Perfil sociodemográfico, epidemiológico e comportamental de mulheres infectadas pelo HTLV-1 em Salvador-Bahia, uma área endêmica para o HTLV

O objetivo foi descrever as características sociodemográficas, epidemiológicas e comportamentais de mulheres infectadas (64) e não infectadas (66) pelo HTLV-1 em Salvador, Bahia. O diagnóstico sorológico foi obtido por ELISA, WB e Imunofluorescência. Dados epidemiológicos e sociodemográficos foram coletados utilizando questionário padronizado. O Qui-quadrado ou teste de Fisher foi usado para dados categóricos e ANOVA ou Kruskall Wallis (3 grupos) e teste T ou Mann Whitney (2 grupos) para os dados contínuos. As variáveis associadas foram ajustadas por regressão logística. Mais da metade (57,8%) das mulheres soropositivas eram assintomáticas. As sintomáticas (com PET/MAH) tinham menor escolaridade. A comparação entre mulheres soropositivas e soronegativas mostrou que a hemotransfusão, a prática de sexo anal, coitarca antes dos 18 anos e ter mais de 3 parceiros sexuais na vida foram fatores de risco para infecção pelo HTLV-1. A prevenção da transmissão sexual e vertical (aleitamento materno) deve ser reforçada e triagem no pré-natal mandatória.

Evaluation of the six-minute walk test in patients with chronic heart failure associated with Chagas' disease and systemic arterial hypertension

INTRODUCTION: To evaluate physical capacity as determined by the six-minute walk test (6MWT) in patients with chronic heart failure due to Chagas' disease associated with systemic arterial hypertension (Chagas-SAH). METHODS: A total of 98 patients routinely followed at the Cardiomyopathy Outpatient Service were recruited. Of these, 60 (61%) were diagnosed with Chagas disease and 38 (39%) with Chagas-SAH. RESULTS: The distance walked during 6 min was 357.9 ±98 m for Chagas-SAH patients and 395.8 ± 121m for Chagas cardiomyopathy patients (p >0.05). In patients with Chagas-SAH, a negative correlation occurred between the 6MWT and the total score of the Minnesota Living with Heart Failure Questionnaire (r= -0.51; p=0.001). No other correlations were determined between 6MWT values and continuous variables in patients with Chagas-SAH. CONCLUSIONS: The results of the 6MWT in Chagas-SAH patients are similar to those verified in Chagas cardiomyopathy patients with chronic heart failure. Coexistence of SAH does not seem to affect the functional capacity of Chagas cardiomyopathy patients with chronic heart failure.

Infecção pelo HIV-1 após acidente ocupacional, no Estado do Amazonas: primeiro caso documentado

O atendimento de acidentes ocupacionais na Fundação de Medicina Tropical Dr. Heitor Dourado (FMT- HVD), envolvendo sangue e fluídos corpóreos, iniciou-se de forma rotineira em 1999. O objetivo deste relato é enfatizar a importância da utilização de medidas para o controle dos acidentes com material biológico. Após investigação epidemiológica detalhada, confirmamos um caso de soroconversão ao vírus da imunodeficiência humana (HIV) após acidente ocupacional, envolvendo fluído corpóreo e perfurocortante.

Dengue infection in children and adolescents: Clinical profile in a reference hospital in northeast Brazil

Introduction This study aimed to describe the clinical spectrum of dengue in children and adolescents from a hyperendemic region who were admitted for hospitalization. Methods A retrospective study was conducted on patients diagnosed with dengue infection upon admission to a reference center in Fortaleza, Brazil. Results Of the 84 patients included, 42 underwent confirmatory testing. The main symptoms were fever, abdominal pain and vomiting. The median level of serum aspartate aminotransferase was 143.5±128mg/dL. Conclusions A peculiar clinical profile was evident among children and adolescents with dengue infection in a reference center in northeast Brazil, including gastrointestinal symptoms and liver involvement.

Evaluation of preventative and control measures for congenital syphilis in State of Mato Grosso

Introduction Congenital syphilis is an important health problem in Brazil. This study assessed measures aimed at the prevention and control of syphilis in the State of Mato Grosso and its capital, Cuiabá. Methods A descriptive study cross-sectional and of time trends assessing the congenital syphilis was performed in Cuiabá and Mato Grosso between 2001 and 2011. We compared maternal sociodemographic characteristics and health care utilization related to cases of congenital syphilis during the periods from 2001 to 2006 and from 2007 to 2011. We assessed the temporal trends in this disease's incidence using a simple linear regression. Results Between 2001 and 2006 in Mato Grosso, 86.8% of the mothers who had live births with congenital syphilis received prenatal care, 90.6% presented with a nontreponemal test reagent at delivery, 96.2% had no information regarding a treponemal confirmatory test at delivery, and 77.6% received inadequate treatment for syphilis; additionally, 75.8% of their partners were not treated. There was a statistically significant reduction in prenatal visits (p = 0.004) and an increase in the proportion of mothers reactive to nontreponemal tests at delivery (p = 0.031) between the two periods. No other variables were found to differ significantly between the periods. In Cuiabá, we observed a similar distribution of variables. In the state and in the capital, the increasing trend of congenital syphilis was not statistically significant. Conclusions The high incidence of congenital syphilis in Mato Grosso and the low levels of health care indicators for pregnant women with syphilis suggest the need to improve the coverage and quality of prenatal care.

Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases

AbstractINTRODUCTION:We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informação de Agravos de Notificação (SINAN)] database.METHODS:A descriptive and retrospective epidemiological study was conducted from 2007 to 2013.RESULTS:A total of 4,118 accidents were recorded. Of these accidents, 88.7% (3,651) were caused by venomous species, and 11.3% (467) were caused by poisonous, traumatic or unidentified aquatic animals. Most of the events were injuries by stingrays (69%) and jellyfish (13.1%). The North region was responsible for the majority of reports (66.2%), with a significant emphasis on accidents caused by freshwater stingrays (92.2% or 2,317 cases). In the South region, the region with the second highest number of records (15.7%), jellyfish caused the majority of accidents (83.7% or 452 cases). The Northeastern region, with 12.5% of the records, was notable because almost all accidents were caused by toadfish (95.6% or 174 cases).CONCLUSIONS:Although a comparison of different databases has not been performed, the data presented in this study, compared to local and regional surveys, raises the hypothesis of underreporting of accidents. As the SINAN is the official system for the notification of accidents by venomous animals in Brazil, it is imperative that its operation be reviewed and improved, given that effective measures to prevent accidents by venomous animals depend on a reliable database and the ability to accurately report the true conditions.

Acute disseminated encephalomyelitis following inactivated influenza vaccination in the Brazilian Amazon: a case report

AbstractHere, we describe a case of acute disseminated encephalomyelitis (ADEM) that occurred during a plausible risk interval following inactivated influenza vaccination in a previously healthy 27-year-old man from Manaus, Brazil. He was treated with intravenous methylprednisolone and immunoglobulin. One-month follow-up revealed resolution of the brain lesions, but not of the spinal cord lesions. No recurrence or progression of the main neurological symptoms was observed. After two years of monitoring, the patient continues to experience weak lower limbs and urinary retention. Thus, we recommend that ADEM should be considered in a patient presenting with neurological symptoms after influenza vaccination.

Arboviral diseases in the Western Brazilian Amazon: a perspective and analysis from a tertiary health & research center in Manaus, State of Amazonas

The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), located in Manaus, the capital of the State of Amazonas (Western Brazilian Amazon), is a pioneering institution in this region regarding the syndromic surveillance of acute febrile illness, including arboviral infections. Based on the data from patients at the FMT-HVD, we have detected recurrent outbreaks in Manaus by the four dengue serotypes in the past 15 years, with increasing severity of the disease. This endemicity has culminated in the simultaneous circulation of all four serotypes in 2011, the first time this has been reported in Brazil. Between 1996 and 2009, 42 cases of yellow fever (YF) were registered in the State of Amazonas, and 71.4% (30/42) were fatal. Since 2010, no cases have been reported. Because the introduction of the yellow fever virus into a large city such as Manaus, which is widely infested by Aedes mosquitoes, may pose a real risk of a yellow fever outbreak, efforts to maintain an appropriate immunization policy for the populace are critical. Manaus has also suffered silent outbreaks of Mayaro and Oropouche fevers lately, most of which were misdiagnosed as dengue fever. The tropical conditions of the State of Amazonas favor the existence of other arboviruses capable of producing human disease. Under this real threat, represented by at least 4 arboviruses producing human infections in Manaus and in other neighboring countries, it is important to develop an efficient public health surveillance strategy, including laboratories that are able to make proper diagnoses of arboviruses.

Temporal distribution of tuberculosis in the State of Amazonas, Brazil

Tuberculosis (TB) is one of the infectious diseases that contributes most to the morbidity and mortality of millions of people worldwide. Brazil is one of 22 countries that accounts for 80% of the tuberculosis global burden. The highest incidence rates in Brazil occur in the States of Amazonas and Rio de Janeiro. The aim of this study was to describe the temporal distribution of TB in the State of Amazonas. Between 2001 and 2011, 28,198 cases of tuberculosis were reported in Amazonas, distributed among 62 municipalities, with the capital Manaus reporting the highest (68.7%) concentration of cases. Tuberculosis was more prevalent among males (59.3%) aged 15 to 34 years old (45.5%), whose race/color was predominantly pardo (64.7%) and who had pulmonary TB (84.3%). During this period, 81 cases of multidrug-resistant TB were registered, of which the highest concentration was reported from 2008 onward (p = 0.002). The municipalities with the largest numbers of indigenous individuals affected were São Gabriel da Cachoeira (93%), Itamarati (78.1%), and Santa Isabel do Rio Negro (70.1%). The future outlook for this region includes strengthening the TB control at the primary care level, by expanding diagnostic capabilities, access to treatment, research projects developed in collaboration with the Dr. Heitor Vieira Dourado Tropical Medicine Foundation .;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD).; and financing institutions, such as the project for the expansion of the Clinical Research Center and the creation of a hospital ward for individuals with transmissible respiratory diseases, including TB.

