ABSTRACT
BACKGROUND: Few reports have investigated the association between human T-lymphotropic virus type 1 (HTLV-1) and tuberculosis (TB) in countries where both infections are endemic. This study estimates the incidence of TB in a cohort infected with HTLV-1, compared with non-infected individuals, over a ten-year period. METHODS: Retrospective cohort study involving the cross-matching of records of individuals for whom a HTLV serology was performed at a referral center for HTLV (CHTLV) with a database of TB cases from Sinan-the Information System on Diseases of Compulsory Declaration between 2002 and 2012. RESULTS: From a cohort of 6,495 individuals, 1,711 were infected with HTLV-1. A total of 73 TB cases occurred during the study period: 33 HTLV-1-infected patients and 40 uninfected individuals. The incidence density for TB in the HTLV-1 infected group was 3.3 person-years per 1,000 individuals and 1.1 person-years per 1,000 individuals in the group HTLV-1 uninfected group. The relative risk of developing TB in the group of patients infected with HTLV-1 was 2.6 (CI 95 % 1.6-4.2) in comparison with HTLV-1 uninfected group. Compared to individuals with isolated TB, those in the HTLV-1 infected group who had TB were older (p = 0.005) and had lower education levels (p = 0.02). No differences were observed with respect to the clinical/radiological presentation, nor in the outcome of TB and prevalence of HIV infection, when comparing among the HTLV-1-infected and uninfected groups. CONCLUSIONS: Patients infected with HTLV-1 are more susceptible to TB. The epidemiological characteristics of HTLV-1/TB subjects and those infected with TB overlap.
Subject(s)
HTLV-I Infections/complications , Human T-lymphotropic virus 1 , Tuberculosis, Pulmonary/epidemiology , Adolescent , Adult , Brazil/epidemiology , Child , Child, Preschool , Cohort Studies , Female , HTLV-I Infections/virology , Human T-lymphotropic virus 1/isolation & purification , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Prevalence , Retrospective Studies , Tuberculosis, Pulmonary/complications , Young AdultABSTRACT
The 16q21 --> qter duplication is a chromosomal abnormality rarely found in liveborn infants, with only four published cases. We report here on the 7-year follow-up of a female patient with trisomy 16q21 --> qter due to a maternal balanced translocation t(4;16)(q35.2;q21). The patient shows severe mental retardation, congenital heart malformations, nephropathy, and other congenital anomalies. The derivative chromosome was characterized by GTG banding, fluorescent in situ hybridization (FISH) with different BAC probes and the array technique, in order to map the breakpoints. The patient has a 16q21 --> qter duplication, with a 4q35 --> qter monosomy, which we assume does not contribute to the abnormal phenotype. This is the first reported case of postnatal survival to the age of 7 years, an unusually long time in this chromosomal syndrome.
Subject(s)
Abnormalities, Multiple/genetics , Chromosome Aberrations , Chromosomes, Human, Pair 16/genetics , Chromosomes, Human, Pair 4/genetics , Heart Defects, Congenital/genetics , Intellectual Disability/genetics , Trisomy/genetics , Abnormalities, Multiple/mortality , Adult , Female , Follow-Up Studies , Heart Defects, Congenital/mortality , Humans , In Situ Hybridization, Fluorescence , Infant, Newborn , Intellectual Disability/mortality , Karyotyping , Male , Monosomy , Survival Rate , Translocation, GeneticABSTRACT
Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the Flavivirus genus of the Flaviviridae family. Since the large outbreaks in French Polynesia in 2013-2014 and in Brazil in 2015, ZIKV has been considered a new public health threat. Similar to other related flavivirus, ZIKV is associated with mild and self-limiting symptoms such as rash, pruritus, prostration, headache, arthralgia, myalgia, conjunctivitis, lower back pain and, when present, a short-term low grade fever. In addition, ZIKV has been implicated in neurological complications such as neonatal microcephaly and Guillain-Barré syndrome in adults. Herein, serum lipidomic analysis was used to identify possible alterations in lipid metabolism triggered by ZIKV infection. Patients who presented virus-like symptoms such as fever, arthralgia, headache, exanthema, myalgia and pruritus were selected as the control group. Our study reveals increased levels of several phosphatidylethanolamine (PE) lipid species in the serum of ZIKV patients, the majority of them plasmenyl-phosphatidylethanolamine (pPE) (or plasmalogens) linked to polyunsaturated fatty acids. Constituting up to 20% of total phospholipids in humans, plasmalogens linked to polyunsaturated fatty acids are particularly enriched in neural membranes of the brain. The biosynthesis of plasmalogens requires functional peroxisomes, which are important sites for viral replication, including ZIKV. Thus, increased levels of plasmalogens in serum of ZIKV infected subjects suggest a link between ZIKV life cycle and peroxisomes. Our data provide important insights into specific host cellular lipids that are likely associated with ZIKV replication and may serve as platform for antiviral strategy against ZIKV.
