Mestrado em Medicina Tropical e Saúde Pública (IPTSP)

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    Desigualdades na epidemiologia do câncer colorretal no Brasil
    (Universidade Federal de Goiás, 2023-06-07) Schaedler, Anelise Camila; Oliveira, Max Moura de;; Oliveira, Max Moura de; Malta, Deborah Carvalho; Iser, Betine Pinto Mochlecke
    Colorectal cancer (CRC) is among the most common cancers worldwide, affecting over 1,931,590 people annually. Social determinants of health related to the incidence and mortality of colorectal cancer have been analyzed, revealing higher incidence rates in socioeconomically favorable regions, while mortality rates are higher in low- and middle-income regions. Objective: To analyze the incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALY) of colorectal cancer in Brazil and its Federative Units, correlating them with socioeconomic indicators.Methodology: This is an ecological study, with a time series analysis of incidence, mortality, DALY, and prevalence rates of CRC in individuals aged 30 years and older. The corrected and estimated data from the Global Burden of Diseases Study 19 (GBD19) for Brazil, by Federative Unit (FU) and sex, from 1990 to 2019, were used. Agestandardized rates were calculated using the GBD19 standard population. Indicator trends were estimated using the average annual percent change and 95% confidence interval (95% CI) by joinpoint regression. Pearson's correlation was used to correlate the indicators with the Human Development Index, using the Socio-Demographic Index (SDI) obtained from GBD19. Results: The analysis of age-standardized rates per 100,000 inhabitants showed an increase in all states, regardless of sex, from 1990 to 2019, with the following changes: incidence from 23.8 (1990) to 35.48 (2019), prevalence from 167.7 (1990) to 319.98 (2019), mortality from 41.74 (1990) to 49.14 (2019), and DALY from 934.4 (1990) to 1,109.35 (2019). The highest incidence and prevalence trends were observed in the North and Northeast macroregions and among males. Mortality and DALY trends showed predominantly higher rates among men in all Federative Units (except the Federal District) and remained stable among women. Correlation analysis between SDI and CRC showed a positive association with incidence and a negative association with mortality and Disability-Adjusted Life Years. Conclusion: The incidence, prevalence, mortality, and DALY rates of colorectal cancer were found to be high throughout the country, which can be explained by Brazil being a developing nation with increasing urbanization and greater access to risk factors. Rates are predominantly higher in more developed Federative Units where Westernized diets are already prevalent in the food routines of these groups. The high incidence trends in less favored regions may be due to the urbanization process, which is making previously absent risk factors more accessible over the years. Another reason could be the amplification of healthcare assistance in these regions, resulting in an increase in the reporting of new cases. The elevated mortality and DALY trends in socioeconomically disadvantaged regions may be related to the lack of public policies for prevention, screening, and treatment in these specific populations. Based on these findings, this study reinforces the importance of creating and implementing public health policies targeting highrisk groups for prevention and screening. Relevance and Impact: Colorectal cancer is a current public health issue worldwide. This study contributes to the epidemiological update of this cancer in Brazil, highlighting its relevance within the Brazilian context. The findings can contribute to prioritizing public health policies aimed at cancer prevention and control.
