O vírus Chikungunya tem origem africana e atualmente é encontrado em diversas partes do mundo. No Brasil, os primeiros relatos ocorreram em meados de 2010, e desde então, houve um aumento considerável de infecções, tendo em vista a necessidade de uma maior atenção a esta patologia. Objetivo: realizar uma revisão integrativa sobre Chikungunya, incluindo artigo do período de 2014 a 2020, referente a dados que contemplassem o Brasil, bem como discorrer como se dá o processo de disseminação da doença e suas particularidades, além de dispor sobre os aspectos clínicos, epidemiológicos, imunológicos. Metodologia: foi realizada uma revisão integrativa, onde foram selecionados artigos publicados em três plataformas como bases de dados científicos: Science Direct, Pubmed e Scientific Electronic Library Online (SciELO), utilizando as palavras-chave chikungunya and brazil characterization, transmission, epidemiological aspects, clinical aspects, immunological aspects and treatment. Resultados: Percebe-se que há correlação entre as abordagens utilizadas, relatando aumento de incidência, além de citar as vulnerabilidades para a aquisição de tal patologia. Conclusão: conclui-se que a prevenção deve-se ser prioritária, principalmente com os grupos de risco.
A hepatite C é uma doença ocasionada pelo vírus HCV, cuja maior dificuldade do diagnóstico é inespecificidade dos sintomas, contribuindo para cronificação e pior prognóstico. A infecção assola cerca de 58 milhões de pessoas no mundo. Nas duas últimas décadas, foram confirmados 265 mil casos no Brasil. Em 2015, o tratamento foi otimizado após a inclusão dos antivirais de ação direta (DAAs) que reduziram os efeitos adversos. Objetivo: avaliar a resposta clínica e laboratorial do tratamento da hepatite C com uso de novas DAAs. Metodologia: Estudo transversal, qualitativo e descritivo com amostra não probabilística dos prontuários de pacientes com HCV assistidos no CTA/SAE de Santarém – PA, no período de janeiro de 2016 a março de 2019. Resultados: Dentre os 265 prontuários, apenas 45 se encaixaram nos critérios de inclusão. O esquema Sofosbuvir + Daclatasvir foi o mais utilizado (44,44%). Observou-se redução nos valores de hematócrito e nas enzimas hepáticas (TGO/TGP) e um aumento de hemoglobina e plaquetas. O genótipo 1B foi o mais prevalente. O grau de fibrose F4 se destacou, sobretudo, nos homens. A comorbidade predominante foi a hipertensão arterial sistêmica. Conclusão: Após a inclusão da 2ª geração de DAAs, houve redução dos casos de anemias graves, das transaminases e de plaquetopenia. Além disso, percebeu-se a necessidade de controle laboratorial mais efetivo da hemoglobina quando há associação da ribavirina com o esquema terapêutico e a via sexual foi o meio de contaminação de maneira oposta aos dados nacionais.
The study aimed to bring current data on hospital infections, identifying the number of infections in four years in five hospitals in western Pará (Brazil). Data collection was carried out by consulting the information bank of the Health Department of the Municipality of Santarém. These hospitals operate in the municipality of Santarém, in the northern region of Brazil. Public or private hospitals that perform surgical procedures were used as inclusion criteria. The study identified that the Regional Hospital of Baixo Amazonas has the highest rates of nosocomial infections and that bloodstream infection was the most frequent in this unit. In addition, there was a notable correlation between the total number of surgeries performed in hospitals and the total number of deaths from nosocomial infections and between the total number of infections and the total number of deaths from infections.
Introduction: Hepatitis A and B are infectious diseases that represent an important public health problem in Brazil. Objective: to analyze the epidemiological profile and possible behavioral and environmental factors that may be related to the occurrence of viral hepatitis A and B in riverside communities located in the Amazon region. Methodology: cross-sectional epidemiological, with a quantitative approach, carried out in the riverside communities of the Paraense Amazon. Results and discussion: The results reveal that the prevalence of hepatitis A and B in this population group is higher than that existing for the entire Brazilian population, it was found that 88.89% of the reported cases were of Hepatitis A and 11.11% of hepatitis B. The majority (53.73%) of the interviewees, never performed the examination for early detection of hepatitis, and part of the 8.96% did not have the vaccines and 35% shared personal objects, such as nail pliers and razors, in addition we have that only about 50% of individuals use contraceptive methods and most use condoms. Final considerations: The riverside populations have satisfactory conditions of basic sanitation, food, a fact that interferes not so much in the quality of life of these individuals, but also leads to a greater susceptibility to the development of health problems.
Mycobacterium leprae is the etiological agent of leprosy. Macrophages (Mφs) are key players involved in the pathogenesis of leprosy. In this study, immunohistochemical analysis was performed to examine the phenotype of Mφ subpopulations, namely M1, M2, and M4, in the skin lesions of patients diagnosed with Leprosy. Based on the database of treatment-naïve patients treated between 2015 and 2019 at the Department of Dermatology of the University of the State of Pará, Belém, routine clinical screening samples were identified. We performed simultaneous multiple immunostaining using monoclonal antibodies specific for inducible nitric oxide synthase (iNOS), IL-6, IL-10, IL-13, TNF-α, TGF-β, FGFb, CD163, CD68, arginase-1, MRP8, and MMP7. Our results demonstrated a statistically significant difference for the M1 phenotype among the Virchowian (VV) (4.5 ± 1.3, p < 0.0001), Borderline (1.6 ± 0.4, p < 0.0001), and tuberculoid (TT) (12.5 ± 1.8, p < 0.0001) clinical forms of leprosy. Additionally, the M2 phenotype showed a statistically significant difference among the VV (12.5 ± 2.3, p < 0.0001), Borderline (1.3 ± 0.2, p < 0.0001), and TT (3.2 ± 0.7, p < 0.0001) forms. For the M4 phenotype, a statistically significant difference was observed in the VV (9.8 ± 1.7, p < 0.0001), Borderline (1.2 ± 0.2, p < 0.0001), and TT (2.6 ± 0.7, p < 0.0001) forms. A significant correlation was observed between the VV M1 and M4 (r = 0.8712; p = 0.0000) and between the VV M2×TT M1 (r = 0.834; p = 0.0002) phenotypes. The M1 Mφs constituted the predominant Mφ subpopulation in the TT and Borderline forms of leprosy, whereas the M2 Mφs showed increased immunoexpression and M4 was the predominant Mφ phenotype in VV leprosy. These results confirm the relationship of the Mφ profile with chronic pathological processes of the inflammatory response in leprosy.
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