ABSTRACT
The control of HIV / Tuberculosis (TB) co -infection remains a challenge for public health. Notification is mandatory for both diseases and the National Case Registry Database (Sinan) is responsible for the collection and processing of individual forms of reporting and monitoring. The adequate fulfillment of these fields chips (completeness) is essential to follow the dynamics of the disease and set priorities for intervention. The aim of this study was to evaluate the completeness of the notification forms of tuberculosis in the priority municipalities of Bahia (Camaçari , Feira de Santana , Ilhéus , Itabuna, Jequié, Lauro de Freitas , Porto Seguro , Teixeira de Freitas , Paulo Afonso, Barreiras and Salvador) to control the disease in individuals with HIV/AIDS using tabulations obtained from the Sinan in the period from 2001 to 2010. The results showed that despite the completeness of the field HIV be above 50 %, more than half the cases were met as "undone" or "being processed" in all municipalities assessed in the period. The low completeness of reporting forms may compromise the quality of surveillance of TB cases. The results suggest the need for greater availability of HIV testing in these individuals.
Subject(s)
Disease Notification/standards , HIV Infections/complications , Records/standards , Tuberculosis/complications , Tuberculosis/prevention & control , Acquired Immunodeficiency Syndrome/complications , Brazil , Cities , Humans , Urban HealthABSTRACT
The aim of this study was to evaluate the completeness of tuberculosis reporting forms in the greater metropolitan areas of five Brazilian capitals where the incidence of tuberculosis was high in 2010 - Salvador, Rio de Janeiro, Cuiabá, Porto Alegre, and Belém - using tabulations obtained from the Sistema Nacional de Informação de Agravos de Notificação (National Case Registry Database). The degree of completeness was highest in Porto Alegre and Cuiabá, whereas it was lowest in Rio de Janeiro, where there are more reported cases of tuberculosis than in any other Brazilian capital. A low degree of completeness of these forms can affect the quality of the Brazilian National Tuberculosis Control Program, which will have negative consequences for health care and decision-making processes.
Subject(s)
Disease Notification/standards , Tuberculosis/epidemiology , Brazil/epidemiology , Cities/epidemiology , Humans , IncidenceABSTRACT
The control of HIV / Tuberculosis (TB) co -infection remains a challenge for public health. Notification is mandatory for both diseases and the National Case Registry Database (Sinan) is responsible for the collection and processing of individual forms of reporting and monitoring. The adequate fulfillment of these fields chips (completeness) is essential to follow the dynamics of the disease and set priorities for intervention. The aim of this study was to evaluate the completeness of the notification forms of tuberculosis in the priority municipalities of Bahia (Camaçari , Feira de Santana , Ilhéus , Itabuna, Jequié, Lauro de Freitas , Porto Seguro , Teixeira de Freitas , Paulo Afonso, Barreiras and Salvador) to control the disease in individuals with HIV/AIDS using tabulations obtained from the Sinan in the period from 2001 to 2010. The results showed that despite the completeness of the field HIV be above 50 %, more than half the cases were met as "undone" or "being processed" in all municipalities assessed in the period. The low completeness of reporting forms may compromise the quality of surveillance of TB cases. The results suggest the need for greater availability of HIV testing in these individuals.
