. This study, worrying about the consistency of neurological evaluation in showing in a reliable manner the situation of patients, aims to correlate the clinical complaints from leprosy patients with sensory and motor findings in upper and lower limbs. For this, an analytical cross-sectional study was conducted in two steps. The first stage included 97 leprosy patients treated at the service between the years 2014 and 2015, in them was applied the simplified neurological evaluation, which was made the examination of nerve palpation, voluntary muscle strength test, tactile sensitivity test at hand and feet with Semmes-Weinstein, in addition to the collection of clinical complaints. For the second stage were randomly selected 14 patients who were submitted to surface sensitivity tests (thermal, painful and tactile) in the path of the most commonly affected nerves. Data analysis was performed using the chi-square test, G test and t test, when relevant to the comparison with the population or between groups. For correlation ordinal variables the Spearman correlation test, considering the alpha significance level of 0.05. Of the 97 leprosy patients, 77 (79.4%) had complaints, the most common being those related to sensory fibers, including pain and numbness were the most mentioned. On palpation, the ulnar nerve and tibial were the most affected and multibacillary patients had higher averages of affected nerves and most sensitive damage. Engine damage was not very common among patients, but low levels of muscle strength found were related to higher sensory damage stages, higher degree of disability and greater amount of affected nerve. When compared to the occurrence of complaint, the complainants patients had more advanced stages of sensory damage, higher degree of disability in the lower limbs and motor damage occurring more frequently, but the type of complaint did not influence these results. In the evaluation of the surface sensitivity in the nerve pathway, there was a higher incidence of sensory changes also among the plaintiffs, and the heat the most affected. It is clear, then, that the complainants patients are more sensitive to sensory and motor damage, the high degree of disability, and the sensitivity of changes in nerve path. Therefore, health professionals should be alert to this patient group, allocating more attention at the time of evaluation in order to avoid the dreaded disabilities.
Acesso aberto (Open Access)
Prevalência da infecção por HTLV em gestantes atendidas em serviços públicos de pré-natal no município de Santarém-Pará
(Universidade Federal do Pará, 2012-12-17) MONTEIRO, Mariana dos Anjos Furtado; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769
Acesso aberto (Open Access)
Prevalência de pneumonia em Unidade de Terapia Intensiva no Hospital Infantil de Imperatriz - MA
(Universidade Federal do Pará, 2012-09-12) ALMEIDA, Maria Olyntha Araújo de; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
Pneumonia is an important public health problem contributing to high rates of morbidity and mortality in the world especially in developing countries. This study aims to evaluate the prevalence of pneumonia in children hospitalized in the pediatric intensive care unit, as well as to estimate the incidence of these children, with diagnosis of pneumonia and identify variables associated with the development of pneumonia, which determine the incidence of infant mortality this ICU for pneumonia. This is a descriptive study with cross-sectional and retrospective approach from a review of medical records of children who were hospitalized in a pediatric intensive care unit of a Municipal Hospital in Imperatriz Maranhão, during the period January to December 2011. data were initially obtained through the records contained in the admission book of children in the Pediatric Intensive Care Unit, where they found 230 admissions. In a second stage, were selected and included in the records of children of both sexes aged one month to 12 years of age, hospitalized pediatric intensive care unit with a diagnosis of nosocomial pneumonia research, making a sample of 60 medical records of which held the collection of the data contained therein using previously structured form. Of the 230 patients admitted to the Intensive Care Unit of the hospital, in the period January-December 2011 26% (n = 60) developed nosocomial pneumonia, age between 1 to 12 months 63% (n = 38), followed ages between 13 and 36 months with 36% (n = 13), the diagnosis of pneumonia was 26%. It was observed that pneumonia related to health care at the Children's Hospital the Imperatriz represented a common complication in pediatric patients under intensive care, being an aggravating factor for the occurrence of deaths, with important relationship to invasive procedures particularly invasive mechanical ventilation as well as therapy used.