Epidemiology of infectious meningitis in the State of Amazonas, Brazil

INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.

Um método alternativo e eficiente de propagação vegetativa de inhame (Colocasia esculenta (L.) SCHOTT) e de taioba (Xanthosoma sagittifolium (L.) SCHOOT)

O experimento foi conduzido em casa-de-vegetação por um período de 30 dias, com o objetivo de testar o método de propagação rápida de inhame e taioba através de divisão de rizomas centrais. Os tratamentos foram constituídos pela divisão dos rizomas em quatro, oito e doze partes e pela utilização de rizomas laterais inteiros. O delineamento experimental utilizado foi o inteiramente casualizado, em quatro repetições. O número de mudas produzidas e de pedaços de rizoma apodrecidas de inhame e taioba aumentaram de forma linear com o aumento do número de divisões dos rizomas.

Elaboração de uma semi-conserva de pescado de água doce "Picles de Peixe". I. Tempo de cura, acidificação, textura e nível de sal

Neste trabalho são estudadas as condições para a correta combinação entre o tempo de cura, acidificação e nível de sal para produzir uma semi-conserva de pescado de de água doce acondicionada em vidro, utilizando o efeito da combinalção sal/ácido. As espécies utilizadas foram jaraqui (Semaprochilodus spp.), Curimatá (Prochilodus nigricans), Dourado (Brachyplastistoma flavicans) e Pirarucu (Arapaima gigas). Na salmora de cura prelimiar o tempo indicado para se obter uma melhor textura foi de 4 semanas, a acidificação até 4,5 foi alcançada na solução contendo 5% de ácido/100 gramas de pescado e o nível adequado de sal foi de 15% (p/v). Na salmora flavorizante a proporção de ácido foi de 1% (v/v) o que torna o produto de sabor agradável, sal na concentração de 2% (p/v) e a adição de 1% de condimentos.

EFICIÊNCIA DE Bacillus thuringieneisE DE DELTAMETRINA, EM APLICAÇÃO AÉREA, PARA O CONTROLE DE Thyrinteina arnobiaSTOLL, 1782 (LEPIDOPTERA: GEOMETRIDAE) EM EUCALIPTAL NO PARÁ

A avaliação da eficiência relativa de formulações de Bacillus thuringiensise de deltametrina, em aplicações aéreas para o controle de Thyrirrteina arnobiaStoll, 1782 (Lepidoptera: Geometndae) em Eucalyptus urophyllaem Monte Dourado no Pará, foi feita no presente ensaio, onde faixas de 10 ha (100x1000 m) foram pulverizadas com formulações comercoais de B. thuringiensise/ou deltametrina. Foram tomados cinco pontos de amostragem para cada tratamento e as avaliações foram feitas 24, 48, 72, 96 e 120 horas após a aplicação dos inseticidas. Cerca de 144 horas após a aplicação, foi feita uma pulverização drástica de uma mistura de malation e deltametrina, para a verificação do número total de insetos presentes nos pontos amostrados. A deltametrina mostrou eficiência máxima nas doses de 200 e 400 ml/ha e grande efeito de impacto sobre a população de lagartas. A ação do B. thuringiensismostrou-se mais lenta, mas o uso de formulações de alta qualidade desta bactéria e promissor para o controle de lagartas em reflorestamentos no trópico úmido, podendo ser usadas isoladamente ou em mistura com a deltametrina para um maior efeito de impacto. Verificou-se, também, o\ue tanto B. thuringiensisquanto a deltametrina tiveram pouco efeito sobre a população de nemípteros predadores. Assim, a deltametrina pode ser usada no controle de lagartas de eucalipto, preservando-se esses inimigos naturais.

Bacterial cellulose as a novel substrate for retinal pigment epithelium cells transplantation in age-related macular degeneration

Tese de Doutoramento em Engenharia Química e Biológica.

Educação para a sustentabilidade: O uso de Sistemas de Informação Geográfica Participativos como instrumento de participação de crianças e adolescentes na construção de sociedades mais sustentáveis

Tese de Doutoramento em Ciências da Educação (Área de Conhecimento: Educação ambiental e para a Sustentabilidade)