O controle da coinfecção HIV/Tuberculose (TB) ainda representa um desafio para a saúde pública. Ambas as doenças são de notificação obrigatória e o Sistema Nacional de Agravos de Notificação (SINAN) é o órgão responsável pela coleta e processamento das fichas individuais de notificação e acompanhamento. O preenchimento adequado dos campos destas fichas (completude) é essencial para acompanhar a dinâmica da doença e definir prioridades de intervenção. O objetivo deste estudo foi avaliar a completude das fichas de notificações de tuberculose nos municípios prioritários da Bahia (Camaçari, Feira de Santana, Ilhéus, Itabuna, Jequié, Lauro de Freitas, Porto Seguro, Teixeira de Freitas, Paulo Afonso, Barreiras e Salvador), para controle da doença em indivíduos com HIV/AIDS, através dos relatórios de tabulação do Sinan, no período de 2001 a 2010. Os resultados demonstraram que, apesar da completude do campo HIV estar acima de 50%, mais da metade das fichas estavam preenchidas como "não realizado" ou "em andamento", em todos os municípios avaliados no período. A baixa completude das fichas de notificação pode comprometer a qualidade de vigilância dos casos de TB. Os resultados sugerem a necessidade de maior disponibilidade de teste para HIV nesses indivíduos.
Subject(s)
Gold/chemistry , Nanocomposites/chemistry , Silver/chemistry , Spectrum Analysis, Raman , Chlorides/chemistry , Electrochemical Techniques , Gold Compounds/chemistry , Microscopy, Electron, Transmission , Nanotechnology/instrumentation , Nanotechnology/methods , Oxidation-Reduction , Spectrum Analysis, Raman/instrumentation , Spectrum Analysis, Raman/methods , Surface PropertiesABSTRACT
Este trabalho descreve e comenta uma experiência piloto de ensino de semiologia pediátrica em Unidades de Saúde da Família, através do uso de fluxogramas individualizados por idade, de acordo com a rotina do Ministério da Saúde para acompanhamento durante o primeiro ano de vida. O estudo foi realizado durante atendimento pediátrico inserido no módulo Piesc III para alunos do terceiro ano de Medicina da Universidade Estadual de Feira de Santana - Bahia (UEFS). Os fluxogramas foram aplicados em campo, mostrando-se efetivos para a sistematização das consultas de puericultura na etapa em que os estudantes se encontravam, reduzindo o estresse inicial, proporcionando maior segurança aos alunos e possibilitando anamneses mais extensas e esclarecedoras, com repercussão no aprendizado dos alunos e possibilidade de melhoria na qualidade da assistência às crianças e na oferta de dados em prontuários para pesquisa.
This paper describes and comments on a pilot teaching experience in clinical pediatrics in Family Health Units, using individualized flowcharts by age, according to the Brazilian Ministry of Health's guidelines for monitoring infants (0-12 months of age). The study was performed during pediatric care as part of training for third-year medical students at the State University in Feira de Santana, Bahia (UEFS). The flowcharts were applied in the field and proved effective for systematizing child care consultations at the students' respective stage of development, reducing the initial stress, providing greater security for students, and allowing more extensive and instructive case histories, with positive repercussions on the students' learning and the possibility for improved quality of care for children and recording of relevant data on patient charts, for use in future research.
Subject(s)
Humans , Education, Medical , Teaching/methods , Medical History Taking , Students, MedicalABSTRACT
O Ministério da Saúde iniciou, em 1993, a implantação dos Centros de Referência de Imunobiológicos Especiais (CRIE) para facilitar o acesso de pessoas com quadros clínicos especiais a produtos de alto custo. Atualmente, existem mais de quarenta CRIE no Brasil, distribuídos em todas as capitais e em algumas cidades do interior. A proposta de implantação de um CRIE em Feira de Santana, Bahia, segunda cidade mais populosa do estado, sob a forma de um projeto de cooperação técnica entre a Universidade Estadual de Feira de Santana (UEFS) e a Secretaria de Saúde do Estado da Bahia (SESAB), envolvendo a Segunda Dires (SESAB) e o Hospital Geral Clériston Andrade (HGCA), objetiva beneficiar diretamente os portadores de quadros clínicos especiais, contribuir para aumentar as coberturas vacinais de crianças e adultos na rotina, acompanhar os casos de reações adversas aos imunobiológicos (vacinas e imunoglobulinas) e oportunizar aos estudantes de graduação e pós-graduação na área de Saúde a realização de projetos e trabalhos científicos, inserindo as estatísticas locais no contexto nacional. A publicação desta proposta poderá auxiliar outros profissionais na elaboração de projetos para implantação de CRIE em outras localidades.
