Mestrado em Medicina Tropical e Saúde Pública (IPTSP)
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Item Reconhecimento dos Antígenos Recombinantes MPT-51 e GlcB do Mycobacterium tuberculosis por Anticorpos Séricos de Indivíduos com Tuberculose Ativa(Universidade Federal de Goiás, 2007-02-23) ALMEIDA, Cristina de Melo Cardoso; KIPNIS, Ana Paula Junqueira; http://lattes.cnpq.br/1252262903952987Tuberculosis (TB) caused by the Mycobacterium tuberculosis is responsible for more than 2 million deaths annually in the world. Although one third of the world population carries the bacilli, only 5% of the infected people develop active disease. 80% of TB cases are concentrated among 21 countries and Brazil is one of them. Due to the flaws existent inherent to the TB diagnostic, many works try to discover TB antigens to be used on an ELISA assay to detect active TB in underdeveloped countries, endemic for other mycobacterias such as leprosy (L). Several researches are identifying bacilli proteins obtained under nutritional culture stress, in order to mimic the intracellular milieu. It has been selected the immunodominant ones as a disease marker. The objective of this work was to characterize the humoral immune response among TB patients to rMPT-51 and rGlcB using an ELISA indirect test. It was included voluntaries that were HIV negative and the ones without pregnancy, chronic disease or under immunosuppressant treatment. Serum IgM and IgG against MPT-51 and GlcB recombinant antigen from 49 patients with active tuberculosis were measured by indirect ELISA, paired by sex and age with: healthy PPD negative individuals (controls) and lepromatous leprosy patients (LL). Patients with TB (0.810±0.319) showed higher levels of IgM against rMPT-51 than both LL individuals (0.454±0.195) and control (0.448±0.162) with statistical significant, p= 0.001 and p<0.001) respectively. These test showed 96.9% specificity and 67.3% sensitivity. Conversely, tuberculosis, controls, and LL individuals showed lower of MPT-51 IgG levels, which could not be distinguished among the groups. rGlcB antigen was able to distinguished TB patients from controls for IgM levels (specificity, 95.9 % and sensitivity, 8.2% ) and IgG levels (specificity, 99% and sensitivity, 18.2%). In order to evaluate the profiles of IgM and IgG against rMPT-51 and rGlcB before and after chemotherapy, the sera from 11 patients was collected and paired according to the treatment status (before or after). IgM and IgG against MPT-51 remained with the same profile levels before and after the treatment. The levels of serum IgG against rGlcB clearly diminished after the chemotherapy (p<0.01). Our results suggest that serum IgM levels against recombinant MPT-51 could to be useful to distinguish between active TB, controls and LL individuals. In addition, after TB treatment the IgG response to rGlcB diminished suggesting that it could be used to follow up of the TB treatmentItem Análise das Bases Moleculares da Resistência à Isoniazida e Rifampicina em Cepas Obtidas de Pacientes com Tuberculose no Estado de Goiás(Universidade Federal de Goiás, 2010-03-11) ALVES, Sueli Lemes de ávila; KIPNIS, André; http://lattes.cnpq.br/4434965360286741Multidrug-resistant tuberculosis is a challenge worldwide. Rapid diagnosis by molecular techniques can provide a more aggressive and appropriate initial therapy. This study aimed to analyze the molecular basis of resistance to isoniazid (INH) and rifampin (R) of Mycobacterium tuberculosis strains isolated from cases of human tuberculosis in Goiás and to genetically determine the causes of the observed resistances. Of the 4.607 cultures for mycobacteria processed in the period of September of 2005 and December of 2007, 24 isolates from 16 patients resistant to at least H and/or R were analyzed. We compared the results obtained by phenotypic tests with mutations in key genes responsible for the development of resistance to these drugs, the rpoB gene for isolates resistant to R and katG gene for strains resistant to H. Seventy one percent of the isolates were resistant to H, and the mutations involved with resistance observed in the katG gene were in codon 315 (41%). The most frequent mutations observed in the rpoB gene of the R resistant isolates (71%) were in codons 456 (76.5%) and 451 (17.6%). Our findings are similar to those reported in the literature. We conclude that the percentage of agreement between genotypic and phenotypic tests was 41% for H and 94% for R considering the number of isolates and 40% and 91%, respectively considering the number of patients.Item Avaliação do processo de descontaminação de brocas odontológicas e seu impacto no controle de infecção(Universidade Federal de Goiás, 2006-03-31) ANDERS, Patrícia Staciarini; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; PIMENTA, Fabiana Cristina; http://lattes.cnpq.br/2230554075502158Objective: to describe the process of decontamination of burs to assess the microbial contamination of burs after-processing that were available to the use to isolate and to identify the possible microorganisms Methods: This study was conducted in 110 private dental offices of the central area of Goiânia-Goiás during the period of March/2004 to August/2005 using a check-list measure of dry heat sterilizer temperature and microbial burs tests The burs were seeded in brain heart infusion broth incubated at 37ºC for 20 days and subcultured on specific agar to isolate microorganisms The isolates were identified by micro/macroscopic characteristics subcultured on