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Resumo Objetivo Identificar as publicações que discorreram sobre a COVID-19 como acidente laboral e sua notificação pelos trabalhadores da saúde. Métodos A busca para esta scoping review, explorou literatura nacional e internacional, no período de 2020 e 2021, em inglês, português e espanhol, nas bases de dados do Portal Regional da Biblioteca Virtual em Saúde, na MEDLINE por meio do PubMed e no Portal de Periódicos da Capes empregou-se: Embase, Scopus, Web of Science, CINAHL. Os textos foram importados para o EndNote, suprimido os duplicados e exportados para o aplicativo Rayyan, sendo feita a inclusão dos artigos em planilha Excel com os rótulos/etiquetas: COVID-19 como acidentes de trabalho e Notificação de COVID-19. Resultados Foram identificados 5.665 estudos, excluindo 2.088 duplicações, resultando 3.577 publicações, selecionadas por título e resumo. Destas, 3.280 não atendiam aos critérios de inclusão, resultando 297 artigos. Destes, 10 foram selecionados para análise completa do texto por tratarem da COVID-19 como acidente de trabalho e/ou notificação deste agravo pelos trabalhadores da saúde. Dois artigos foram excluídos por se tratar de revisão de literatura, permanecendo 8 como corpus do estudo. Conclusão Apesar de determinados países já reconhecerem a COVID-19 como doença ocupacional, alguns trabalhadores ainda apresentam dificuldades em relacionar a infecção pelo SARS-CoV-2 com o trabalho na assistência à saúde, caracterizando como acidente laboral. Todos devem ser orientados e capacitados quanto ao reconhecimento da COVID-19 como acidente laboral e notificar sua ocorrência, uma vez que já existe a definição da infecção como doença de notificação compulsória.
Resumen Objetivo Identificar las publicaciones que abordaron el COVID-19 como accidente laboral y su notificación por parte de los trabajadores de la salud. Métodos La búsqueda para esta scoping review exploró la literatura nacional e internacional, durante el período de 2020 a 2021, en inglés, portugués y español, en las bases de datos del Portal Regional de la Biblioteca Virtual de Salud, en MEDLINE a través de PubMed, y en el Portal de Periódicos de Capes se utilizó Embase, Scopus, Web of Science, CINAHL. Los textos fueron importados a EndNote, se eliminaron los duplicados y se exportaron a la aplicación Rayyan, se incluyeron los artículos en una planilla de Excel con la clasificación/etiquetas: COVID-19 como accidente de trabajo y Notificación de COVID-19. Resultados Se identificaron 5.665 estudios, se excluyeron 2.088 duplicaciones, que dio como resultado 3.577 publicaciones, seleccionadas por título y resumen. De ellas, 3.280 no atendían los criterios de inclusión, por lo que se obtuvieron 297 artículos. De estos, 10 fueron seleccionados para análisis completo del texto porque trataban el COVID-19 como accidente de trabajo o notificación de este daño por parte de los trabajadores de la salud. Se excluyeron dos artículos porque se trataban de revisión de literatura, por lo cual permanecieron ocho como corpus de estudio. Conclusión Aunque determinados países ya reconocieron el COVID-19 como una enfermedad ocupacional, algunos trabajadores aún tienen dificultad de relacionar la infección por SARS-CoV-2 con el trabajo en la atención a la salud, caracterizándolo como un accidente laboral. Todos deben ser orientados y capacitados sobre el reconocimiento del COVID-19 como accidente laboral y notificar su ocurrencia, dado que ya existe la definición de la infección como enfermedad de notificación obligatoria.
Abstract Objective To identify the publications that discussed COVID-19 as an occupational injury and its notification by health workers. Methods The search for this scoping review explored national and international literature, between 2020 and 2021, in English, Portuguese and Spanish, in the databases of the Regional Portal of the Virtual Health Library, in MEDLINE through PubMed and in Capes Journal Portal used: Embase, Scopus, Web of Science, CINAHL. The texts were imported into EndNote, duplicates were removed and exported to the Rayyan application, and the articles were included in an Excel spreadsheet with the labels: COVID-19 as injuries at work and Notification of COVID-19. Results A total of 5665 studies were identified, excluding 2088 duplicates, resulting in 3577 publications, selected by title and abstract. Of these, 3280 did not meet the inclusion criteria, resulting in 297 articles. Of these, 10 were selected for full text analysis because they dealt with COVID-19 as an injury at work and/or notification of this condition by health workers. Two articles were excluded because they were a literature review, remaining 8 as the study's corpus. Conclusion Although certain countries already recognize COVID-19 as an occupational injury, some workers still have difficulties in relating the SARS-CoV-2 infection with work in health care, characterizing it as an occupational injured. Everyone should be guided and trained regarding the recognition of COVID-19 as an occupational injury and notify its occurrence, since the definition of the infection as a notifiable disease already exists.