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    Estudo da interação plasmodium-hospedeiro via meta-análise de dados públicos de sequenciamento duplo de RNA
    (Universidade Federal de Goiás, 2023-06-29) Silva, Bárbara Fernandes da; Gardinassi, Luiz Gustavo Araújo;; Gardinassi, Luiz Gustavo Araújo; Matteucci, Kely Catarine; Fonseca, Simone Gonçalves da
    Malaria is a potentially fatal disease caused by Plasmodium parasites transmitted by Anopheles mosquitoes. Infection causes an intense inflammatory response, but the molecular mechanisms of interaction between host and parasite remain largely unknown. Although many studies have been dedicated to understanding the host immune response using RNA sequencing of whole blood from malaria patients, technological advances have enabled an integrative evaluation of both host and parasite transcriptomes. The accumulation of different datasets in public repositories provides an opportunity to uncover the interaction between host and Plasmodium via integrative data analysis. Methods. We evaluated whole blood RNA-seq data from 8 different datasets of individuals with malaria caused by infection with Plasmodium falciparum (Pf). The transcriptomes from humans were transformed to Blood Transcriptional Modules (BTM). Spearman´s correlation method was used to evaluated associations between BTMs and Pf genes. PlasmoDB platform was used to evaluate Pf genes. Results Initially, we selected correlations (p < 0.001) conserved in 60% of the datasets to generate a hostparasite transcriptional network composed, for exemplo, of BTMs related to the activation and response of dendritic cells and myeloid cells, besides of leukocyte differentiation and NK cells. Later, we selected correlations conserved in 75% of the datasets, which revealed a host-parasite transcriptional sub network, in which BTMs are related to monocytes, activation of innate immunity, as well as regulation of inflammation. Moreover, the comparison between the activity of BTMs included in this sub network between individuals with malaria and healthy controls demonstrated the downregulation of genes involved with SMAD2/3 signaling and transcriptional targets of glucocorticoid receptor, while the other BTMs were upregulated, including modules related to monocytes and signaling by TLR, RIG-I and cytosolic DNA sensors. Conclusion. In conclusion, our study identified diverse associations between genes of P. falciparum and gene modules reflecting cells and processes of the human immune response that can be prioritized in experimental assays.
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    Análise das interações proteína-proteína da chaperona de cobre ATX1 em Paracoccidioides brasiliensis
    (Universidade Federal de Goiás, 2022-08-12) Lugo, Danize Eukales Menezes; Silva, Kleber Santiago Freitas e;; Soares, Celia Maria de Almeida;; Soares, Celia Maria de Almeida; Pereira, Maristela; Bailão, Alexandre Melo
    Paracoccidioidomycosis is the most prevalent systemic mycosis in the Americas, mainly in Brazil, Colombia, Venezuela and Argentina. The disease is caused by fungi of the genus Paracoccidiodes that exhibit thermodimorphism. The fungus is present in the soil in the mycelial form at 28°C and in the yeast form in the host at 37°C. The ability to differentiate is considered a virulence factor of this pathogen. Copper (Cu) is an essential component of enzymes that carry out electron transfer reactions. Homeostasis of this metal was first described in Saccharomyces cerevisiae and homologous genes were identified in several organisms. Among these, the ATX1 gene, related to a copper metallochaperone, stands out, which transports Cu1+ from Ctr1 (transmembrane transporter) to Ccc2 (P-type ATPase) in a trans-Golgi vesicle for eventual insertion into Fet3. The latter is a highaffinity Cu-dependent iron absorption protein. Atx1 was identified in S. cerevisiae as a small 8 kDa Cu chaperone, being classified as an antioxidant molecule. Little is known about Cu homeostasis metabolism and the specific function of the ATX1 gene in Paracoccidioides brasiliensis. Thus, the identification of Atx1 interaction networks in P. brasiliensis can elucidate details of Cu metabolism in this organism. The main objective of this research was to characterize, through molecular anchoring, how ATX1 interacts with P. brasiliensis proteins, providing an understanding of the biology of the fungus and aiming to identify possible therapeutic targets as a future perspective. A group of proteins that interact with Atx1 was identified and validated through pull-down assays. These proteins are part of the maintenance of homeostasis, interacting with other proteins of copper metabolism, electron transport and detoxification proteins. These interactions indicate the importance of Atx1 for maintaining copper homeostasis in the fungus, being a potential target for alternative drugs, which may collaborate to expand therapeutic options.
