Este estudo teve por objetivo identificar aspectos clínicos e evolutivos da sífilis gestacional (SG) em Sobral-CE, a partir da análise do perfil epidemiológico no período de 2012 a 2017. Realizou-se coleta de dados no Sistema Nacional de Agravos de Notificação (Sinan). Cinco características epidemiológicas foram avaliadas: escolaridade; cor da pele; idade da paciente; zona de residência; e classificação clínica da doença. Um total de 452 casos da doença foi notificado no período de estudo, evidenciando aumento de notificações no município em comparação com a década passada. Constatou-se que 217 mulheres (48%) tinham Ensino Fundamental incompleto, 403 (89,1%) eram pardas ou negras, 336 (74,4%) tinham entre 20 e 39 anos de idade, 377 (83,4%) moravam na zona urbana do município e 341 dos casos (75,4%) foram classificados como sífilis terciária. Concluiu-se que ações voltadas à prevenção, ao diagnóstico e ao tratamento da doença são importantes para reduzir o número de casos de SG em Sobral. Ademais, mostra-se necessário direcionar políticas sociais aos grupos vulneráveis, visando a diminuir os agravos dessa infecção.
BackgroundThe aim of this work was to explore the potential risk of vector-borne Chagas disease in urban districts in northeastern Brazil, by analyzing the spatiotemporal distributions and natural infection rates with Trypanosoma cruzi of triatomine species captured in recent years. The main motivation of this work was an acute human case of Chagas disease reported in 2008 in the municipality of Sobral.Methodology/principal findingsWe analyzed data from community-based entomological surveillance carried out from 2010 to 2014. Triatomine natural T. cruzi infection was assessed by examination of insect feces by optical microscopy. Sites of triatomine capture were georeferenced through Google Earth and analyzed with ArcGIS. A total of 191 triatomines were collected, consisting of 82.2% Triatoma pseudomaculata, 7.9% Rhodnius nasutus, 5.8% T. brasiliensis, 3.7% Panstrongylus lutzi, and 0.5% P. megistus, with an overall natural infection index of 17.8%. Most infestations were reported in the districts of Dom José (36.2%), Padre Palhano (24.7%), and Alto do Cristo (10.6%). The overwhelming majority of insects (185/96.9%) were captured inside houses, and most insects tended to be collected in intermittent peaks. Moreover, captured triatomines tended to constitute colonies. The acute case reported in 2008 was found to be situated within a T. pseudomaculata hotspot.ConclusionThe triatomine collection events carried out by dwellers were aggregated in time and space into distinct foci, suggesting that insects are intermittently and artificially introduced into the city, possibly via accidental migration from their natural reservoirs. The relatively high T. cruzi infection rate indicates considerable circulation of the parasite in these areas, increasing the risk of vector-borne Chagas disease infection. These data suggest a need to strengthen epidemiological surveillance and integrate appropriate control actions targeting triatomines, T. cruzi reservoirs, and human populations. Our data also identify Chagas disease transmission as a hazard in urban areas of Sobral.
Homeostasis of blood volume (BV) is attained through a functional interaction between the cardiovascular and renal systems. The gastrointestinal tract also adjusts its permeability and motor behavior after acute BV imbalances. We evaluated the effect of progressive nephron loss on gut motility. Male Wistar rats were subjected or not (sham) to 5/6 partial nephrectomy (PNX) in two steps (0 and 7th day). After further 3, 7, or 14 days, PNX and sham operation (control) rats were instrumented to monitor mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), and blood collection for biochemical analysis. The next day, they were gavage fed with a liquid test meal (phenol red in glucose solution), and fractional dye recovery determined 10, 20, or 30 min later. The effect of nonhypotensive hypovolemia and the role of neuroautonomic pathways on PNX-induced gastric emptying (GE) delay were also evaluated. Compared with the sham-operated group, PNX rats exhibited higher (P < 0.05) MAP and CVP values as well as increased values of gastric dye recovery, phenomenon proportional to the BV values. Gastric retention was prevented by prior hypovolemia, bilateral subdiaphragmatic vagotomy, coelic ganglionectomy + splanchnicectomy, guanethidine, or atropine pretreatment. PNX also inhibited (P < 0.05) the marker's progression through the small intestine. In anesthetized rats, PNX increased (P < 0.05) gastric volume, measured by a balloon catheter in a barostat system. In conclusion, the progressive loss of kidney function delayed the GE rate, which may contribute to gut dysmotility complaints associated with severe renal failure.