specific agar biochemical/enzymatic test and automation technique (MicroScan ®) Results:A total of 110 burs were evaluated and 35 (31.8%) were contaminated Fungi were detected in 13 (30.2%) burs [Aspergillus sp (27.9%) and Micelia (2.3%)]; Gram-positive cocci (staphylococci) represented 13 (30.2%) isolates [2.3% Staphylococcus aureus and 27.9% (12) coagulase negative staphylococci] nine (20.9%) isolates were Gram-positive bacilli and eight (18,6%) fastidioso microorganisms Considering the obtained results some factors detected could be interfered in the burs sterilization ineficiency: enzymatic detergent inadequate use abrasive products use inadequate dry heat sterilization time and temperature multiple use burs kits and interruption the asseptical chain after sterilization Conclusion: The frequency of contaminated burs was high (31.8%) and it was detected failures in operational steps of burs processing and/or after sterilizationItem Isolamento, identificação e suscetibilidade in vitro de fungos causadores de onicomicose(Universidade Federal de Goiás, 2010-02-24) ATAÍDES, Fábio Silvestre; SILVA, Maria do Rosário Rodrigues; http://lattes.cnpq.br/7119226630434725Onychomycosis is the nail infection caused by a wide spectrum of fungi species, including yeasts, dermatophyte and filamentous fungi nondermatophytes (FFND). In this work, patients with lesions nails from Dermatology Department in Clinics Hospital of the Federal University of Goiás were studied. These patients were submitted to mycologic tests and the etiologic agents identified were evaluated on in vitro activity for systemic antifungal agents. During the period of March 2008 to March 2009, 114 patients clinically suspected of having onychomycosis were examinated. The nail samples collected were submitted to direct examination with potassium hydroxide 20% and grown in dextrose Sabouraud agar and specific fungal pathogens agar. The antifungal susceptibility test was performed according to the method of broth microdilution, recommended by the Clinical Laboratory Standards Institute (CLSI), through M38-A and M27-A2 documents. The onychomycosis diagnosis was established in 83.3% (95/114) patients, of which most were women between 40 to 59 years old. The isolated fungi were identified as yeasts in 54.6%; dermatophytes in 28.7%; and filamentous fungi nondermatophytes in 16.7%. Among yeasts, Candida parapsilosis was the most common etiologic agent (52.5%); among dermatophytes, Trichophyton rubrum was the most found (74.2), and among the filamentous fungi nondermatophytes, Fusarium spp was the most isolated genus (44.4%). Both distal and lateral subungual lesions were predominant in cases of onychomycosis by all the agents identified, showing that there was no correlation with the clinical presentation and etiology. Although most of the isolates have showed susceptible to several antifungal agents studied, five Candida spp strains were resistant; one to voriconazole, one species to itraconazole and three to amphotericin B. The in vitro susceptibility testing profile for dermatophytes was similar for each antifungal agent analyzed. The minimal inhibitory concentration (MIC) of itraconazole, ketoconazole and griseofulvin for 50% of isolates were lower than 1 μg/mL, and terbinafine was extremely low, with concentration 0.015 μg/mL for 90% of isolates. The MIC for itraconazole in 90% isolates of FFND was 16 g/mL, while for amphotericin B and voriconazole was 8 g/mL. In summary, this study showed a higher frequency of onychomycosis in women. Candida spp and dermatophytes with FFND emergence, especially of the genus Fusarium, were the main fungi involved. Besides, the presence of resistant fungi to some antifungal agents showed the need of using susceptibility tests for these fungi.Item Resistência primária aos antirretrovirais e diversidade genética do HIV-1 em pacientes do estado do Tocantins.(Universidade Federal de Goiás, 2011-02-21) CARVALHO, Bruna Coelho; STEFANI, Mariane Martins de Araújo; http://lattes.cnpq.br/5581414958714905Regional differences in the molecular epidemiology of HIV-1 have been reported in Brazil, where there is scarce publication about the epidemic in north region. Despite the large number of antiretroviral drugs (ARV) belonging to nucleoside and non-nucleoside reverse transcriptase inhibitors (NRTI and NNRTI) and protease inhibitors (PI) classes, the selection of resistance-associated mutations may compromise the therapeutic efficacy. Primary resistance mutations, present prior to ARV use, occur mainly due to the transmission of resistant virus. This study describes the prevalence and profile of primary resistance mutations to ARV and the molecular epidemiology of HIV-1 in ARV naive patients from Tocantins State. For HIV-1 genotyping of the entire protease gene (PR) and 750 bp of reverse transcriptase (RT) gene, plasma RNA was extracted, reverse transcribed into cDNA) and used as the target for nested polymerase chain reaction (K1/K2 and F2/DP10 primers) and fragments were sequenced (kit DYEnamic ET Dye Terminator, GE Healthcare; ABI Prism 3130). The sequences were edited by the Staden Package software. Primary drug resistance was analyzed using the Calibrated Population Resistance (CPR) tool employing the Stanford Surveillance Drug Resistance Mutation (SDRM). The susceptibility profile of ARV mutations was analyzed by Stanford HIV Drug Resistance Database (hivdb.stanford.edu). HIV-1 genetic subtypes were identified by REGA HIV-1 and SIMPLOT softwares and by phylogenetic inference. Naïve patients (n=52) were