In 1993 the National Health Service began the implementation of the Special Immunobiology Referral Centers (CRIE), in order to make it easier the access of people with special clinical needs to high cost drugs. Nowadays, in Brazil there are more than forty CRIEs, which are spread out in all the capitals and in some country towns. This new CRIE unit is a project of technical cooperation among the Universidade Estadual de Feira de Santana (UEFS) and Public Health Department of Bahia (SESAB), the II DIRES, Health Regional Directory which is subordinated to SESAB, and the General Hospital Cleriston Andrade (GHCA), a public hospital. The proposal for the implementation of one CRIE unit in Feira de Santana, the second most populous city of Bahia, aims to benefit immediately the carriers of special clinical needs, contributing to increase the coverage of vaccines in children and adults. It also aims to monitor the cases of adverse drugs reactions in the special immunobiologicals (vaccines and immunoglobulin), besides to give a chance to the Graduation and Post Graduation students in the Health Area to develop projects and academic works, inserting the local statistics in the national context. The publishing of this work will may help other professionals on the implementation of CRIE in other regions.
En 1993, el Ministerio de la Salud inició la implantación de los Centros de Referencia de Inmunobiológicos Especiales (CRIE), para facilitar el acceso de personas con cuadros clínicos especiales a productos de alto costo. Actualmente, existen más de cuarenta CRIE en Brasil, distribuidos en todas las capitales y en algunas ciudades del interior. La propuesta de implantación de un CRIE, dentro del proyecto de cooperación técnica entre la Universidad Estadual de Feira de Santana (UEFS) y la Secretaría de Salud del Estado de Bahia (SESAB), involucrando la Segunda Dires (SESAB) y el Hospital General Clériston Andrade (HGCA), en Feira de Santana, Bahía, segunda ciudad más poblada del estado de la Bahía, objetiva beneficiar directamente a los portadores de cuadros clínicos especiales, contribuir para aumentar las coberturas de vacunación de niños y adultos en la rutina, acompañar los casos de reacciones adversas a los inmunobiológicos (vacunas e inmunoglobulinas) y propiciar a los estudiantes de pregrado y posgrado en el área de Salud la realización de proyectos y trabajos científicos, insertando en el contexto nacional las estadísticas locales. La publicación de esta propuesta podrá auxiliar a 760 otros profesionales en la elaboración de proyectos para la implantación de los CRIE en otras localidades.
Subject(s)
Immune System , Immunoglobulins/adverse effects , Vaccines/adverse effects , BrazilABSTRACT
OBJETIVOS: analisar a aplicação do protocolo do Projeto Nascer Maternidades, estratégia do Ministério da Saúde para a adoção de medidas profiláticas e/ou terapêuticas no momento do parto, para gestantes com sorologias para sífilis/Aids desconhecidas, no primeiro ano de implantação em uma maternidade de referência em Feira de Santana, Bahia, Brasil. MÉTODOS: foram analisadas sorologias para HIV e sífilis solicitadas no pré-natal e na maternidade e a adoção de medidas profiláticas e/ou terapêuticas. Os dados foram coletados em uma amostra randomizada de 337 prontuários de gestantes admitidas para assistência obstétrica no período de julho de 2003 a julho de 2004. RESULTADOS: no pré-natal, 8,4 por cento das gestantes realizaram sorologia para HIV e 8 por cento para sífilis. Na maternidade, o teste rápido para HIV foi realizado para 17,7 por cento das gestantes e o VDRL para 97,8 por cento. A profilaxia das gestantes infectadas pelo HIV foi aplicada no momento do parto...
OBJECTIVES: to analyze the implementation of the Nascer Maternidades Project protocol, a guideline from the Brazilian Ministry of Health for prophylactic/therapeutic measures on delivery for pregnant women whose serological status vis-à-vis syphilis/HIV was unknown in the first year of implementation, at Maternity Hospital Referral Centre in Feira de Santana, Bahia, Brazil. METHODS: the women's serum was analyzed for HIV and syphilis, as requested during prenatal sessions or at the maternity hospital, and prophylactic and/or therapeutic measures were adopted. Data were obtained from 337 randomized medical records of pregnant women admitted to obstetric care between July 2003 and July 2004. RESULTS: during the prenatal follow-up, 8.4 percent and 8.05 of the pregnant women were tested for HIV and syphilis, respectively. On delivery, HIV rapid test was performed to 17.7 percent and VDRL to 97.8 percent. Prophylactic measures for HIV were taken on delivery in the case of HIV-infected women...