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1.
PLoS One ; 13(4): e0196630, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29709007

RESUMO

BACKGROUND: Chikungunya virus (CHIKV) emerged in Aruba for the first time in 2014. We studied the clinical presentation of acute CHIKV infection and the contribution of serologic and molecular assays to its diagnosis. In a cohort of confirmed CHIKV cases, we analysed the frequency, duration and predictors of post-chikungunya chronic polyarthralgia (pCHIK-CPA), defined as joint pains lasting longer than 6 weeks or longer than 1 year. METHODOLOGY: Patient sera obtained within 10 days of symptom onset were tested for CHIKV, using an indirect immunofluorescence test for the detection of CHIKV-specific Immunoglobulin M (IgM) and post-hoc, by reverse-transcription polymerase chain reaction (RT-PCR). CHIKV was isolated from selected samples and genotyped. For confirmed CHIKV cases, clinical data from chart review were complemented by a Telephone survey, conducted 18-24 months after diagnosis. When joint pain was reported, the duration, presence of inflammatory signs, type and number of joints affected, were recorded. Joint involvement was scored according to the 2010 'American College of Rheumatology/ European League Against Rheumatism' criteria for seronegative rheumatoid arthritis (ACR-score). Risk factors for pCHIK-CPA were identified by logistic regression. PRINCIPAL FINDINGS: Acute CHIKV infection was diagnosed in 269 of 498 sera, by detection of IgM (n = 105), by RT-PCR (n = 59), or by both methods (n = 105). Asian genotype was confirmed in 7 samples. Clinical data were complete for 171 of 248 (69.0%) patients, aged 15 years or older (median 49.4 [35.0-59.6]). The female-to-male ratio was 2.2. The main acute symptoms were arthralgia (94%), fever (85%), myalgia (85%), headache (73%) and rash (63%). In patients with arthralgia (n = 160), pCHIK-CPA longer than 6 weeks was reported by 44% and longer than 1 year by 26% of cases. Inflammatory signs, stiffness, edema and redness were frequent (71%, 39% and 21%, respectively). Joints involved were knees (66%), ankles (50%), fingers (52%), feet (46%), shoulders (36%), elbows (34%), wrists (35%), hips (31%), toes (28.1%) and spine (28.1%). Independent predictors of pCHIK-CPA longer than 1 year were female gender (OR 5.9, 95%-CI [2.1-19.6]); high ACR-score (7.4, [2.7-23.3]), and detection of CHIKV-RNA in serum beyond 7 days of symptom onset (6.4, [1.4-34.1]. CONCLUSIONS: We identified 269 CHIKV patients after the first outbreak of Asian genotype CHIKV in Aruba in 2014-2015. RT-PCR yielded 59 (28%) additional CHIKV diagnoses compared to IgM antibody detection alone. Arthralgia, fever and skin rash were the dominant acute phase symptoms. pCHIK-CPA longer than 1 year affected 26% of cases and was predicted by female gender, high ACR-score and CHIKV-RNA detection beyond 7 days of symptom onset.


Assuntos
Artralgia/virologia , Febre de Chikungunya/complicações , Vírus Chikungunya/genética , Adolescente , Adulto , Anticorpos Antivirais/sangue , Artralgia/complicações , Artralgia/epidemiologia , Aruba , Febre de Chikungunya/epidemiologia , Doença Crônica , Estudos de Coortes , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Genótipo , Humanos , Imunoglobulina G/sangue , Articulações/patologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
2.
Am J Trop Med Hyg ; 94(6): 1380-4, 2016 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-27022152

RESUMO

The epidemiology of Guillain-Barré syndrome (GBS) in tropical areas is different compared with developed countries. We investigated the epidemiology of GBS on the Caribbean island of Aruba. Data were collected retrospectively from all 36 patients hospitalized with GBS between 2003 and 2011 in Aruba. We observed a seasonal distribution of GBS cases with a peak in February. The incidence rate (IR) fluctuated heavily between individual years. The overall IR was 3.93/100,000, which is higher than that observed in developed countries. Serological studies indicated a possible relation of GBS cases with dengue virus infections. We also observed a relation between the annual number of dengue cases in Aruba and the number of GBS cases in the same year. We conclude that the epidemiology of GBS in tropical areas can be different from temperate climate regions and that dengue may be a trigger for developing GBS.