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    Fatores associados a lesões por acidentes de trânsito em jovens condutores em capitais selecionadas do Brasil
    (Universidade Federal de Goiás, 2022-03-23) Yamamoto, Rogers Kazuo Rodrigues; Morais Neto, Otaliba Libânio de;; Morais Neto, Otaliba Libânio de; Guimarães, Rafael Alves; Mandacarú, Polyana Maria Pimenta
    Introduction: According to the World Health Organization (WHO), traffic accidents are among the leading causes of death and early disability in the world. In some countries they are the leading cause of death of young adult individuals, and in most of these countries, they have a high cost of hospitalizations and productive losses, as is the case in Brazil. Nevertheless, the existence of few analytical studies and disaggregated by standardized age group aimed at estimating injuries caused by TA, especially in young drivers, justify the importance of this study. Objectives: estimate the prevalence of Traffic Accidents Injury (TAI) and traffic safety indicators among young drivers as well as to evaluate the factors associated with traffic accidents in this age group living in 14 Brazilian capitals (Belo Horizonte, Boa Vista, Campo Grande, Cuiabá, Curitiba, Florianópolis, Goiânia, Macapá, Palmas, Salvador, São Luís, São Paulo, Teresina and Vitória). Methodology: Data collection was performed through a standardized questionnaire applied in the form of face-to-face interviews in two places: at the points of agglomerations (AP) of people in the cities surveyed and in points of surveillance of sobriety or Traffic Blitz (SP), from March to December 2019. A total of 1,880 young drivers living in the capitals included in the study at the agglomeration points and 2,074 young drivers in the blitzes were approached. The Rake method was used to weight the data. The statistical analysis consisted of bivariate analysis for the selection of potentially associated variables and multivariate logistic regression to adjust the model and define the main factors associated with injuries in young drivers, remaining in this model only variables whose Prevalence Ratio (PR) remained significant (p-value < 0.05) after adjustment of confounding factors for both data collection points (agglomeration and blitzes). Results: At the agglomeration points, about 25.07% of the drivers declared that they did not have a driver's license (CNH); 11.94% reported a history of involvement in accidents in the last 12 months and 13.42% reported having taken illicit drugs in the last 30 days. In relation to the individuals approached in the context of police surveillance, a lower proportion of drivers who declared not a national driver's license (CNH) was observed 3.91%; reported a history of involvement in accidents in the last 12 months (7.81%) and illicit drug use in the last 30 days (3.97%) as well as greater support for the use of personal protective equipment (seat belts and helmets). In the evaluation of factors associated with the prevalence of accidents with injuries, the logistic regression model showed a statistically significant association (p < 0.05) for the following variables: incomplete mean level of education (PRadj 1.48 ; IC95% 1.02 - 2.17 for motorcyclists; and PRadj 2.18 ; IC95% 1.08- 4.40 for other drivers), motorcycle driving (PRadj 2.68 ; CI95% 1.9 - 3.74 (AP) and PRadj 6.12; CI95% 2.47 - 15.21 (SP), direction after use of psychotropic substances (PRadj 1.69 ; IC95% 1.218 - 2.342 for Beverages and PRadj 1.65; CI95% 1.08 - 2.53 for Drugs); and driving at speed above the limit established on regulated roads of 50 km/h (PRadj 1.95; IC95% 1.15 - 3.32). Conclusion: results obtained allowed estimating the prevalence of the main traffic safety indicators and the main associated factors in young drivers. The supervision exercised by traffic agencies has the potential to contribute to the decrease in the prevalence of the reporting of risk conduct associated with traffic accident injuries in young drivers and induces the use of personal protective equipment by them. The capitals of the North, Northeast and Midwest region presented higher prevalence of the history of accidents with injuries among young drivers interviewed. Finally, the need to implement public policies and interventions focused on the associated factors identified in the study with emphasis on motorcycle drivers is highlighted.