recruited in LACEN/Palmas/TO between 2008-2010. The majority of investigated patients (59.6%) were males and 73.1% reported heterosexual exposure. Primary mutations that confer resistance to ARV were identified in 11.5% (06/52) of the isolates: BRTO08-43: M41L, L210W, T215D (NRTI); BRTO02-83: Y181C (NNRTI); BRTO13-83: D67G, K219E (NRTI); BRTO20-83: V108I, Y181C (NNRTI); BRTO02-66: M46L (PI); e BRTO13-66: V90I, K103N (NNRTI). Isolates with concordant subtypes in PR/RT regions represented 86.5% (45/52): subtype BPRBRT=78.8% (41/52), subtype CPRCRT=5.8% (3/52), subtype F1PRF1RT=1.9%. Isolates with discordant subtypes in PR and RT genes indicating intersubtype recombination represented 13.5% (07/52): BPRF1TR=1.9% (01/52); BPRBF1TR=7.7% (04/52) e CPRCF1TR=3.9% (02/52). Our study among naive patients from Tocantins State describes moderate prevalence of primary resistance to ARV, the predominance of subtype B that co-circulates with subtype C and a significant number of B/F1 and C/F1 recombinant forms. These results indicate the transmission of ARV resistant HIV-1 isolates among patients from a small inland city in north Brazil, where the epidemic is more recent. In this context, it is important to monitor the prevalence of primary drug resistance in order to assess the need and the cost-benefit of the implementation of pre-treatment genotipic tests aiming to optimize the choice of the ARV regimen among naive patients from Tocantins State.Item Atividade inseticida do extrato bruto etanólico de persea americana (lauraceae) sobre larvas e pupas de aedes aegypti (diptera, culicidae)(Universidade Federal de Goiás, 2011-02-25) CARVALHO, George Harrison Ferreira de; SILVA, Ionizete Garcia da; http://lattes.cnpq.br/5021551669347602In the search for new alternatives for control of Aedes aegypti, in view of its resistance to chemical insecticides in use, research on plant substances has been increasing, due to be degradable and less toxic to vertebrates. The aim of this study was to evaluate the insecticidal effect of crude ethanol extract (cee) of bark of Persea americana Mill, on larvae and pupae of Ae. aegypti in the laboratory and field. After obtaining this cee was dissolved in dimethyl sulfoxide (DMSO), thus obtaining the test solution. For each test, and repetition, in both laboratory and field were used 100 larvae of the 1st, 2nd, 3rd and 4th instars and 100 pupae too. The same amount of larvae and pupae was used for the groups positive and negative controls, performed respectively with temephos at 1 ppm and 1.6% of the DMSO. Both the laboratory bioassays and field were conducted with key artificial urban tire, glass and plastic. The results showed the insecticidal activity of the cee P. americana larvae and pupae of Ae. aegypti, both in laboratory and field. There was 100% mortality of the larvae of the 1st and 2nd instars in the laboratory at a dose of 5 ppm and field at a dose of 10 ppm. In the laboratory the LC50 and LC90 were respectively 7.2 and 19.3 ppm for 3rd instar, 6.6 and 15.4 ppm for 4th instar and 93.6 and 158.7 ppm for pupae. Following the same order, in the field, the LC50 and LC90 were 27.8 and 51.3 ppm plows the 3rd instar, 23.8 and 46.9 ppm for the 4th instar and 145.3 and 261.9 ppm for the pupae. The most important factor of this study was the effect pupicida of P. americana, because it is very rare to find this effect on other products, both natural and synthetic.Tests acute oral toxicity in rats were conducted to cee this plant that proved to be nontoxic according to norms (Acute Toxic Class Method - OECD 423) for products of plant origin.Item Análise bioquímica e equilíbrio ácido-base em Biomphalaria glabrata (Say, 1818), hospedeiro intermediário do Schistosoma mansoni (Sambon, 1907), sob a exposição ao Stryphnodendron polyphyllum (Martius, 1837), planta moluscicida do Cerrado brasileiro.(Universidade Federal de Goiás, 2006-03-31) FERREIRA, Cirlane Silva; BEZERRA, José Clecildo Barreto; http://lattes.cnpq.br/9491755585617846The state of Goiás represents a high risk to schistosomiasis stablishment area The presence of the intermediate host Biomphalaria sp added to high migration levels of people from endemic regions of the country are evidences that favour the installation of this disease life cycle In this state of Goiás there are reports of high parasitary intensity and even cases of paraplegia associated with schistosomiasis. The Stryphnodendron polyphyllum (Martius 1837) known locally as Barbatimão de folha pequena is reported as a molluscicide plant This paper assesses the activity of gross bark extracts from S polyphyllum on the metabolism and on the acid-alkaline balance of B glabrata The mollusks were exposed to the extract at 25 and 50 mg/L concentrations for 24 hours and compared to a control group The concentrations of glucose calcium urea proteins and the activity of the following enzymes dehydrogenases lactate and aminotransferases were estimated using the spectrophotometry method The organic acids citrate propionate α- cetoglutarate succinate acetate malate fumarate pyruvate and lactate were detected and quantified using the liquid chromatography method Of all the organic acids found in the hemolymph, only citrate and propionate presented a significant alteration The acid-alkaline balance was verified by measuring the concentrations found in the pH oxygen carbonic gas carbonate ions and oxygen saturation using Radiomiter equipment The S polyphyllum extract tested proved effective due to celular toxicity on B glabrata(Say 1818) Alterations verified in