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Introdução: Os acidentes de trajeto ocorrem no percurso do domicílio até o local de trabalho e vice-versa. Esse tipo de acidente de trabalho pode resultar em grave desordem à saúde do trabalhador e, em grande quantidade, impactar financeiramente o Sistema Único de Saúde e a Previdência Social Brasileira (PSB). Objetivos: Descrever o perfil epidemiológico e estimar a incidência dos acidentes de trajeto em trabalhadores no Brasil entre 2009 e 2016. Métodos: Estudo retrospectivo descritivo, com análises de séries temporais (20092016), baseado em dados secundários e oficiais extraídos dos Anuários Estatísticos da Previdência Social. As informações de População Economicamente Ativa foram retiradas da Pesquisa Nacional por Amostra de Domicílios. As incidências anuais foram calculadas para cada 100 mil pessoas economicamente ativas, independentemente de sexo, de idade e de contribuição para a PSB. Utilizou-se o Statistical Package for the Social Sciences (SPSS) para realizar testes de regressão linear simples temporal, considerando significância de p<0,05. Resultados: O perfil epidemiológico do trabalhador acometido foi de homem entre 20 e 29 anos com fratura de perna e/ou tornozelo, que representou 24,73% do total de trabalhadores acometidos. No período, a incidência dos acidentes de trajeto aumentou de 88,17 para 105,88, o que resultou em taxa de variação de 20,08% (R2 =0,715; p=0,008). Conclusão: O crescimento da incidência e do número de acidentes demonstra grande necessidade de elaboração de planos governamentais de prevenção, que devem ser direcionados aos principais grupos de risco.
Background: Commuting accidents might have serious consequences for the health of workers, in addition to considerable financial impacts on the national health system and the social security administration. Objective: To describe the epidemiological profile and calculate the incidence of commuting accidents in Brazil in the period from 2009 to 2016. Methods: Retrospective and descriptive study with time series analysis (20092016) based on official secondary data obtained from Social Security Statistical Yearbooks. Information on the economically active population was retrieved from the National Household Sample Survey. Annual incidence rates were calculated per 100,000 economically active population. Simple temporal linear regression analysis was performed with software Statistical Package for the Social Sciences. The significance level was set to p<0.05. Results: The epidemiological profile of workers involved in commuting accidents corresponded to men, aged 20 to 29 and with leg/ankle fractures, which represented 24.78% of the total population of involved workers. The incidence of commuting accidents increased from 88.17 to 105.88 in the analyzed period, which represents an variation rate of 20.08% (R2 =0.715; p=0.008). Conclusion: The detected rise in the incidence and number of commuting accidents point to the need for the government to formulate prevention plans targeting high-risk groups.
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BACKGROUND: The association between infection with Helicobacter pylori and different gastroduodenal diseases is related to bacterial, host and environmental factors. Studies have demonstrated an association between the genetic diversity of H. pylori, especially in the vacA and cagA genes, and the development of digestive diseases such as peptic ulcer and gastric cancer. In addition, the nature of the host inflammatory response may explain these different manifestations of infection caused by this microorganism. In this respect, host factors that regulate the immune and inflammatory responses involving the functional interaction of H. pylori infection with different components of the immune system, particularly T cells, in gastroduodenal diseases still need further investigation. OBJECTIVE: To characterize the immune response, including immunity induced by infection with H. pylori, especially virulent strains (vacA alleles and cagA gene), by analyzing the cytokine profile and T-cell population present in gastroduodenal diseases in a Brazilian population. METHODS: In a prospective study, gastric biopsies were collected from 554 patients with different gastroduodenal diseases for histological analysis and for the determination of bacterial genotype and cytokine production (IL-4, IL-10, IFN-γ and IL-12) by ELISA. RESULTS: The predominant genotype of the H. pylori strains isolated from the patients studied was s1m1cagA+, which was more common among patients with gastric ulcer, duodenal ulcer and gastric cancer. A significant association was observed between the s1m1cagA+ genotype and a higher degree of inflammation, higher neutrophil activity and the development of intestinal metaplasia. The gastric concentrations of IFN-γ and IL-12 were significantly higher in patients infected with H. pylori than in uninfected individuals. Higher levels of these cytokines were detected in patients with gastric ulcer and cancer, while the levels of IL-4 and IL-10 in the gastric mucosa were lower in these patients. In addition, IFN-γ and IL-12 concentrations in gastric biopsies were higher in patients infected with the virulent s1m1cagA+ genotype. In contrast, IL-4 and IL-10 levels were higher in tissue infected with s2m2cagA in gastric biopsies. CONCLUSION: Our study shows that the interaction between the type of infectious strain and the Th1 immune response can influence and perpetuate gastric inflammation, and thus contributes to the development of the different clinical manifestations of H. pylori infection.