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    Percepção e adesão de usuários de internet às medidas não farmacológicas para mitigação da Covid-19: uma análise de inquéritos repetidos nos períodos de menor e maior adesão no Brasil
    (Universidade Federal de Goiás, 2022-12-08) Sérgio, Luciana Madeleine da Silva; Rosa, Michelle Quarti Machado da;; Toscano, Cristiana Maria;; Toscano, Cristiana Maria; Oliveira, Max Moura de; Souza, Romulo Cristóvão de
    Introduction: Mitigation of the Covid-19 pandemic caused by the new coronavirus (SARS-CoV 2), which started in 2020, required the implementation of a set of public health measures to reduce virus transmission in the population. Prior to the availability of specific vaccines and antiviral drugs, so-called non-pharmacological measures (social distancing, hand sanitization, and mask wearing) were the only measures with the potential to reduce the number of cases, hospitalizations, and deaths from Covid-19. Understanding and comprehension of the importance of these measures, as well as public adherence to them, are therefore key factors for their effective implementation. Little is known yet about the perception, knowledge, and behavior of society regarding the measures advocated and implemented during the Covid-19 pandemic. Objective: To characterize and evaluate, specifically for Brazil, the perception, knowledge, and behavior of Brazilian Internet users regarding Covid-19, including the population's adherence to non-pharmacological measures implemented. Also, we sought to identify factors associated with adherence to non-pharmacological measures among users in two periods identified as periods of lowest and highest adherence to non-pharmacological measures. Method: This is a cross-sectional study with repeated surveys. We used data from a sample of adult users (over 18 years) of the Facebook application who were invited to participate in an international survey conducted by the Massachusetts Institute of Technology (MIT) in collaboration with Johns Hopkins University in the United States. In Brazil the data was collected in the period July/2020 to March/2021. The source of information, knowledge, perception about Covid-19, and population behavior regarding adherence to Covid-19 protective measures were reported by a convenience sample that included recording 63,989 responses from internet users over 19 surveys. The following groups of variables were considered: 1) sociodemographics, 2) individuals' behavior regarding protective measures to Covid-19 (prevention with physical distance, hand sanitization, and mask use), 3) individuals' perception of Covid-19 (risk in the community; risk of infection; infection control; severity of infection; effectiveness of mask use, and effectiveness of hand sanitization), 4) knowledge about Covid-19 (knowledge about risk group and knowledge about transmission), and 5) source of information about Covid-19. Due to the lack of information on independence between waves in the study, two moments (lower and higher adherence of individuals regarding distancing, hand sanitization, and mask use) were selected to be analyzed. The descriptive analysis of the variables presented the frequency estimates and response percentages for the categorical variables, as well as their respective confidence intervals. In order to identify factors associated with greater adherence of the population to the measures, univariable and multivariable analysis was performed through Poisson regression models, with estimated prevalence ratio (PR) and respective 95% confidence intervals (CI). Results: The recorded number of internet user responses in the lowest adherence period (Nov 9 - 14 Nov 23/2020) was 2,339 and the highest adherence period (Mar 15 - Mar 29/2021) was 2,668. The sociodemographic characterization of the users regarding gender, age and education were similar during the two periods, lowest and highest adherence respectively, where the majority were female (53.3% and 53.7%), young (62% and 61.8%) and more than 40% had high school education (47.7% and 48.2%). Most individuals presented an important perception about the risk of Covid-19, where in the period of lowest adherence, 39.4% (330) and highest adherence 55.1% (528) claimed that the risk of the disease to the community is very and extremely dangerous. As for the understanding about the effectiveness of the measures, in the periods of lower and higher adherence respectively, 49.5% (1,094) and 52.4% (1,372) claimed that hand hygiene is extremely effective. Regarding the behavior, during the periods of lower and higher adherence respectively, considering the adoption of protective measures, it is observed that 56.8% (1,394) and 65.1% (1,869) of users reported adherence to physical distancing, 88.9% (2,139) and 94.2% (2,549) used a mask, and 83.3% (2,018) and 86% (2,391) sanitized their hands. Through Poisson regression, it is found that the prevalence in performing the protective measures (distancing, hand sanitization, and mask use) during the period of lower adherence was higher among the young (PR = 1.28; PR = 1.05 and PR = 1.07) and elderly (PR = 1.52; PR = 1.31 and PR = 1.35). For the period of higher adherence, it is observed that young (PR = 1.63; PR = 1.19 and PR = 1.05), elderly (PR = 1.25; PR = 1.33 and PR = 1.00) and individuals with knowledge about the form of transmission (PR = 1.48; PR = 1.62 and PR = 1.06) performed the protective measures more frequently. In addition, it is found that women (PR = 1.02 and 1.18) and individuals with greater understanding about the effectiveness of hand hygiene (PR = 1.16) and mask use (PR = 2.13) did more hand hygiene and used a mask more frequently. Conclusion: Throughout the Covid-19 pandemic in Brazil it is observed that internet users' adherence to non-pharmacological measures may be associated with the epidemiological picture of the disease, in which, the periods of lower (Nov 9 - 14 Nov 23/2020) and higher (Mar 15 - Mar 29/2021) adherence are characterized by lower and higher numbers of reported cases, respectively. Thus, during the periods, there was high adherence to the use of masks and hand washing. The number of individuals who adhered to physical distancing was high, although it could have been higher. A significant perception of risk was observed, as well as levels of knowledge about the effectiveness and importance of the protective measures implemented. However, these values varied in the population according to age and education level. Importantly, greater knowledge about the disease was associated with greater adherence of individuals to non-pharmacological measures implemented as public health strategies. Relevance and impact: The results showed how internet user's knowledge of Covid-19 influenced the adherence of individuals to non-pharmacological measures to face the pandemic. Continuous information dissemination and risk communication to the population are key strategies that should be instituted and prioritized during public health emergencies in order to increase the population's adherence to non-pharmacological mitigation measures. The findings of this study present important points for the Brazilian and international literature, and above all, relevant evidence to support managers and health policies during public health emergencies.
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    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) Limong, Loanda Carvalho Sant’ Ana; Kipnis, Ana Paula Junqueira;; Kipnis, Ana Paula Junqueira
    Pleural 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.
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    Saúde mental e trabalho: prevalência de morbidade psiquiátrica e fatores associados, entre servidores municipais em licença médica, Goiânia-Goiás, 2010
    (Universidade Federal de Goiás, 2013-09-13) Mendonça, Mauro Elias; Turchi, Marília Dalva;; Turchi, Marília Dalva; Corrêa Filho, Heleno Rodrigues; Siqueira Júnior, João Bosco
    Introduction: Mental disorders (MD) have high morbidity and high load in the years lived with disability, reducing quality of life and producing large socioeconomic impact. Objective: To estimate the prevalence and potential factors associated with psychiatric morbidity of municipal employees on sick leave in Goiânia, Brazil, in 2010. Methods: Cross-sectional census study linking Human Resources System with records of licenses issued by the Medical Board municipality. Socio-demographic and occupational variables and duration of the associated removal by MD licenses were analyzed. The level of significance was set at <5%. Results: Among the 20,535 servers, 5,028 (24.5%) had at least one license, with 801 of these for psychiatric morbidity. In total 9,101 licenses, of which 1,569 were granted for MD. The MD represented the greatest burden of the total period of absence (22.1%) with 75% of the servers on leave for > 15 days. The prevalence of MD was 39.0 licensed servers/1.000 active servers, with 76.4 licenses/1.000 active servers. The prevalence of MD was higher among women and servers with primary or higher education level. There were differences in the leave of absence profile caused by DM between men and women regarding age, ethnicity, marital status and salary. In relation to work, there was a higher prevalence of MD on servers with double bond, length of service <3 years (probation) and with 11-20 years of work. The highest prevalence of MD among women, was found in positions of education and health, and, among men, in surveillance jobs. Mood disorders (25.4/1,000) and neurotic (16.9/ 1,000) were clusters of higher prevalence, with high co-morbidity between both. The diagnostic category of depression was more prevalent. Discussion and Conclusions: In the present study, the prevalence of MD was more than six times higher than the one found on workers of the general social security system in the country. The results confirm the relevance of MD in health of servers, and bring subsidies to boost promotion measures, surveillance and occupational health care. The need to deepen the study of psychosocial factors associated with high prevalence of psychiatric morbidity in the public sector and differences in gender and occupation was pointed out in this study.