the biochemical dosages reflect the metabolic disturbances in the hemolymph of the mollusk The Cirlane Silva Ferreira x extract interference caused an increase in the levels of glucose urea calcium aspartate alanine aminotransferases and carbonic gas pressure simultaneously causing a decrease in the levels of lactate dehydrogenase pH oxygen pressure carbonate ions and oxygen saturation This study confirms the bioactivity of the S polyphyllum aqueous extract on B glabrata One of the main contributions of the methodology used is that it enabled observation after direct contact with the extract that proved bioactivity on the metabolism of the mollusk The analysis of the aqueous extract taken from the bark of the barbatimão may be the basis for new and less toxic as well as less costly alternative for the control of schistosomiasis in Brazil, where the savannah is vast and financial resources are often scarce in the health sectorItem Tétano acidental, um problema de saúde pública susceptível de controle(Universidade Federal de Goiás, 2001-12-14) FERREIRA, Denise Milioli; NETTO, Joaquim Caetano de Almeida; http://lattes.cnpq.br/3444498706763045Accidental tetanus is a millenary disease of high lethal indices, even when proven and effective, low cost prophylactics are available. Several studies have tried to identify the physiopathological process which releases the succession of clinical manifestations of the disease. The objective of these studies is to recognize and make available a new strategy for the treatment of tetanus after exposition to the toxin. The diagnosis of tetanus is eminently clinical. Several factors may occur during the evolution of the disease which complicate its prognosis. The most frequent complications are infections and autonomic dysfunction. Several therapeutic options exist. However, they have a supportive and symptomatic role. This study has as its objective to show the complexity which involves the physiopathological process and treatment of accidental tetanus as well as to emphasize that the only effective way of reducing tetanic mortality is, doubtless, a better vaccine coverage of susceptible individuals. NOTE: Essay with review articles. This is the sum of the first.Item Prevalência e fatores de riscos associados à infecção por Neisseria gonorrhoeae em adolescentes e jovens do sexo feminino em um município de médio porte do Estado de Goiás(Universidade Federal de Goiás, 2011-05-30) FONSECA, Zulmirene Cardoso; NETTO, Joaquim Caetano de Almeida; http://lattes.cnpq.br/3444498706763045BACKGROUND: Adolescents and youth are the group most vulnerable to sexually transmitted diseases (STDs), which are among the most prevalent infections in the world and represent a serious impact on reproductive health in this age group. OBJECTIVE: To estimate the prevalence and identify risk factors for infection by N. gonorrhoeae and co-positivity with C. trachomatis in sexually active adolescents and young adults living in a midsize city of Goias and describe the socio-demographic and behavioral profile of the population seen at the Family Health Program (PSF). METHODOLOGY: The study was designed as a prevalence study in 651 adolescents and young adults, not pregnant, 15 to 24 years were enrolled in the Family Health Program (FHP) in Inhumas, Goiás were excluded pregnant or postpartum teens in antibiotics or menstruating. The diagnosis of gonococcal infection and infection by C. trachomatis was performed using the Polymerase Chain Reaction (PCR) in endocervical specimens using the Roche Amplicor kit for N. gonorrhoeae and C. trachomatis. The socio-demographic and sexual behavior were obtained through a questionnaire as an interview. Univariate analysis was performed to identify potential risk factors associated with infection. Endocervical swab samples were collected from 322 sexually active patients to dtect the DNA of N. gonorrhoeae and C. trachomatis. RESULTS: The mean age of 428 sexually active adolescents and young adults was 18.6 (SD = 2.7), with 64.3% single. Inconsistent use of condoms was observed in 78.0% of girls and 11.9% never used it. The first sexual intercourse occurred before the age of fifteen in 23.4%. Pregnancy before age 20 occurred in 90% and 23.5% of them before age 15. The prevalence of N. gonorrhoeae was 3.4% (95% CI 1.8 to 6.2) in 322 patients from whom samples were collected endocervical swab. Co-infection with chlamydia was 27.3%. Univariate analysis showed that the risk factor associated with infection by N.gonorrhoeae was not using condoms. CONCLUSIONS: Young women and adolescents in this study exhibited various behaviors considered at risk for STDs and those who reported not using condoms had a higher risk of being infected by the gonococcus. WORDS - KEY: Neisseria gonorrhoeae; Adolescents Prevalence; STD; PCR.Item Aspectos psicopatológicos na hanseníase e nas reações hansênicas(Universidade Federal de Goiás, 2006-03-31) JUNQUEIRA, Alessandra Vidal e; NETTO, Joaquim Caetano de Almeida; http://lattes.cnpq.br/3444498706763045; CAIXETA, Leonardo Ferreira; http://lattes.cnpq.br/9536747113677509Hansen s disease (leprosy) is an endemic infectious disease in underdeveloped countries Disease s burden and reaction episodes can lead to anxious and depressive symptoms relatively frequent although poorly explored in leprosy To 90 patients presenting leprosy and 30 without the disease, but under the same environmental stress conditions in Goiânia-GO Brazil were applied the Hamilton Depression Rating Scale (HAM-D) Patients with leprosy were distributed in