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Úlcera Duodenal/imunologia , Mucosa Gástrica/imunologia , Gastrite/imunologia , Infecções por Helicobacter/imunologia , Helicobacter pylori/genética , Neoplasias Gástricas/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Citocinas/biossíntese , DNA Bacteriano , Úlcera Duodenal/microbiologia , Feminino , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite/microbiologia , Genes Bacterianos/imunologia , Genótipo , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Prospectivos , Neoplasias Gástricas/microbiologia , Adulto JovemRESUMO
ABSTRACT BACKGROUND: The association between infection with Helicobacter pylori and different gastroduodenal diseases is related to bacterial, host and environmental factors. Studies have demonstrated an association between the genetic diversity of H. pylori, especially in the vacA and cagA genes, and the development of digestive diseases such as peptic ulcer and gastric cancer. In addition, the nature of the host inflammatory response may explain these different manifestations of infection caused by this microorganism. In this respect, host factors that regulate the immune and inflammatory responses involving the functional interaction of H. pylori infection with different components of the immune system, particularly T cells, in gastroduodenal diseases still need further investigation. OBJECTIVE: To characterize the immune response, including immunity induced by infection with H. pylori, especially virulent strains (vacA alleles and cagA gene), by analyzing the cytokine profile and T-cell population present in gastroduodenal diseases in a Brazilian population. METHODS: In a prospective study, gastric biopsies were collected from 554 patients with different gastroduodenal diseases for histological analysis and for the determination of bacterial genotype and cytokine production (IL-4, IL-10, IFN-γ and IL-12) by ELISA. RESULTS: The predominant genotype of the H. pylori strains isolated from the patients studied was s1m1cagA+, which was more common among patients with gastric ulcer, duodenal ulcer and gastric cancer. A significant association was observed between the s1m1cagA+ genotype and a higher degree of inflammation, higher neutrophil activity and the development of intestinal metaplasia. The gastric concentrations of IFN-γ and IL-12 were significantly higher in patients infected with H. pylori than in uninfected individuals. Higher levels of these cytokines were detected in patients with gastric ulcer and cancer, while the levels of IL-4 and IL-10 in the gastric mucosa were lower in these patients. In addition, IFN-γ and IL-12 concentrations in gastric biopsies were higher in patients infected with the virulent s1m1cagA+ genotype. In contrast, IL-4 and IL-10 levels were higher in tissue infected with s2m2cagA in gastric biopsies. CONCLUSION: Our study shows that the interaction between the type of infectious strain and the Th1 immune response can influence and perpetuate gastric inflammation, and thus contributes to the development of the different clinical manifestations of H. pylori infection.
RESUMO CONTEXTO: A associação da infecção por Helicobacter pylori com diferentes doenças gastroduodenais pode estar associada a fatores bacterianos, do hospedeiro e do ambiente. Nesse contexto, estudos têm demonstrado que a diversidade genética do H. pylori, sobretudo nos genes vacA e cagA, está associada ao desenvolvimento de doenças gastroduodenais como a úlcera péptica e o câncer gástrico. Além disso, a natureza da resposta inflamatória do hospedeiro pode explicar essas diferentes manifestações da infecção por esse microrganismo. Portanto, fatores do hospedeiro que regulam as respostas imunológica e inflamatória, envolvendo a interação funcional da infecção por H. pylori com diferentes membros do compartimento imunológico, especialmente respostas imunes de células T nas doenças gastroduodenais, ainda precisam ser melhor estudados. OBJETIVO: Caracterizar a resposta imune, incluindo imunidade induzida por infecção pelo H. pylori, especialmente com cepas virulentas de H. pylori (alelos vacA e gene cagA), através da análise do perfil de citocinas e da caracterização da