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    Soroprevalência de COVID-19 e infecção por toxoplasma gondii e fatores associados à ocorrência de lesão renal aguda em pacientes coinfectados
    (Universidade Federal de Goiás, 2022-06-06) Silva, Wania Gonçalves da; Amancio, Ana Laura de Sene;; Castro, Ana Maria de;; Castro, Ana Maria de; Storchilo, Heloisa Ribeiro; Freitas, Nara Rúbia de
    Title: Seroprevalence of COVID-19 and Toxoplasma Gondii Infection and Factors Associated with the Occurrence of Acute Kidney Injury in Coinfected Patients. Introduction: Coronavirus 2019 (COVID-19) is a severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), considered one of the greatest global public health challenges, contributing to a high burden of disease and death. in different age groups, in addition to those with comorbidities, such as cardiopulmonary and renal diseases, neoplasms, among others. Faced with the global SARS-CoV-2 pandemic and the high prevalence of Toxoplasma gondii infection in the population, studying the factors associated with the occurrence of acute kidney injury in COVID-19 patients, and the seroprevalence of T. gondii infection becomes necessary, to provide support for adequate initial assessment, improvement in prognosis and prevention strategies for the control of Covid-19 and Toxoplasmosis. Objective: To epidemiologically characterize a group of inpatients in an intensive care unit with COVID-19, coinfected with T. gondii. Methods: Analytical cross-sectional study, with an analytical approach, carried out in a public university hospital in Goiânia - Goiás. A total of 314 patients participated in the study, admitted to an intensive care unit, diagnosed with COVID-19 by the RT-PCR or RTLAMP methods, and serology for toxoplasmosis by the IgG ELISA method, and IgM Results: A study of seroprevalence of toxoplasmosis in patients with COVID-19 was not identified. Seropositivity was found for the IgG class: 78.1%, and IgM/IgG: 3.5%. In the sample, there was a predominance of males, ie (55.4%). Most of them are people aged 60 years or older (49.7%), living in Goiás (98.5%), which represents the highest frequency of hospitalizations among elderly people. 20-39 years (p=0.014) and 40-59 years (p=0.027) were protective factors for toxoplasmosis in patients with COVID-19. 88.5% of mixed race, living with someone (65.6%), retired (38.6%), with income of less than 2 years minimum (51.8%), with incomplete elementary school (53.4%) and living with 3 residents (52.3%). It is observed that there is an inverse trend, the higher the level of education, the lower the prevalence of toxoplasmosis. For behavioral habits (alcohol consumption, smoking, use of illicit drugs), no statistically significant was found. As for the origin of origin (67.9%) from a Basic Health Unit. As comorbidities prevail, systemic arterial hypertension, diabetes mellitus, obesity, COPD, neoplasms, and clinical manifestations, fever, asthenia, myalgia and headache. As for death, 158.5 % died. There were no significant differences between patients and patients who were discharged or downloaded. There were no significant results associating Acute Renal Failure (AKI) with toxoplasmosis in patients with COVID-19. Patients with COVID-19 and evidenced the presence of kidney disease 9 who are hospitalized in patients, evolution of the clinical condition to hemodialysis (P) No statistically significant results were identified that show associations between variables, a factor that demands further investigation. Conclusions: The results of the study show a elevated prevalence of toxoplasmosis patients at susceptibility to COVID-19 (77%), suggesting a high susceptibility of patients with developmental disease, evidencing opportunistic opportunities. Individuals over 60 years of age are at greater risk of being co-infected. There were no ARI, associations between toxoplasmosis infection in patients with COVID-19 and patients with COVID-19, who have more kidney problems and consequently progress to hemodialysis. Relevance and impact: It is valid, due to the high frequency of Toxoplasmosis and COVID-19 cases and association with renal impairment of patients who evolved with the need for renal replacement therapy, it is important to reflect and understand the severity of the disease, establish preventive, diagnostic and effective therapies in a more targeted and faster way, as well as preventive measures for effective decision making.