three groups of 30: group 1 without reactions; group 2: outpatients with reactions; group 3: inpatients with reactions The group 4 was composed by individuals without the disease Higher scores were found in leprosy patients than in the group without the disease with statistically significant differences specially between groups 3 and 4 Leprosy patients without reactions had lower scores (60%) Depressive symptoms were more common in reactions 83.3% in outpatients and 96.7% in medical inpatients The most symptoms found were anxiety depression lack of labor capacity and insomnia We concluded that anxious and depressive symptoms were more frequent in leprosy patients mainly in those with severe reactionsItem Fenotipagem de bactérias isoladas em hemoculturas de pacientes admitidos na unidade clínica de terapia intensiva de um hospital escola(Universidade Federal de Goiás, 2006-03-31) LEÃO, Lara Stefânia Netto de Oliveira; PIMENTA, Fabiana Cristina; http://lattes.cnpq.br/2230554075502158Introduction: In hospitals the bloodstream infections represent a serious complication in critical patients The detection of bacteria in blood cultures is considered an important diagnosis instrument This study aimed to detect and characterize bacteria from blood of clinical intensive care unit admitted patients of a teaching hospital in Goiânia-Goiás in the period of April/2003 to April/2004 Methods: The blood samples were seeded in brean heart infusion broth (Bacto - BD Diagnostic Systems/ USA) incubated until 7 days at 37oC and subcultived on chocolate agar to isolated microorganisms The isolated bacteria were identified by biochemical / enzymatic test and automation technique The identification and antimicrobial susceptibility profile were performed by MicroScan ® system. Results: A total of 304 blood cultures of 195 patients were evaluated Forty-nine (16.1%) bloods cultures were positive The Gram-positive cocci represented 47.7% of isolated and Gram-negative rods 50.0% One (2.3%) coryneform bacilli were isolated The most prevalent specie was Pseudomonas stutzeri (18.2%) The Gram-positive cocci and enterobacterias showed higher resistance rate against ampicillin; 66.7% of staphylococci were oxacillin resistant and 77.8% of pseudomonas were resistant aztreonam Vancomycin and linezolid were the most active agents for Gram-positive cocci and the carbapenems for Gram-negative rods Conclusion: The frequency of positive blood cultures was 16.1% with a similar distribution of Gram-positive and Gram-negative bacteria that showed high resistance rate against antimicrobial agents Due to the impact of bloodstream infection in the hospital context others studies are necessary to support measure of prevention and controlItem Ocorrência da infecção por Trichomonas vaginalis em mulheres HIV positivas e negativas atendidas em hospitais de referência em Goiânia, Goiás, Brasil.(Universidade Federal de Goiás, 2008-12-17) LEMOS, Patrícia Abreu Pinheiro de; GARCÍA-ZAPATA, Marco Túlio Antonio; http://lattes.cnpq.br/3672512339058369This study evaluated the frequency of Trichomonas vaginalis infection in human immunodeficiency virus positive (HIV+) and negative (HIV-) women in Goiania, Goiás, Brazil, comparing the presence of the parasite in the two groups and correlating it with the conditions of immunodeficiency present in these women. The diagnostic techniques used, wet mount microscopy, culture and cytology, were also evaluated, and the principal inflammatory alterations in the two groups were assessed. The HIV+ samples (test group) were collected at the Hospital of Tropical Diseases and in the Maternal and Child Healthcare Hospital, whereas the HIVnegative samples (control group) were collected at the Maternity Hospital. Swabs were used for wet mount microscopy (saline solution) and for culture (Diamond s medium), and Ayre s spatula and brush were used for the cytology smears, which were fixed using a commercial fixative. A total of 237 samples were analyzed, 125 HIV-positive test samples and 112 HIV-negative controls. The overall frequency of T. vaginalis was 13.9%, 18.4% in the HIV+ and 8.9% in the HIV- group. This difference was statistically significant (p<0.05); however, the infection was not associated with immunodeficiency according to CD4, viral count and lymphocytes. There was a significant difference in the prevalence of the parasite between HIV+ and HIVpregnant women (22.6% versus 12.5%). Culture identified a frequency of T. vaginalis of 13.9%, while cytology identified a rate of 13.5% and wet mount microscopy 11.4%. Perinuclear halos were the most frequent inflammatory alteration; however, there was no difference between the groupsItem Prevalência de bastonetes gram-negativos isolados da nasofaringe de crianças de creches do município de Goiânia(Universidade Federal de Goiás, 2007-10-11) LIMA, Ana Beatriz Mori; PIMENTA, Fabiana Cristina; http://lattes.cnpq.br/2230554075502158Introduction: the nasopharynx (NP) constitutes the primary ecological reservoir or source of dissemination of microorganisms as Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus and Gram-negative bacilli (GNB). Several studies demonstrated that asymptomatic nasopharyngeal (NP) carriage of pathogens is prevalent in young infants and precedes the development of invasive disease. Children in day-care centers act as an important vector for horizontal spread of the respiratory pathogens and GNB within the community. The infants are susceptible to condition of carrier and take a fundamental role in the epidemiology of respiratory