população de células T presentes em doenças gastroduodenais em nossa população. MÉTODOS: Em um estudo prospectivo, foram coletadas biópsias gástricas de 554 pacientes portadores das diferentes doenças gastroduodenais. Nas amostras biológicas destes pacientes foi realizada a determinação do genótipo bacteriano e a detecção das citocinas IL-4, IL-10, INF-γ e IL-12 através do método Elisa. Foram obtidas biópsias gástricas para avaliação histológica. RESULTADOS: Observamos que o genótipo predominante nas cepas de H. pylori isoladas dos pacientes estudados foi s1m1cagA positivo, sendo mais frequentes entre os pacientes com úlcera gástrica, úlcera duodenal e câncer gástrico. Houve associação significativa das cepas com o genótipo s1m1cagA positivo com maior grau de inflamação, atividade neutrofílica e desenvolvimento de metaplasia intestinal. As concentrações gástricas de INF-γ e IL-12 foram significativamente mais elevadas em pacientes infectados pelo H. pylori do que nos não infectados. Foram detectados níveis mais elevados dessas citocinas nos portadores de úlcera e câncer gástrico, sendo que nesses pacientes foram observados níveis mais baixos de IL-4 e IL-10 na mucosa gástrica. Além disso, as concentrações de INF-γ e IL-12 em biópsias gástricas, foram mais elevadas nos pacientes portadores das cepas bacterianas virulentas s1m1cagA+. Contrariamente, os níveis de IL-4 e IL-10 foram maiores em tecido infectado por cepas s2m2cagA. Pacientes com maior grau de inflamação, de atividade neutrofílica e presença de metaplasia intestinal, apresentaram níveis mais elevados de INF-γ e IL-12 e uma concentração mais baixa de IL-4 e IL-10 nas biópsias gástricas. CONCLUSÃO: Nosso estudo demonstra que a interação entre o tipo de cepa infectante e resposta imunológica com perfil Th1, podem influenciar e perpetuar a inflamação gástrica contribuindo para o desenvolvimento de diferentes manifestações clínicas na infecção pelo H. pylori.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Neoplasias Gástricas/imunologia , Helicobacter pylori/genética , Infecções por Helicobacter/imunologia , Úlcera Duodenal/imunologia , Mucosa Gástrica/imunologia , Gastrite/imunologia , Neoplasias Gástricas/microbiologia , Proteínas de Bactérias/genética , DNA Bacteriano , Reação em Cadeia da Polimerase , Estudos Prospectivos , Citocinas/biossíntese , Helicobacter pylori/isolamento & purificação , Infecções por Helicobacter/microbiologia , Úlcera Duodenal/microbiologia , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite/microbiologia , Genes Bacterianos/imunologia , Genótipo , Pessoa de Meia-Idade , Antígenos de Bactérias/genéticaRESUMO
BackgroundThe hepatitis C virus has been recognized as the leading cause of chronic liver disease in the world. Host genetic factors have been implicated in the persistence of hepatitis C virus infection. Single nucleotide polymorphisms at positions -607 C/A (rs1946518) and -137 G/C (rs187238) in the IL-18 gene promoter have been suggested to be associated with delayed hepatitis C virus clearance and persistence of the disease.ObjectiveIdentify these polymorphisms in a population infected with hepatitis C virus from the Brazilian Amazon region.MethodsIn a cross-sectional analytical study conducted in Belém, Pará, Brazil, 304 patients infected with hepatitis C virus were divided into two groups: group A, patients with persistent infection; group B, patients with spontaneous clearance. The control group consisted of 376 volunteers not infected with hepatitis C virus. Samples were analyzed by RT-PCR for the detection of viral RNA and by RFLP-PCR to evaluate the presence of the -137 G/C and -607 C/A IL-18 gene promoter polymorphisms.ResultsComparison of polymorphism allele frequencies between the patient and control groups showed a higher frequency of allele C at position -607 among patients (P=0.02). When the association between the polymorphisms and viral infection was analyzed, patients carrying genotype C/A at position -607 were found to be at higher risk of persistent hepatitis C virus infection (P=0.03).ConclusionThe present results suggest a possible role of the -607 IL-18 gene promoter polymorphism in the pathogenesis of hepatitis C virus infection.