Assuntos
Dengue/epidemiologia , Síndrome de Guillain-Barré/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Estudos Retrospectivos , Estações do Ano , Adulto Jovem
3.
Ernstia ; 24(1): 85-110, 2014. tab, graf
Artigo em Espanhol | LILACS, MOSAICO - Saúde integrativa | ID: biblio-877905

RESUMO

Se realizó el estudio de las plantas medicinales en la comunidad de Pelelojo, municipio Urdaneta, estado Aragua, con la finalidad de contribuir en el rescate del conocimiento tradicional sobre uso de tales plantas. Para esto, se realizaron encuestas semi-estructuradas a aproximadamente 20% de la población, incluyendo personas de distinto sexo y rangos de edad; además, se colectaron e identificaron las plantas mencionadas por los informantes. Para el análisis cuantitativo, se aplicaron los índices de Friedman, valor de uso y factor de consenso, y se hicieron análisis multivariantes a fin de reconocer patrones de distribución del conocimiento tradicional. Se señala la presencia de 82 especies de uso medicinal, pertenecientes a 74 géneros y 44 familias botánicas, siendo Fabaceae y Malvaceae las mejor representadas; la mayoría de las especies son herbáceas y de origen silvestre. Las partes aéreas de la planta son las más utilizadas en la elaboración de los tratamientos, y el modo de preparación más común es la decocción en agua. El índice de Friedman no fue mayor que 50% en ninguna de las especies mencionadas, lo que indica que el conocimiento tradicional en la comunidad posiblemente se está erosionando. Los valores de uso más altos los presentaron plantas cultivadas, debido probablemente a que son de fácil acceso para la mayoría de la población. Los grupos de enfermedades con un mayor número de plantas utilizadas en su tratamiento, son las infecciosas y gastrointestinales y el factor de consenso fue superior a 0,70 en todas las categorías de uso de plantas establecidas, lo que estaría reflejando un alto grado de acuerdo en la comunidad con respecto a la utilización de las plantas medicinales. No se observó correlación entre la edad y el sexo de los informantes y su conocimiento sobre el uso de las plantas medicinales.


Assuntos
Humanos , Masculino , Feminino , Etnobotânica , Fabaceae , Malvaceae , Plantas Medicinais , Grupos Populacionais , Coleta de Dados , Venezuela
4.
COPD ; 2(1): 17-25, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17136957

RESUMO

We have previously reported diminished immunohistochemical staining of decorin in lung tissue from patients with severe emphysema. The aim of this study is to investigate whether this diminished staining is due to a quantitative abnormal production of decorin by pulmonary fibroblasts in vitro. Therefore, we measured decorin (Western blot), collagen type I (ELISA), and fibronectin (ELISA) production by fibroblasts obtained from lung tissue of patients with severe and mild emphysema at basal culture conditions and after modulation with transforming growth factor-beta1, basic fibroblast growth factor, and interferon-gamma. Decorin production at basal culture conditions was significantly higher in fibroblast cultures from patients with severe emphysema compared to fibroblasts from mild emphysema. After stimulation with transforming growth factor-beta1 and basic fibroblast growth factor, decorin production was significantly more reduced in fibroblast cultures from patients with severe emphysema whereas collagen type I and fibronectin production were not affected. We conclude that decorin production by lung fibroblasts of patients with severe emphysema is dysregulated after modulation with cytokines known to be important in smoking associated inflammation. This dysregulation of decorin production may contribute to the impaired lung tissue repair, present in patients with emphysema, since these alterations in the extracellular matrix may cause diminished cytokine binding and neutralization.


Assuntos
Proteínas da Matriz Extracelular/biossíntese , Fibroblastos/metabolismo , Proteoglicanas/biossíntese , Enfisema Pulmonar/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Decorina , Feminino , Humanos , Pulmão/citologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
5.
Exp Lung Res ; 29(5): 291-302, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12746043

RESUMO

To characterize the possible role of a dysregulated proliferative capacity of pulmonary fibroblasts in insufficient tissue repair in lungs from patients with pulmonary emphysema, the authors undertook in vitro proliferative studies with pulmonary fibroblasts obtained from lung tissue of patients with emphysema. A comparison was made with fibroblasts from control subjects. The authors determined the in vitro proliferative capacity of fibroblasts at basal culture conditions and after modulation with interleukin-1beta, interferon-gamma, transforming growth factor-beta(1), and basic fibroblast growth factor. Proliferative capacity was determined by measurement of 5-bromo-2-deoxyuridine (BrdU) incorporation. BrdU incorporation by fibroblast cultures from both groups was very similar. Fibroblast cultures from control subjects, however, incorporated more BrdU after incubation with interleukin-1beta than cultures from patients with emphysema (P<.05). On the other hand, transforming growth factor-beta(1) decreased incorporation of BrdU stronger in fibroblast cultures from control subjects than from patients with emphysema (P<.05). Thus, the proliferative capacity of fibroblast cultures isolated from lung tissue of patients with pulmonary emphysema is different from that of control subjects. Although the difference is small, it may be an essential contribution to the development of pulmonary emphysema that only occurs after repeated smoke-induced injury over many years of an individual's life.


Assuntos
Enfisema/patologia , Fibroblastos/patologia , Pulmão/patologia , Adolescente , Adulto , Idoso , Bromodesoxiuridina/metabolismo , Divisão Celular , Células Cultivadas , Enfisema/metabolismo , Feminino , Fator 2 de Crescimento de Fibroblastos/farmacologia , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Humanos , Interferon gama/farmacologia , Interleucina-1/farmacologia , Pulmão/metabolismo , Masculino , Pessoa de Meia-Idade , Fator de Crescimento Transformador beta/farmacologia , Fator de Crescimento Transformador beta1
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