infections. The nasopharyngeal flora becomes established during the first year of life and is densely colonized by a broad variety of microorganisms, commensal bacteria as well as potential pathogens that may cause infections. Epidemiologic studies demonstrate that many factors influence nasopharyngeal carriage rates: age, gender, season, acute respiratory illness, exposure to other children, socio-economic status, family size, warm-climate countries, passive smoking exposure, antibiotic therapy are risk factors of colonization of the NP by BGN. Objective: this study aimed to determinate the prevalence and susceptibility pattern of BGN isolated from NP of children less than five years old attending day-care centers at municipality of Goiânia. Methods: the investigation was conducted in the municipality of Goiânia as part of an ongoing prospective surveillance of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus in children of 62 day-care centers. The surveillance was carried out from August to December, 2005 and was collected 1192 samples. The nasopharyngeal specimens were collected with a transwab, extrathin and flexible, placed in Stuart transport medium tubes and transported to the Laboratory of Bacteriology of the Federal University of Goias-Institute of Tropical Pathology and Public Health to processing. The isolates were identified by colony morphology, Gram staining technique and according to standardized tests. Susceptibility tests were performed by the disk diffusion method. Results: a total of 106 (8,9%) Gram-negative bacilli were isolated and 13 species were identified. The species more prevalent were twenty-six (24,5%) Enterobacter aerogenes, seventeen (16,0%) K. pneumoniae, eleven (10,4%) E. coli, eight (7,5%) E. agglomerans and five (4,7%) Pseudomonas sp. It was observed that forty-three (57,3%) GNB were resistant to ampicillin; twenty (26,7%) to trimethoprim-sulfametoxazole; eighteen (24,0%) showed resistance to amoxicillin-clavulanic acid and nine (12,0%) presented resistance to tetracycline. The production of extended-spectrum beta-lactamase was not detected. Conclusion: in this study was demonstrated that young children attending in daycare centers at municipality of Goiania might be GNB carrier and therefore have a fundamental role in the dissemination of microorganisms involved in community-acquired infections. It is necessary that more studies be developed to establish strategies more effectives to minimize the problem of the nasopharyngeal colonization and communityacquired infections due to importance and seriousness that both represent in the public health.Item Reação imunoenzimática (ELISA) para detecção de imunoglobulina M, imunoglobulina G e imunoglobulina A contra a proteína rHsp-X (Rv 2031c)de Mycobacterium tuberculosis em pacientes com tuberculose pleural(Universidade Federal de Goiás, 2009-12-18) LIMONGI, Loanda Carvalho Sant'ana; KIPNIS, Ana Paula Junqueira; http://lattes.cnpq.br/1252262903952987Pleural tuberculosis (TBP) has often spontaneous resolution, even without treatment. However, the lack of proper diagnosis and treatment can lead to the occurrence of pulmonary and/or extra-pulmonary tuberculosis in 65% of the cases, in the five years subsequent. The objective of this study was to evaluate the effectiveness of the recombinant Hsp-X antigen (rHsp-X) in an enzyme immunoassay for determining the presence of TBP in patients with pleural effusion. For this study we used 132 samples of serum and pleural fluid (PF) from patients with pleural effusion. Of these, 97 samples were from TBP patients and 35 patients with diseases other than tuberculosis (NTBP) (28 patients with metastatic cancer, 1 patient with congestive heart failure, 2 patients whit liver failure, 1 patient with systemic lupus erythematosus and 3 patients with parapneumonic effusion). The IgM levels of PF were higher in patients with PTB than NTBP, the sensitivity and specificity of the ELISA for the PF was 42% and 83%, respectively. Testing for IgG from the serum and the PF against the recombinant antigen Hsp-X were not effective in discriminating TB patients from other diseases, the sensitivity was found to be 13% and 16% using serum and LP, respectively, with the same specificity of 83%. TBP patients presented higher levels of IgA specific for the rHSP-X than NTBP, the IgA ELISA using PF presented better sensitivity (65%) than using serum (39%), while the IgA ELISA for both types of samples presented the same specificity (83%). In conclusion, the recognition of Mycobacterium tuberculosis rHsp-X by IgA antibodies from the PF of patients with TBP reveals its possible role in the development of a diagnostic test for additional cases of TBP. Further studies must be conducted to confirm this hypothesis.Item Ação leishmanicida de extratos de plantas no desenvolvimento de promastigotas de Leishmania amazonensis e estudo do perfil metabólico utilizando a técnica de cromatografia líquida de alta eficiência (CLAE).