ContextoO vírus da hepatite C é reconhecido como a maior causa de doença hepática crônica no mundo. Fatores genéticos do hospedeiro têm sido implicados na persistência da infecção pelo vírus da hepatite C. Polimorfismos de nucleotídeos únicos na posição -607 C/A (rs1946518) e -137 G/C (rs187238) na região promotora do gene da IL-18 têm sido evidenciados em alguns estudos que sugerem sua associação ao atraso na depuração do vírus da hepatite C e na persistência da doença.ObjetivoO presente estudo pretende identificar esses polimorfismos em uma população da região da Amazônia Brasileira infectada pelo vírus da hepatite C.MétodosEstudo do tipo transversal analítico no município de Belém-PA foi realizado em 304 pacientes infectados pelo vírus da hepatite C, divididos em: grupo A, pacientes com infecção persistente; grupo B, pacientes que apresentaram clareamento viral. Como grupo controle participaram 376 voluntários não infectados pelo vírus da hepatite C. As amostras foram submetidas à RT-PCR, para detecção do RNA viral e, posteriormente, à RFLP-PCR para avaliação do polimorfismo na região promotora do gene da IL-18, nas posições -137 G/C e -607 C/A.ResultadosA comparação das frequências dos polimorfismos no grupo de pacientes com o grupo controle demonstrou uma maior frequência do alelo C na posição -607 entre os pacientes (P=0,02) que no grupo controle. Na análise da associação dos polimorfismos com a infecção viral foi obtido que portadores do genótipo C/A na posição -607 possuíam maior risco de infecção persistente pelo vírus da hepatite C (P=0,03).ConclusãoNossos resultados sugerem uma possível implicação do polimorfismo da região promotora -607 do gene IL-18 na patogenia da infecção pelo vírus da hepatite C.
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Feminino , Humanos , Masculino , Hepatite C/genética , /genética , Polimorfismo de Nucleotídeo Único , Brasil , Estudos Transversais , DNA Viral/análise , Predisposição Genética para Doença , Genótipo , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Regiões Promotoras Genéticas/genética , RNA ViralRESUMO
INTRODUCTION: The genomic heterogeneity of hepatitis C virus (HCV) influences liver disorders. This study aimed to determine the prevalence of HCV genotypes and to investigate the influence of these genotypes on disease progression. METHODS: Blood samples and liver biopsies were collected from HCV-seropositive patients for serological analysis, biochemical marker measurements, HCV genotyping and histopathological evaluation. RESULTS: Hepatitis C virus-ribonucleic acid (HCV-RNA) was detected in 107 patients (90.6% with genotype 1 and 9.4% with genotype 3). Patients infected with genotype 1 exhibited higher mean necroinflammatory activity and fibrosis. CONCLUSIONS: HCV genotype 1 was the most prevalent and was associated with greater liver dysfunction.
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Hepacivirus/genética , Hepatite C Crônica/virologia , Cirrose Hepática/virologia , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biópsia , Progressão da Doença , Feminino , Genótipo , Hepatite C Crônica/enzimologia , Hepatite C Crônica/patologia , Humanos , Cirrose Hepática/patologia , Masculino , RNA Viral/sangue , gama-Glutamiltransferase/sangueRESUMO
Introduction: The genomic heterogeneity of hepatitis C virus (HCV) influences liver disorders. This study aimed to determine the prevalence of HCV genotypes and to investigate the influence of these genotypes on disease progression. Methods: Blood samples and liver biopsies were collected from HCV-seropositive patients for serological analysis, biochemical marker measurements, HCV genotyping and histopathological evaluation. Results: Hepatitis C virus-ribonucleic acid (HCV-RNA) was detected in 107 patients (90.6% with genotype 1 and 9.4% with genotype 3). Patients infected with genotype 1 exhibited higher mean necroinflammatory activity and fibrosis. Conclusions: HCV genotype 1 was the most prevalent and was associated with greater liver dysfunction. .
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Adulto , Feminino , Humanos , Masculino , Hepacivirus/genética , Hepatite C Crônica/virologia , Cirrose Hepática/virologia , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biópsia , Progressão da Doença , Genótipo , Hepatite C Crônica/enzimologia , Hepatite C Crônica/patologia , Cirrose Hepática/patologia , RNA Viral/sangue , gama-Glutamiltransferase/sangueRESUMO
The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92-7.46, and P = 0.002). A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation.
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CONTEXT: Although more than half of the world's population is colonized with Helicobacter pylori, it remains unknown why this organism is able to produce severe disease in some hosts and be innocuous in others. The clinical outcome of infection is determined by several factors, including differences in the host response to bacterial stimulation, specific virulence factors of the organism and environmental influences, or a combination of these factors. OBJECTIVES: This study compared the prevalence of H. pylori infection and risk factors (infection with CagA+ strains, excessive alcohol consumption, smoking, and inadequate eating habits) between patients with different gastrointestinal disorders and associated these risk factors with the histopathological findings. METHODS: In a prospective study, samples were collected from 442 patients and a standardized questionnaire regarding lifestyle habits (excessive alcohol consumption, smoking, and eating habits) was applied. The presence of H. pylori and of the cagA gene was investigated by polymerase chain reaction (PCR). Gastric biopsies were obtained for histological assessment. RESULTS: The frequency of alcohol consumption, smoking, inadequate diet and infection with CagA+ H. pylori was higher among patients with peptic ulcer and adenocarcinoma when compared to those with gastritis. Gastric inflammation was more pronounced in patients infected with CagA+ strains. CONCLUSION: We conclude that infection with CagA+ H. pylori strains, excessive alcohol consumption, smoking and inadequate eating habits increase the risk of developing peptic ulcer and gastric carcinoma.