Acesso aberto (Open Access)
Impacto na incidência de infecção relacionada a cateter vascular central após medidas de educação na unidade de terapia intensiva do Hospital Universitário João de Barros Barreto
(Universidade Federal do Pará, 2007) COSTA, Maria Heliana Alencar da; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Central venous catheters are commonly employed in the management of critically ill patients in intensive care units (ICU). Primary bloodstream infections resulting from central venous catheterization (CVC-BSI) are a common cause of excess morbidity, mortality, and medicalcare costs associated in the ICU setting. Many strategies have been used to decrease the risk of CVC-BSI and educational initiatives aimed at improving CVC insertion and care has been demonstrated successful results. The purpose of the study was to determine the impact of an educational program targeted to specific points observed during CVC care practices on decreasing CVC-BSI rates in ICU setting. This was a preintervention and postintervention study. Barros Barreto Hospital is a 260-bed university urban teaching hospital located in Belém city, Pará, Brazil and its ICU is a 10-bed surgical-medical unit. In this ICU, reported CVC-BSI from January 2003 to December 2005 was 11.8 episodes of CVC-BSI per 1000 CVC-days. Between January 2006 and July 2007 this study was carried in this setting. An educational program based on CDC Guidelines for Prevention of Intravascular Catheter- Related Infection directed to nurses and physicians was developed by a multidisciplinary task force to highlight correct practices for CVC care. Posters concerning CVC-BSI pathogenesis and prevention, tips about importance of handwashing were available in the unit. BSI-CVC rates were monitored in the following 12-months period after educational intervention. Twenty episodes of catheter-associated bloodstream infections (11.8 per 1,000 catheter-days) occurred in the 36 months before the introduction of the education program. Following implementation of the intervention, the rate of catheter-associated bloodstream infection decreased to four episodes in 1667 catheter-days (2.4 per 1,000 catheter-days), a decrease of 78%. Behavior changes such as adherence to hand hygiene before manipulating CVC and CVC dressing was dramatically enhanced after the educational intervention (49.5% to 98.5% and 15.4% to 96.9%, respectively) [p < .0001]. A multiple approach included a focused educational strategy targeted to specific problems observed during a careful evaluation of CVC care practices, and policy changes can lead to decrease in the incidence of bloodstream infections associated to CVC. Educational programs directed to healthcare professionals may lead to decrease in cost, morbidity, and mortality associated to healthcare-related infections.
Acesso aberto (Open Access)
Detecção do Mycobacterium leprae pela reação em cadeia da polimerase (PCR) em amostras de tecido e SWAB pós - biópsia de pacientes portadores da hanseníase
(Universidade Federal do Pará, 2007-12-01) ALMEIDA, Maria das Graças Carvalho; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872
The Mycobacterium leprae DNA of the samples of tissue fragments and swab pos biopsy conserved in lysis buffer solution 2 and swab pos biopsy conserved in lysis buffer solution 1, removed of leprosy lesions of 20 patients with different clinical forms of the illness, was submitted to the amplification for the PCR, aiming at to evaluate the sensitivity of this method. The extration of the DNA was carried through by the technique of modified phenol-chloroform and had been used for the amplification three pairs of primers, LP1/LP2, R1/R2 and S13/S62 that amplify fragments of 129pb, 372pb and 531pb, respectively. Of the patients in study, 55% were paucibacillary and multibacillary 45%. The PCR with primer LP1/LP2 detected 40%, being 15% PB and 25% MB of the samples conserved in lise 1 and, of the conserved ones in lise 2 had been 15%, being 5% PB and 10% MB; primer R1/R2 detected 15%, with 5% in PB and 10% in MB in lise 1, in lise 2 did not have amplification; primer S13/S62 did not amplify the samples in lise 1 and amplified only 10% in lise 2, being one of each group. The bacilloscopy of skin smears presented positives results for 20% patient dos MB and was negative for all PB; the histophatology was positive for 30%, being 20 % for PB and 10% for MB. The PCR with primer LP1/LP2 left to detect DNA of the Mycobacterium leprae in 60% of the samples, the bacilloscopy in 80% and the histophatology in 70%. Due to reduced sensitivity of the PCR in the samples conserved in lise 2, in this study the best ones resulted had been gotten in samples of swab pos biopsy conserved in lysis buffer solution 1, with DNA extracted for the phenol method chloroform modified and amplified for primer LP1/LP2.