RESUMOEste estudo teve por objetivo analisar o per f il sociodemográf ico dos casos de hepatite viral (HV) no Estado do Ceará, no per íodo entre 2010 e 2015. Trata-se de pesquisa documental, descr itiva e retrospec tiva, com abordagem quantitativa, realizada com informações colhidas no banco de dados do Sistema de Informação de Agravos de Notif icação (SINAN) e examinadas por 2 pesquisadores independentes. Foram selecionadas 5 carac ter ísticas epidemiológicas para avaliação: a) classif icação etiológica; b) escolar idade; c) sexo; d) faixa etár ia; e e) raça. No per íodo em foco, foram notif icados 3.228 casos de HV. Ademais, notou-se oscilação no número de pacientes no decorrer desses anos. Constatou-se que homens, adultos, pardos e os vírus B e C foram as carac ter ísticas mais relevantes. Vale salientar que não foi possível traçar o per f il da doença em relação à escolar idade, uma vez que mais da metade dos casos foram ignorados ou não aplicados quanto a essa carac ter ística. Por tanto, medidas voltadas à prevenção, ao diagnóstico precoce e ao tratamento ef icaz, aliadas a maior qualidade das notif icações, são ações impor tantes para reduzir o número de pacientes.
Background Agile, accessible and cheap diagnosis of hepatitis C virus (HCV) infection is essential to achieve the elimination of this infection, worldwide, as mandated by the World Health Organzation as part of its strategy for 2030. Dried blood spots (DBS) can be an attractive alternative for sample collection among people living in remote areas and vulnerable populations due to the less invasive collection, its biosafety, and storage & transportation of samples at room temperature. Design This study aims to estimate the usefulness of dried blood spot samples for the diagnosis and the assessment of HCV infection rates in three different settings in Brazil. Cross-sectional analysis of a sample collection from different populations, aiming to assess the performance of the testing algorithms and respective procedures among different populations with diverse background infection rates. Methods We reported the evaluation of DBS as alternative samples for detecting anti-HCV in different groups in real life conditions: (I) Vulnerable subjects living in remote areas of Southeast, North and Northeast Brazil (n = 1464); (II) Beauticians (n = 288); (III) People who use non-injectable drugs (n = 201); (IV) patients referred to outpatient care (n = 275). Results General assay accuracy was 99%, with a weighted kappa value of 0.9, showing an excellent performance. Sensitivities ranged from 87.5% to 100.0% between groups and specificities were above 99.2%. A total of 194 individuals had HCV RNA in serum and concordance of anti-HCV detection in DBS was 98.4%. Conclusions DBS samples could be used for anti-HCV detection in different populations recruited in real life conditions and ambulatory settings, with a high overall sensitivity and specificity.
Este estudo teve por objetivo avaliar o estado nutricional de menores de 5 anos de idade em Sobral-CE, no período entre 2013 e 2017. Para tanto, foram usados dados dos seguintes índices nutricionais disponíveis no Sistema de Vigilância Alimentar e Nutricional do Ministério da Saúde (SISVAN/MS): a) peso-para-altura; b) peso-para-idade; c) idade-para-altura; e d) IMC-para-idade. Nesse período, constatou-se que o número de crianças acometidas por magreza e magreza acentuada aumentou no município, porém, o agravo nutricional com crescimento mais acentuado foi o sobrepeso (aumento de 58,2%). Constatou-se, ainda, aumento do número de crianças com altura baixa e muito baixa para a idade, além do peso baixo e muito baixo. O IMC-para-idade indicou aumento do sobrepeso e da obesidade. Diante do aumento tanto da magreza e magreza acentuada quanto do sobrepeso e da obesidade entre crianças menores de 5 anos, concluiu-se que coexistem em Sobral diversos agravos nutricionais nessa população. Por tanto, mostra-se necessário adotar ações na atenção primária à saúde (APS) para reduzir e corrigir as carências nutricionais, além de investir em pesquisas voltadas à promoção de hábitos saudáveis desde a mais tenra infância.
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