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Infecções por Helicobacter/complicações , Helicobacter pylori , Estilo de Vida , Gastropatias/microbiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Brasil , DNA Bacteriano , Comportamento Alimentar , Feminino , Helicobacter pylori/genética , Helicobacter pylori/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fumar/efeitos adversos , Fatores Socioeconômicos , VirulênciaRESUMO
Context Although more than half of the world's population is colonized with Helicobacter pylori, it remains unknown why this organism is able to produce severe disease in some hosts and be innocuous in others. The clinical outcome of infection is determined by several factors, including differences in the host response to bacterial stimulation, specific virulence factors of the organism and environmental influences, or a combination of these factors. Objectives This study compared the prevalence of H. pylori infection and risk factors (infection with CagA+ strains, excessive alcohol consumption, smoking, and inadequate eating habits) between patients with different gastrointestinal disorders and associated these risk factors with the histopathological findings. Methods In a prospective study, samples were collected from 442 patients and a standardized questionnaire regarding lifestyle habits (excessive alcohol consumption, smoking, and eating habits) was applied. The presence of H. pylori and of the cagA gene was investigated by polymerase chain reaction (PCR). Gastric biopsies were obtained for histological assessment. Results The frequency of alcohol consumption, smoking, inadequate diet and infection with CagA+ H. pylori was higher among patients with peptic ulcer and adenocarcinoma when compared to those with gastritis. Gastric inflammation was more pronounced in patients infected with CagA+ strains. Conclusion We conclude that infection with CagA+ H. pylori strains, excessive alcohol consumption, smoking and inadequate eating habits increase the risk of developing peptic ulcer and gastric carcinoma. .
Contexto Apesar de o H. pylori colonizar o estômago de aproximadamente metade da população mundial, ainda se desconhece por quê esse organismo é capaz de causar doença severa em certos hospedeiros e ser inofensivo em outros. As manifestações clínicas da infecção são determinadas por vários fatores, tais como: diferentes respostas do hospedeiro ao estímulo bacteriano, fatores de virulência específicos do organismo e influências ambientais ou a combinação desses fatores. Objetivos Esse estudo tem como objetivo comparar a prevalência e a associação dos fatores de risco, tais como: infecção por cepas H. pylori CagA+, consumo excessivo de bebidas alcoólicas, uso de tabaco e hábitos inadequados de alimentação entre pacientes com diferentes doenças gastrointestinais e a associação deles com achados histopatológicos. Métodos Em estudo prospectivo, foram cole-tadas amostras de 442 pacientes submetidos a um questionário padronizado com perguntas sobre hábitos de vida (uso excessivo de álcool, tabaco e, hábitos alimentares). A presença do H. pylori e do gene cagA foi detectada utilizando a Reação em Cadeia da Polimerase (PCR). As biópsias gástricas foram avaliadas histologicamente. Resultados O consumo de bebida alcoólica, uso de tabaco, dieta inadequada e infecção por cepas H. pylori CagA+ foram maiores entre pacientes com úlcera péptica e adenocarcinoma do que em pacientes com gastrite. Os pacientes infectados por cepas H. pylori CagA+ apresentaram inflamação gástrica de maior intensidade. Conclusão A presença de infecção por cepas H. pylori CagA+, o consumo excessivo de álcool, de tabaco ...
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Helicobacter pylori , Infecções por Helicobacter/complicações , Estilo de Vida , Gastropatias/microbiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Antígenos de Bactérias/genética , Brasil , Proteínas de Bactérias/genética , DNA Bacteriano , Comportamento Alimentar , Helicobacter pylori/genética , Helicobacter pylori/patogenicidade , Reação em Cadeia da Polimerase , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Fumar/efeitos adversos , VirulênciaRESUMO
Introduction This study compares virulence markers of Helicobacter pylori isolated from patients in 2 cities in the Brazilian Amazon. Methods The study analyzed 168 patients with chronic gastritis from Belém and 151 from Bragança, State of Pará, Brazil. Levels of bacterial DNA associated with cagA and vacA alleles were checked by PCR, and hematoxylin-eosin staining was used for histologic diagnosis. Results In Bragança 87% of patients were genotype s1m1 cagA-positive (s1m1 cagA+), compared with 76% in Belém. In samples from patients in both cities, there was an association between s1m1 cagA+ strains and gastric mucosal damage. Conclusions Both cities have a high frequency of s1m1 cagA+ strains of H. pylori. .