Acesso aberto (Open Access)
Análise conformacional da enzima protease do HIV-1 relacionada à resistência ao inibidor Nelfinavir
(Universidade Federal do Pará, 2017) HOLANDA, Luiz Henrique Campos; SILVA, Jerônimo Lameira; http://lattes.cnpq.br/7711489635465954; SOUSA, Maisa Silva de; http://lattes.cnpq.br/1775363180781218
The Human Immunodeficiency Virus (HIV), which causes acquired immunodeficiency syndrome (AIDS), is a retrovirus that has highly virulent glycoproteins that invade the CD4 + T lymphocyte through its CCR4 and CXCR5 receptors. The biological cycle of HIV is mediated by the protease, transcriptase and integrase enzymes. HIV-1 protease is an enzyme that is present in the final phase of the biological cycle, where virus maturation occurs, and is an important pharmacological target. The main objective of this project is to verify the effects of the D30N, I84A and M46I mutations on the HIV-1 protease enzyme and the complex formation with the nelfinavir inhibitor through molecular dynamics and bioinformatics techniques. The results based on the structural analyzes showed structural differences between the studied systems. The 1OHR system presented a closed conformation, the systems D30N and D30N_I84A_M46I presented semi-open conformation and the D30N_I84A system presented open conformation, in which the latter presented lower free energy value and greater instability in the RMSD analyzes, however the greater flotation of residues Of amino acids. The theoretical analyzes showed the importance in the resistance of the double mutation D30N_I84A and the conformational restructuring capacity of the M46I mutation and catalytic capacity.
Acesso aberto (Open Access)
Soroprevalência da rubéola nas puérperas de uma maternidade pública, Belém-PA
(Universidade Federal do Pará, 2013) ROCHA, Margareth Vargas; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760
Rubella was considered a disease of little relevance to the fourth decade of the twentieth century, by presenting a benign symptoms, however, in 1941, in Australia, the ophthalmologist Norman McAlister Gregg made association between rubella infection in early pregnancy and the occurrence of defects congenital, passing thus constitute a public health problem today preventable disease, the aim of this study is to evaluate the prevalence of postpartum rubella in a public hospital, Bethlehem PA, describing and correlating the demographic profile (age, origin, education level, marital status, race, and income) and conditions of prenatal seropositivity found. The prospective study involved 228 women, randomly chosen from the wards in Obstetrics Maternity Holy House of Mercy of Para, between January to March 2011, with application protocol form for interview and serology for rubella blood obtained before delivery or immediately after this, using the ELISA method for antibodies to anti-IgG. Prevailed in this study the age range 14-26 years (66.2 %), living in a stable relationship (58.8 %), Caucasian women (58.3 %), with schooling up to primary education (40.8 %), both derived from the capital (45.6 %) as in the state (47.4 %), working only in the home (59.7 %) and those living with 1-3 minimum wages (52.2 %); conditions prenatal showed that 95.2 % reported having acceded to prenatal care, beginning in the first quarter (32.9 %), are vaccinated for rubella (59.2 %) and received guidance on infectious diseases in pregnancy (53.5 %). The prevalence upon detection of IgG Anti- Rubella Virus was 80.2 % (183 /228). The correlation between seropositivity and exposure factors for some of the socio demographic and prenatal associations were not found, however, in the analysis of prevalence rates relative to age and income, observed that this was significant (P < 0.0001), 1.3 times lower seropositivity among the mothers with 19 years or less, with lower prevalence ratio (P = 0.0084), about 1.2 times among those with wage income ≤ the minimum wage. Considering the differences in prevalence data antibodies against rubella and the limited information that is available on the immune status of the population of northern Brazil, it was with this research to evaluate the immune status against rubella in women at the time delivery, yielding a prevalence that is still below that necessary to eliminate the risk of congenital rubella. Important observations are aimed at women under 20 years with low education and income, since it is the strata with higher HIV negative. These data may contribute to the reorientation of public policies that seek to control this disease by vaccination strategies, among others, how to improve the care given to the actions of prenatal education.
