Epidemiological and clinical profile of patients with Chagas disease in the Central-North area of Paraná, Southern Brazil

Abstract INTRODUCTION Profiles of patients with Chagas disease in Paraná were studied. METHODS A descriptive, questionnaire-based study was performed. RESULTS Of 270 participants, 64% were female, 60% were aged ≥65 years, 91% were infected via vector transmission, and 44% were infected in Paraná. Indeterminate (30%), cardiac (36%), cardiodigestive (20%) and digestive (14%) forms were found. CONCLUSIONS: Patients who were older than 65 years of age, retired, female, living in the urban area of Maringá, and infected by vector transmission in childhood in Paraná presented cardiac and digestive signs and did not receive etiological treatment when first diagnosed.

Accidental infection by Trypanosoma cruzi follow-up by the polymerase chain reaction: case report / Infecção acidental pelo Trypanosoma cruzi acompanhada pela reação em cadeia da polimerase: relato de caso

We report a case of accidental infection by Trypanosoma cruzi in a 42-year-old female patient who presented an inoculation chagoma. Laboratory confirmation was based on examination of fresh blood, Giemsa-stained blood smear, immunoenzyme test (EIA-IgG), indirect immunofluorescence (IIF-IgM, IgG) and polymerase chain reaction (PCR). Only the PCR gave a positive result, and the EIA test was inconclusive. Two treatments with benznidazole were necessary. PCR was the only technique that continued to give positive results for approximately two months (65 days, or 2.2 months) following the second treatment and negative results from 96 days (3.2 months) to 850 days (28.3 months). We concluded that the presence of an inoculation chagoma and use of PCR were important and decisive for diagnosis and follow-up of the case.

Reportamos caso de infecção acidental pelo Trypanosoma cruzi em paciente do gênero feminino, 42 anos, que apresentou chagoma de inoculação. A confirmação laboratorial foi realizada pelo exame de sangue a fresco, esfregaço corado com Giemsa, imunoenzimaensaio (ELISA-IgG), imunofluorescência indireta (IFI-IgM, IgG) e reação em cadeia da polimerase (PCR). Somente a PCR foi positiva e a ELISA foi inconclusiva. Dois tratamentos com benznidazol foram necessários. PCR foi a única técnica que permaneceu positiva por aproximadamente dois meses (65 dias ou 2,2 meses) após o segundo tratamento e negativa de 96 dias (3,2 meses) a 850 dias (28,3 meses). Concluimos que a presença do chagoma de inoculação e o uso da PCR foram importantes e decisivos para o diagnóstico e o acompanhamento do caso.

Exploração de fatores de risco para câncer de mama em mulheres de etnia Kaingáng, Terra Indígena Faxinal, Paraná, Brasil, 2008 / Exploring breast cancer risk factors in Kaingáng women in the Faxinal Indigenous Territory, Paraná State, Brazil, 2008

O objetivo do presente estudo foi analisar a saúde das mulheres Kaingáng da Terra Indígena Faxinal, Paraná, Brasil, quanto aos fatores de risco para o câncer de mama. O estudo, de caráter descritivo-exploratório, foi realizado com 95,4 por cento da população feminina com vinte anos ou mais. O aleitamento materno por mais de 1 ano foi relatado por 92,3 por cento das mulheres; 41,4 por cento tinham mais de cinco filhos; a idade média da menarca foi 13,4 anos; 61,5 por cento nunca tinham ouvido falar do câncer de mama; o auto-exame da mama era realizado por apenas 2,9 por cento das mulheres; o médico não realizava o exame clínico da mama, segundo 81,7 por cento delas, e 99 por cento nunca fizeram mamografia. Não foi relatado caso de câncer de mama ou extramamário. Destacaram-se a presença dos fatores de proteção para a carcinogênese e a ausência de alguns fatores de risco, como o uso de terapia de reposição hormonal por mais de cinco anos e etilismo, na maioria das mulheres Kaingáng.

This study analyzes the health of Kaingáng women in the Faxinal indigenous territory in Paraná State, Brazil, with regard to risk factors for breast cancer. A descriptive and exploratory investigation was undertaken that included 95.4 percent of females 20 years or over. Data showed that 92.3 percent of Kaingáng women reported breastfeeding for more than one year; 41.4 percent had more than 5 children; mean age at menarche was 13.4 years; 61.5 percent had never heard of breast cancer; breast self-examination was only performed by 2.9 percent; 81.7 percent reported no clinical breast examination by a physician; 99 percent had never had a mammogram. No cases of breast or non-breast cancer were reported. The study highlights protective factors against carcinogenesis and the absence of key risk factors like hormone replacement therapy for more than five years and alcohol consumption in most Kaingáng women.