(Universidade Federal de Goiás, 2006-03-31) MENDES, Josireny Mariano; BEZERRA, José Clecildo Barreto; http://lattes.cnpq.br/9491755585617846Two million new cases of Leishmaniose occur annually in the tropical and subtropical areas of the globe, with a estimate of twelve million people currently infected in world and three hundred and fifty million under infection risk. The Leishmania sort, responsible for the disease, understands many diverse and complex species that present resistance to the drugs used in its treatment, beyond the characteristics undesirable. The effectiveness of the control and treatment of a parasitic disease depends on the detailed knowledge of the cycle of life, metabolism and biology in general of the parasite. The World Health Organization, associated with other agencies of research has stimulated the extract inquiry new of native plants as alternative for the treatment and combat of the parasitic disease In this work one standardized techniques of studies biochemists through liquid chromatography high performace (HPLC) evaluating organic acid excretion and consumption of in promastigotes of Leishmania amazonensis and became fullfilled biotests with Magonia pubescens (tingui) and Glycyrrhisa glabra (alcaçuz) in the concentrations of 25 50 and 100 mg.L-1 The acid had been detected following: lactate oxalate citrate -Ketoglutarate succinate fumarate malate and propionate demonstrated activities in the glycolytic pathway cycle of Krebs and respiratory chain Both the tested extracts had presented leishmanicid action with better effect for Glycyrrisa glabra 100 mg.L-1 and Magonia pubescens 25 mg.L-1 The Glycyrrisa glabra had better action in the stationary phase of growth to opposes it of Magonia pubescens that better acted in the logaritmic phase Chemical components of plants can act directly or indirectly in the metabolism of the parasite affecting essential metabolic pathwaysItem Prevalência da infecção e caracterização molecular no vírus linfotrópico de células T humanas 1 (HTLV-1) em remanescentes de quilombos no Brasil Central(Universidade Federal de Goiás, 2009-02-27) NASCIMENTO, Laura Branquinho do; CARNEIRO, Megmar Aparecida dos Santos; http://lattes.cnpq.br/8398563469665169; MARTINS, Regina Maria Bringel; http://lattes.cnpq.br/2582896795892370Human T-lymphotropic virus 1 (HTLV-1) has infected human beings for thousands of years, but knowledge about the infection is only recently emerging. The virus can be transmitted from mother to child, through sexual contact, and contaminated blood products. There are endemic areas for this infection in sub-Saharan Africa and South America. African individuals were introduced in Brazil by slave trade. Some of them escaped to remote valleys and stayed in communities, called quilombos. Nowadays, their history and tradition allows them to be identified as remnants of quilombos. The epidemiological status of HTLV infection of these communities remains unknown. The aim of this study was to investigate the epidemiological and molecular profile of HTLV infection among remnant communities in Central Brazil. This study included 1,837 individuals from 13 quilombo remnant communities in the States of Goiás and Mato Grosso do Sul. They were interviewed about demographic and risk characteristics known to be associated with HTLV transmission. Blood samples were collected from all individuals and screened by ELISA for the presence of antibodies to HTLV 1/2. Positive samples were tested for confirmation by western blot and/or PCR. Also, they were submitted to sequencing and phylogenetic analyses. Of the 1,837 individuals, nine were found to be positive by ELISA. All of them were confirmed as being positive for HTLV-1, resulting in an anti-HTLV prevalence of 0.5% (CI 95%: 0.2-1.0). The HTLV-1 infected individuals ranged in age from 11 to 82 years. Seven were females and two were male. Regarding risk characteristics, history of breastfeeding (9/9), blood transfusion (2/9), multiple sexual partners (2/9) and history of sexually transmitted diseases (1/9) were reported by the infected individuals. The virus isolates were classified as Transcontinental subgroup of the HTLV-1 Cosmopolitan subtype. The association of phylogenetic analysis and epidemiological data suggests the intrafamilial transmission of the HTLV-1 among three generations of one family in Boa Sorte Mato Grosso do Sul community. These findings show a low endemicity for HTLV-1 infection and the circulation of the Transcontinental subgroup of the HTLV-1 Cosmopolitan subtype in quilombo remnant communities in Central Brazil.Item Meningites Bacterianas Agudas em crianças e adolescentes: Fatores de risco para óbito ou seqüelas precoces(Universidade Federal de Goiás, 2005-11-26) NEVES, Jane Marcia Brito das; NETTO, Joaquim Caetano de Almeida; http://lattes.cnpq.br/3444498706763045Objetive: To identify possible risk factors associate with poor prognosis among children and teenagers with acute bacterial meningitis Methods: Prevalence study with casecontrol analysis by review of medical records of patients aged 1 month to 19 years admitted to Tropical Disease Hospital in Goiânia Goiás with acute bacterial meningitis from 1 january 1998 to 31 december 2001 Patients who died or had one or more neurological sequelae at discharge were cosidered cases and patients with the same diagnosis but discharged with healthy recoveries as controls Risk factors for adverse outcome such as age sex proceeding area period between onset of symptoms and hospital admission history of antibiotic use etiologic agent meningeous signs level of consciousness convulsion circulatory and respiratory distress and laboratory values including peripheral white blood cels counts cerebrospinal fluid (CSF) protein level CSF glucose level and CSF white blood cels count were analysed Univariate analysis and logistics regression was used to evaluate the association between death or neurologic sequelae (depedents variables) and each risk factors (independent variable) Results: Of the 409 children and 117 teenagers admitted during the period of study 430 discharged with healthy recoveries 43 (8,2%) died and 53 (10,1%) had at least one sequelae at discharge (motor deficit, seizure hydrocephalus hearing impairment, cranial nerve deficits cerebral palsy and ataxia) Age < 24 months circulatory and respiratory distress torpor or coma seizure absence of meningeous signs proceeding area and peripheral white blood cels count < 5000/ mm³ were associated with poor prognosis However, age <24 months respiratory distress and torpor or coma were independently associated with adverse outcome Conclusion: Age < 24 months respiratory distress and torpor or coma were the main risk factors independently associated with poor prognosis Early identification of the all risk factors is very important to select the patients who need special care during of stay in hospital and after discharge at least until school ageItem DISTRIBUIÇÃO GEOGRÁFICA E INDICADORES ENTOMOLÓGICOS DE TRIATOMÍNEOS SINANTRÓPICOS, CAPTURADOS NO ESTADO DE GOIÁS, BRASIL.(Universidade Federal de Goiás, 2006-03-31) OLIVEIRA, Antonio Wilson Soares de; SILVA, Ionizete Garcia da; http://lattes.cnpq.br/5021551669347602The Chagas disease occurs from the United States to Patagonia, affecting about 16 million peopleThis disease was always associated with poverty conditions which are represented by the primitive houses made out of wood and mud The incidence of this infection in Brazil was estimated at a hundred thousand annual new cases in the end of the seventies and has a prevalence of 4,2% in the rural population The highest rates were found in Minas Gerais and Rio Grande do Sul with the seroprevalence of 8,8% following by Goiás (7,4%) and Bahia (5,4%) In Goiás within 2000 and 2003 249.868 home units were investigated and 51.570 triatomíneos were captured with 335 specimens infected by T. cruzi The peridomiciliar infestation was significantly bigger than the intradomiciliar by the species Triatoma sordida following by Panstrongylus megistus The inverse was observed with the species Rhodnius neglectus Panstrongylus geniculatus and Triatoma pseudomaculata (p <0,018) There was not significant difference in the infestations intra and peridomiciliar by the species Panstrongylus diasi Triatoma costalimai and Triatoma williami Only one specimen of Triatoma infestans was captured in the year 2000Item CARACTERIZAÇÃO DA SUSCEPTIBILIDADE DE CAMUNDONGOS ISOGÊNICOS (MUS MUSCULUS) C57BL/6 E B10.A À INFECÇÃO POR Lagochilascaris minor E SUA ATUAÇÃO COMO HOSPEDEIRO DEFINITIVO NA INFECÇÃO EXPERIMENTAL.(Universidade Federal de Goiás, 2006-03-31) PADUA, Alessandra Gonçalves de; KIPNIS, Ana Paula Junqueira; http://lattes.cnpq.br/1252262903952987; CARVALHAES, Mara Silvia; http://lattes.cnpq.br/2411156777003181Item Georreferenciamento e genotipagem de Mycobacterium tuberculosis isolados de pacientes atendidos na cidade de Goiânia GO pelo método de MIRU-VNTR(Universidade Federal de Goiás, 2012-03-07) PEREIRA, Alyne Melo; KIPNIS, Ana Paula Junqueira; http://lattes.cnpq.br/1252262903952987; KIPNIS, André; http://lattes.cnpq.br/4434965360286741Tuberculosis (TB) is a chronic infectious bacterial disease, very contagious, that, despite almost 130 years of biomedical research since the discovery of the tubercle bacillus, it continues to be a major threat to global health and is one of the leading causes of death by a bacterial organism, particularly in the developing world. The etiologic agent, Mycobacterium tuberculosis, is a bacterium that is easily transmitted by air. The disease control depends on several factors, being the correct diagnosis; efficient treatment; and active disease patient management to avoid transmission, essential ones. In order to improve the success in diagnosis, the knowledge of genotypic profiles by molecular techniques has provided positive results. Additionally, the correlation between the geographical locations of TB cases is a useful tool to aid epidemiological control strategies, especially when it is performed together with the knowledge of genetic variability of the studied TB strains. In this study we used the 15 loci MIRU-VNTR technique to identify polymorphisms among Mycobacterium tuberculosis isolates. A total of 119 M. tuberculosis samples, isolated between 2006 and 2007 from patients attending two reference hospitals of Goiânia city, were genotyped and the results compared with the gold standard RFLP-IS6110 technique. The 15 loci MIRU-VNTR analysis of 119 TB isolates provided 110 distinct genotypes, 105 of which contained only one isolate while 14 isolates were grouped in five genetic groups (clusters). This technique showed a good discriminatory power (0.9986). The 15 loci MIRU-VNTR technique was more discriminatory than RFLP-IS6110 (0.9942). We also performed the georeferencing of 241 TB cases, corresponding to all clinical forms reported in Goiânia during the year 2007 by the City´s Secretary of Health Department. The cases were randomly distributed throughout the city. The distribution of cases showed that, visually, there was no relationship between disease and socio-economic situation of the population. Among the georeferenced cases, we were able to genotype 50 isolates by 15 loci MIRU-VNTR. A great genetic variability of genotypes among the 50 isolates was observed, and the few ones that were clustered did not show epidemiological links. Based on the observed data, no transmission source the TB was identified in the city of Goiânia, and consequently we can infer that TB in the City of Goiânia could be resulted from a previously acquired infection due to the high degree of heterogeneous genetic profiles observed.