Acesso aberto (Open Access)
Inquérito sorológico da infecção pelo vírus linfotrópico humano de células T (HTLV) em comunidades amazônicas localizadasnas margens do Lago da Usina Hidrelétrica de Tucurui/PA
(Universidade Federal do Pará, 2010-12-20) FALCÃO, Luiz Fábio Magno; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
The aim of this study was to evaluate seroprevalence lymphotropic virus human T cells (HTLV) in individuals living in communities of Alcobaça e Ararão, located on the shores of lake Hydroelectric Plant Tucuruí / PA. Serum samples from 657 individuals were analyzed by immunoenzymatic assays the type of ELISA (Symbioys ®). There was a significant prevalence of HTLVI / II (4.7%) in the study population and the demographic characteristics reflects most of them are older than 40 years (p = 0.0239), unmarried (p = 0.035), resident for over 10 years in the catchment area of the study (p = 0.0027) and educational level was equal to or less than 4 years (p = 0.0308). There was no statistically significant difference when analyzing variables such as sex, birth, blood transfusion and previous surgery. The prevalence for HTLV is considered high according to current literature, justifying the screening for this virus at the study sites in order that we can better understand the epidemiology of HTLV transmission in the population.
Acesso aberto (Open Access)
Prevalência da co-infecção por Leishmania sp. em pacientes portadores de HIV/AIDS atendidos pelo Programa Municipal de DST/AIDS no Centro de Testagem e Aconselhamento (CTA) de Imperatriz-MA
(Universidade Federal do Pará, 2012) SILVA, Lúcio André Martins da; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872
The co-infection with Leishmania-HIV-AIDS is a serious public health problem in most of the world. However, cases of coinfection remain underestimated, since leishmaniasis is not AIDS-defining illness. It was conducted a cross-sectional survey from December 2011 to February 2012, with the objective to investigate the prevalence of co-infection HIV/Leishmania in patients enrolled in the cityprogram STD/AIDS in the Centro de Testagem e Aconselhamento (CTA) de Imperatriz-MA. The study population consisted of 199 individuals. Data collection was conducted through a questionnaire to obtain demographic, socioeconomic and epidemiological data, and it was also performed tests through collection of biological material (blood) of all patients for detection of infection with Leishmania sp., through laboratory tests (CD4 and CD8 counting) and PCR research. Among the patients it was observed similarity between the frequency of gender, 49.2% male and 50.8% female, with an average age of 40 years. It was observed that 61.8% have a low level of education and 69.3% have an income of up to minimum wage. 2.01% (4/199) of patients analyzed presented coinfection Leishmania/HIV. From these, 3 showed mixed infection with Leishmania (V.) sp and Leishmania (L.) amazonensis causing ATL, and one patient infected by Leishmania (L.) chagasi, causing VL. Comparing the risk factors, comorbidities and complications among patients analyzed it was observed that malaria was the only factor that proved significant at around 10.05%. This was the first study that investigates the Leishmania HIV coinfection in the city of Imperatriz, Maranhão and identification of coinfected patients was of fundamental importance to the service as from which will be able to then follow up these patients. This study provided the magnitude of the prevalence of co-infection Leishmania/HIV. Thus, we suggest that the anti-Leishmania test is performed on all subjects with HIV/AIDS, and are incremented public policies for this problem.
