Delinear o perfil epidemiológico das hepatites A, B e C, em Juiz de Fora, Minas Gerais, no período de 2011 a 2020, e propor intervenções para prevenir e reduzir os casos. Trata-se de um estudo epidemiológico transversal descritivo, com análise quantitativa de casos de hepatites virais de Juiz de Fora, obtidos no Sistema de Informação de Agravos de Notificação. Posteriormente, realizou-se uma revisão integrativa para subsidiar o desenvolvimento das propostas de intervenção. Após o levantamento, observou-se predominância do sexo masculino em todas as hepatites e da hepatite C, com 78,8% dos casos. Evidenciou-se predominância de transmissão via alimentos contaminados para a hepatite A, com 74,29% dos casos, e das vias brancas e ignoradas para as hepatites B e C, seguidas pela via sexual, com 21,38%, e transfusional, com 20,75%, respectivamente. Após revisão integrativa, foram obtidos sete artigos sobre vacinação e abordagens educacionais. Evidenciando-se a alta incidência de hepatites virais em Juiz de Fora, é relevante aplicar intervenções envolvendo vacinação, ações educativas em saúde e a capacitação de profissionais da Saúde, com o intuito de prevenir e reduzir os casos dessas doenças no município.

Delinear o perfil epidemiológico das hepatites A, B e C em Juiz de Fora, Minas Gerais, no período de 2011 a 2020 e propor intervenções para prevenir e reduzir os casos. Trata-se de um estudo epidemiológico transversal descritivo, com análise quantitativa de casos de hepatites virais de Juiz de Fora, obtidos no Sistema de Informação de Agravos de Notificação (SINAN). Posteriormente, realizou-se uma revisão sistemática para subsidiar o desenvolvimento das propostas de intervenção. Após o levantamento, observou-se predominância do sexo masculino em todas as hepatites e da hepatite C com 78,8% dos casos. Evidenciou-se predominância transmissão via alimentos contaminados para hepatite A, com 74,29% dos casos e das vias brancas e ignoradas para as hepatites B e C, seguidas pelas via sexual com 21,38% e transfusional com 20,75%, respectivamente. Após revisão sistemática, foram obtidos sete artigos sobre vacinação e abordagens educacionais. Evidenciando-se a alta incidência de hepatites virais em Juiz de Fora, ressalta-se a relevância de aplicar intervenções envolvendo vacinação, ações educativas em saúde e a capacitação de profissionais da Saúde, com intuito de prevenir e reduzir os casos dessas doenças no município.

No abstract

Background: SPS is a disorder consisting of rigidity of axial muscles with painful spasms. More than 80 % of SPS patients have high titer antibodies against glutamic acid decarboxylase (GAD). The use of rituximab for the treatment of SPS is a recent therapeutical approach showing promising results. We present a case of SPS treated with rituximab, showing a good and safe response. Case: A 38-year-old female patient presented with a history of rigidity of abdominal and paravertebral muscles associated with painful spasms in lower back region, increased tonus, lumbar lordosis, frequent falls and severe functional limitation. The anti-GAD antibodies were positive in high titles. Electromyography showed continuous motor activity with normal morphology especially on paravertebral muscles. She had a partial response to baclofen and diazepam, but could not tolerate it because of somnolence, and started the treatment with rituximab. After one year, the baclofen was discontinued and the diazepam reduced. The axial stiffness and spasm frequency improved, including postural instability, without new episodes of falls. Discussion: Rituximab is a monoclonal antibody targeting the CD20 antigens on the surface of mature B lymphocytes. After binding to these antigens, it initiates a cascade of biochemical events leading to apoptosis. Its use has been approved for numerous diseases with promising results. The use of rituximab in the treatment of SPS is a recent approach and good results have been reported. Conclusion: Rituximab may be a promising option in SPS treatment. However, this is a preliminary paper showing partial results requiring long-term follow-up.

Background: The long incubation period of leprosy, its insidious signs and symptoms produce difficulties in its diagnosis and correct clinical classification. The early recognition of neural impairment in leprosy, especially in household contacts with subclinical infection and in the primary neural form, in which the classic clinical and laboratory findings of the disease are, by definition, absent, represents a major challenge in clinical practice. Objectives: Characterize the clinical, molecular, serological and neurophysiological aspects in the early diagnosis of leprosy neuropathy, in household contacts with subclinical infection (positive ELISA anti-PGL1 serology. Design and setting: Longitudinal study carried out at the Clinics Hospital - Federal Univeristy of Uberlândia, a center specialized in Leprosy/Sanitary Dermatology. Methods: 361 seropositive household contacts (CDSP), defined as subclinical infection, were recruited, followed up at a national referral center for leprosy in Brazil, from 2014 to 2016. All individuals underwent a clinical, laboratory and neurophysiological evaluation. Results: 361 CDSP were evaluated. The qPCR analysis was positive in 35.5% (128/361) in the dermal shaving and in 25.8% (85/361) in the skin biopsy of the CDSP. In the electroneuromyographic evaluation, 23.5% (93/361) of the CDSP showed signs of neural involvement, with an average of 2.1 nerves compromised by CDSP. 62.3% (53/93) presented a pattern of mononeuropathy in ENMG. Conclusions: Annual monitoring of CDSP, a prevalence of peripheral neural impairment assessed by ENMG, favoring early treatment.