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Gastrite/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/patogenicidade , Brasil , Biomarcadores/análise , Doença Crônica , DNA Bacteriano/genética , Genótipo , Helicobacter pylori/genética , Helicobacter pylori/isolamento & purificação , Reação em Cadeia da Polimerase , Fatores de Virulência/genéticaRESUMO
Epidemiologically, the relevance of infection caused by hepatitis viruses is related mainly to their wide geographic distribution and the large number of infected individuals in all parts of the world. In this study, 668 residents from the islands around the Tucuruí Dam were selected. Blood samples were collected for investigation of serological markers (HBsAg, total anti-HBc, anti-HBS, and anti-HCV) by enzyme immunoassays. HCV-positive subjects were tested using RT-PCR and RFLP for the identification of viral genotypes. Among the 668 subjects studied, 1.9% were HBsAg positive, 28% were total anti-HBc positive, and 41.9% were anti-HBs positive. The anti-HBs marker alone (vaccine response) was detected in 25.7% of the volunteers. Anti-HCV antibody was detected in 2.2% of the subjects and genotype 1 was the predominant genotype (70%). The results indicate an intermediate level of HBV and HCV endemicity in the region studied, as well as low HBV vaccination coverage.
Assuntos
Hepacivirus/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Brasil/epidemiologia , DNA Viral/genética , Feminino , Genótipo , Hepacivirus/genética , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/genética , Anticorpos Anti-Hepatite C/sangue , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Polimorfismo de Fragmento de Restrição , Prevalência , RNA Viral/genética , Fatores de Risco , Rios , Adulto JovemRESUMO
INTRODUCTION: Viral hepatitis is a major public health concern in Brazil. There are few past studies on this issue, especially among riparian communities. This study aims at determining the seroprevalence of viral hepatitis B and C in the riparian community of Pacuí Island, within the Cametá municipality of Pará State, Brazil. Moreover, this study aims to investigate the principal risk factors that this community is exposed to. METHODS: The current study has accessed blood samples from 181 volunteers who have answered an epidemiological questionnaire. Analyses on serological markers have been tested with commercial ELISA kits for detecting HBsAg, total anti-HBc, anti-HBs, and anti-HCV. Within seroreactive patients for HCV, RT-PCR and line probe assay have been performed to identify the viral genotype. RESULTS: In the serological marker analysis for hepatitis B, no reactivity for HBsAg, rate of 1.1 percent for total anti-HBc, and rate of 19.3 percent for anti-HBs have been observed. On hepatitis C, 8.8 percent seroprevalence has been found, in which 62.5 percent have gotten viral RNA. Among the risk factors studied, the following have been highlighted: non-use of condoms, sharing of cutting instruments, use of illicit drugs, and reports of family disease with HBV or HCV. CONCLUSIONS: The vaccination coverage against HBV is low, and the high prevalence of HCV within this community has been observed.
INTRODUÇÃO: As hepatites virais constituem um importante problema de saúde pública no mundo. No Brasil existem poucos estudos sobre esta questão, especialmente entre as comunidades ribeirinhas. O objetivo deste estudo foi determinar a soroprevalência das hepatites B e C virais na comunidade ribeirinha da Ilha do Pacuí, no Estado do Pará, Brasil, e investigar os principais fatores de risco principal a que está comunidade está exposta. MÉTODOS: O presente estudo avaliou amostras de sangue de 181 voluntários que responderam a um questionário epidemiológico. Análises de marcadores sorológicos foram testados com kits comerciais de ELISA para detecção de HBsAg, anti-HBc total, anti-HBs e anti-VHC. Nos pacientes reagentes para VHC, RT-PCR e um line probe assay foi realizado para identificar o genótipo viral. RESULTADOS: Na análise dos marcadores sorológicos para hepatite B, observou-se taxas de 1,1 por cento para anti-HBc total e 19,3 por cento para anti-HBs, o marcador sorológico HBsAg não foi encontrado nesta população. Para a hepatite C foi encontrada um soroprevalência de 8,8 por cento, destes 62,5 por cento tinham RNA viral. Entre os fatores de risco estudados se destacaram: a não-utilização de preservativos, o compartilhamento de instrumentos cortantes, uso de drogas ilícitas e relatos de doença na família com VHB ou VHC. CONCLUSÕES: Observamos que a cobertura de vacinação contra o VHB é baixa e uma alta prevalência da hepatite C nesta comunidade.