Acesso aberto (Open Access)
Caracterização antigênica e molecular de amostras de rotavírus do tipo G1, obtidas de crianças participantes de estudos em gastroenterites virais, no período de 1982 a 2003, em Belém, Pará, Brasil
(Universidade Federal do Pará, 2006-07-03) SOARES, Luana da Silva; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435; LINHARES, Alexandre da Costa; http://lattes.cnpq.br/3316632173870389
Infant mortality remains an important problem of public health worldwide, mainly in developing countries. Of more than the 50 etiologic agents implied in this disease, rotavirus causes 111 million episodes of diarrhoea, resulting in more than 600,000 deaths among children less than five years, of which 82% are notified in the poorest countries of the world. This study aimed at the antigenic and molecular characterization of G1 rotavirus strains among children participanting of viral gastroenteritis studies, carried out from 1982 to 2003, in Belém, Pará, Brazil. One hundred and forty-eight specimens of G1 rotavirus were analyzed in the present investigation. Overall, the prevalence of the G1 type was of 41.3%, being that frequencies of this genotype through studies ranged from 11.0% to 67.6%. Eletropherotypes, G serotypes and P genotypes characterization of G1 rotavirus occurred in frequencies of 78.4%, 89.9% and 87.8%, respectively. Three long eletropherotypes varieties were identified, being that the L1 variety was found frequently (79.3%). The G1, G9 and G1+G4 serotypes were detected in 88.0%, 9.8% and 2.2% of the specimens, respectively. Mixed infection by G1+G4 genotype was detected in one sample. The prevalent binary combination was P[8],G1, being responsible for 72.3% of the cases. Mixed infections circulated in percentage of 20.0%, including genotypes P[4]+P[8],G1, P[6]+P[8],G1, P[4]+P[6],G1, P[4]+P[6]+P[8],G1 and P[6]+P[8],G1+G4. The G1 genotype circulated among 2nd to 35th months of age and a highest number of cases was registered between 6 to 16 months of age. Clinical severity differences among G1 and other genotypes of rotavirus were not verified. The present analysis gathers pioneer findings in Brazil, allowing to extend the knowledge concerning the antigenic and molecular diversity of the infections by G1 rotavirus and these results will allow to understand the genetic complexity of such viral agents.
Acesso aberto (Open Access)
Soroprevalência da infecção pelo vírus linfotrópico de células T humanas em parturientes de maternidade pública de Belém, Pará, Brasil
(Universidade Federal do Pará, 2014-05-29) FERREIRA, Louise de Souza Canto; SOUSA, Maisa Silva de; http://lattes.cnpq.br/177536318078121
Introduction: The Human T Lymphotropic virus type-1 was first retrovirus identified and associated epidemiologically to leukemia/lymphoma T-cell adult (LLTA), tropical spastic parapesis (TSP), polymyositis, arthritis, uveitis, skin lesions and strongyloidiasis and other diseases. The vertical transmission has fundamental role on HTLV silent dispersion and the implementation of policies needs epidemiological indicators to develop prevention campaigns of infection transmission. Objective: To investigate the infection by the human T lymphotropic virus (HTLV-1 and HTLV-2) with parturients attended on public maternity of Belém, Pará, Brazil. Materials and Methods: A representative sample of parturients was investigated on period of March to August 2013, to detection of antibodies anti-HTLV by imunoenzimatic method (ELISA) and for research proviral genome by polymerase chain reaction. Results: The seroprevalence of 0.2% (1/452) identified one infected parturient who reported to be intravenous drug user and to have multiple sexual partners, without genotype identification. The postpartum carrier of HTLV did not breastfeed her newborn son, who showed no anti-HTLV antibodies one year after birth, like her mother and her older daughters, excluding the vertical familial transmission. Conclusion: This study identified a low but present prevalence of HTLV in pregnant women attended at a public maternity, as has been identified in other units of primary and secondary health care throughout Brazil, demonstrating the need for control measures of this infection in all levels of public health attention.