Assuntos
Adulto , Feminino , Humanos , Masculino , Hepacivirus , Vírus da Hepatite B , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Brasil/epidemiologia , Brasil/etnologia , DNA Viral/sangue , ELISPOT , Genótipo , Hepacivirus/genética , Hepacivirus/imunologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite C/sangue , Hepatite C/diagnóstico , Reação em Cadeia da Polimerase , Prevalência , RNA Viral/sangue , População Rural , Fatores SocioeconômicosRESUMO
AIM: To investigate the ABH and Lewis antigen expression in erythrocytes, saliva and gastric epithelium, as well as the association between H pylori and the presence of gastric epithelial lesions. METHODS: The distribution of ABH and Lewis blood group antigens in erythrocytes, saliva and gastric mucosa of H pylori-infected gastric ulcer patients was analyzed. Forty-two patients with gastric ulcer were studied, and fifty healthy individuals were used as control group. The blood group antigens were determined by direct hemagglutination, dot-ELISA and immunohistochemical methods in erythrocytes, saliva and gastric mucosa specimens, respectively. Diagnosis for H pylori infection was performed by conventional optical microscopy and ELISA. RESULTS: A higher seroprevalence of IgG H pylori specific antibodies was observed in gastric ulcer patients (90%) compared to the control group (60%). We observed a significant increase of phenotypes O, A2 and Lewis b in H pylori-infected patients. The expression of these antigens had progressive alterations in areas of ulcerous lesions and intestinal metaplasia. CONCLUSION: ABH and Lewis blood group antigens are a good indicator for cellular alterations in the gastric epithelium.
Assuntos
Sistema ABO de Grupos Sanguíneos/análise , Mucosa Gástrica/imunologia , Infecções por Helicobacter/imunologia , Helicobacter pylori/imunologia , Antígenos do Grupo Sanguíneo de Lewis/análise , Saliva/imunologia , Úlcera Gástrica/imunologia , Sistema ABO de Grupos Sanguíneos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Ensaio de Imunoadsorção Enzimática , Eritrócitos/imunologia , Feminino , Mucosa Gástrica/patologia , Infecções por Helicobacter/sangue , Humanos , Imunoglobulina G/análise , Imuno-Histoquímica , Antígenos do Grupo Sanguíneo de Lewis/sangue , Masculino , Pessoa de Meia-Idade , Fenótipo , Saliva/citologia , Úlcera Gástrica/sangue , Úlcera Gástrica/microbiologiaRESUMO
We have examined the prevalence of gene cagA and vacA alleles in 129 patients, 69 with gastritis and 60 with peptic ulcer diseases from North Brazil and their relation with histopathological data. vacA and cagA genotype were determined by polymerase chain reaction. Hematoxylin-eosin staining was used for histological diagnosis. 96.6 percent of the patients were colonized by Helicobacter pylori strains harboring single vacA genotype (nont-mixed infection). Among them, 11.8 percent had subtype s1a, 67.8 percent had subtype s1b, and 17 percent subtype s2. In regard to the middle region analysis, m1 alleles were found in 75.4 percent and m2 in 21.2 percent of patients. The cagA gene was detected in 78 percent patients infected with H. pylori and was associated with the s1-m1 vacA genotype. The H. pylori strains, vacA s1b m1/cagA-positive, were associated with increased risk of peptic ulcer disease and higher amounts of lymphocytic and neutrophilic infiltrates and the presence of intestinal metaplasia. These findings show that cagA and vacA genotyping may have clinical relevance in Brazil.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Gastrite/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Úlcera Péptica/microbiologia , Alelos , Brasil , DNA Bacteriano/análise , Genótipo , Gastrite/patologia , Infecções por Helicobacter/patologia , Reação em Cadeia da Polimerase , Úlcera Péptica/patologiaRESUMO
We have examined the prevalence of gene cagA and vacA alleles in 129 patients, 69 with gastritis and 60 with peptic ulcer diseases from North Brazil and their relation with histopathological data. vacA and cagA genotype were determined by polymerase chain reaction. Hematoxylin-eosin staining was used for histological diagnosis. 96.6% of the patients were colonized by Helicobacter pylori strains harboring single vacA genotype (nont-mixed infection). Among them, 11.8% had subtype s1a, 67.8% had subtype s1b, and 17% subtype s2. In regard to the middle region analysis, m1 alleles were found in 75.4% and m2 in 21.2% of patients. The cagA gene was detected in 78% patients infected with H. pylori and was associated with the s1-m1 vacA genotype. The H. pylori strains, vacA s1b m1/cagA-positive, were associated with increased risk of peptic ulcer disease and higher amounts of lymphocytic and neutrophilic infiltrates and the presence of intestinal metaplasia. These findings show that cagA and vacA genotyping may have clinical relevance in Brazil.