Acesso aberto (Open Access)
Associação do vírus da Hepatite C com o grupo sanguíneo ABO e Rh(D) em doadores de sangue da Fundação Hemopa, Pará, Brasil
(Universidade Federal do Pará, 2012-06-25) NÓBREGA, Letícia de Souza; CRESCENTE, José Ângelo Barletta; http://lattes.cnpq.br/5243773796185944
Several studies have demonstrated association of blood group systems with different pathologies. Therefore, this work aimed to investigate the association between HCV and blood groups ABO and Rh blood donors Hemopa Foundation from 2000 to 2010. Between January 2000 and December 2010 were analyzed 565,614 samples from individuals who donated blood in Hemopa, and 1064 showed these test reagent for HCV serologic survey, 1246 inconclusive and 563.304 negative. However, this study included only those blood donors who did not have any kind of co-infection to any other pathology researched, naturally Pará and brown skin. After the selection of these criteria led to a sample size of 838 (0.15%) seropositive in 1181 (0.21%) inconclusive and 551,991 (99.64%) seronegative for a total of 554.010 blood donors. For serological diagnosis of hepatitis C were used serological test ELISA (enzyme immunoassay) 4th generation for detection of specific anti-HCV in the serum of donors and the samples positive by serology (ELISA) was carried out extraction of viral RNA. The ABO and Rh blood groups were determined by the research of antigens A and / or B, anti-A and / or anti-B antibodies and Rh (D) antigens in the blood sample from the individual. Over the years we found that the seroprevalence of HCV-specific antibodies in blood donors has undergone reduction, ranging from 132 to 38 cases reactive serum. Most donors were between the age group 30-49 years (57.64%), belonging to the predominantly male 74.5% (624/838) and coming from Belém 72.5% (607/838). When the distribution of the phenotypes of the ABO and Rh blood groups systems between the donor reactive serum and non-reactive to HCV, it was found that no significant variation in the frequency of these phenotypes donor reagents and reactants in the non-HCV-specific antibodies. Donor blood PCR results showed that when compared to Rh and ABO blood groups of patients there was no association between them.
Acesso aberto (Open Access)
Prevalência e variabilidade genotípica de Chlamydia trachomatis em amostras cervicais de estudantes universitárias em Belém, Pará, Brasil
(Universidade Federal do Pará, 2015) SANTOS, Leonardo Miranda dos; SOUSA, Maisa Silva de; http://lattes.cnpq.br/1775363180781218
Infection with Chlamydia trachomatis is a Sexually Transmitted Infection (STI) more prevalent bacterial in the world and can be asymptomatic in up to 80% of cases and is associated with late complications. The university students are part of a differentiated demand of the population for their high level of education. Objective was to assess the prevalence and variability of the genotypes of C. trachomatis in cervical infection of public university students in the state of Pará, Brazil, and to evaluate the association of the respective socio-behavioral characteristics and gynecological complaints. They included 438 college students from September 2012 to October 2014 and cervical samples were obtained during gynecological examination. It was performed phenol-chloroform technique for extracting total DNA from the sample cervical secretion, and for the detection of C. trachomatis used the Polymerase Chain Reaction (PCR) PCR-seminested the type for amplification 224pb gene omp1. For the identification of genotypes, we carried out a nested PCR for the amplification of the gene omp1 990pb, which was purified and subjected to ABI3130 sequencer, then the nucleotide sequences were compared with GenBank. The prevalence of cervical infection by C. trachomatis was 12.5% (CI: 95% ± 5.89) and genotypes were identified J genotype (36.3%), followed by D genotypes (18.2%) E (18.2%), F (18.2%) and la (9.1%). There was no significant association for age, first sexual intercourse, number of partners, and condoms are used, the presence of gynecological complaints and genotypes found in the study population. Although the prevalence found present itself high among university students, the lack of statistical significance may be due to small sample size and/or result in socially acceptable answers. Efforts are made to trace the expansion of C. trachomatis infection in restricted populations.