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    Rastreamento sorológico da infecção pelo vírus da hepatite C em cortadores de cana-de-açúcar nos estados de Goiás e Paraíba
    (Universidade Federal de Goiás, 2019-02-22) Oliveira, Brunna Rodrigues de; Carneiro, Megmar Aparecida dos Santos;; Carneiro, Megmar Aparecida dos Santos; Martins, Regina Maria Bringel; Teles, Sheila Araujo
    Introduction: Hepatitis C virus (HCV) infection is a major problem for a global public health, with about 71 million people chronically infected worldwide, being a major cause of cirrhosis and hepatocarcinoma. The World Health Organization (WHO) set the goal of eliminating viral hepatitis as a public health problem by 2030. To do so, it is necessary to track infections in all populations. Sugarcane cutters are a population of seasonal workers, with difficulty to access to health services, which lack information on hepatitis C. Objective: This study aimed to perform the serological screening of hepatitis C virus infection in sugarcane cutters in Goiás and Paraíba. Methods: The population consisted of 937 sugar cane cutters, 636 in Goiás and 301 in Santa Rita-PB. All cutters were invited to participate in the study, and those who signed the consent form were interviewed using a standardized questionnaire. Then, blood samples were collected and screened for anti-HCV by rapid tests and ELISA. The data were analyzed in the statistical program SPSS version 17.0 for Windows. Results: The population was composed of males (100%), with a mean age of 35.4 years. Regarding schooling, 47.4% reported having up to four years of study and the monthly family income of 78.8% of the participants was less than 2,000.00 reais. After screening for anti-HCV by rapid test and ELISA, it was verified that no individual was exposed to HCV. The risk characteristics for potential viral spread reported by cane cutters were tattooing/piercing, sharing of personal use material, and use of non-injectable drugs. Rapid tests are highly sensitive to anti-HCV, so they are appropriate and feasible for hard-to-reach populations such as sugarcane cutters and other populations. Conclusion: The present study showed that there was no exposure to HCV in the sugarcane cutters of the regions of Goiás and Santa Rita-PB. To achieve WHO's goal of eliminating viral hepatitis as a public health problem, it is important that more research on HCV prevalence is conducted, especially in groups that have difficulty accessing the health system.
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    Validação da técnica de avidez de IgG em amostras de sangue de recém-nascidos coletadas em papel filtro: valor prognóstico para indicação de infecção ativa pelo Toxoplasma gondii
    (Universidade Federal de Goiás, 2017-02-21) Souza, Jéssica Yonara de; Castro, Ana Maria de;; Castro, Ana Maria de; Avelar, Juliana Boaventura; Avelino, Mariza Martins
    Congenital toxoplasmosis is an infectious disease that results from the transplacental transfer of the protozoan Toxoplasma gondii to the concept and can cause serious fetal damage, its diagnosis and complex, and the sooner realized improves the prognosis of infection. The evaluation of IgG avidity is used as an indicator of recent infection mainly in the follow-up of pregnant women at risk, and to date it is not established for use in blood samples of newborns and in blood samples collected on filter paper. The general objective of this study was to evaluate the prognostic importance of the IgG avidity test in sera and in blood collected on RN filter paper in the indication of T. gondii congenital infection. Blood samples were collected on RN filter paper at the Hospital das Clínicas-UFG, Dona Íris Maternity Hospital, Goiânia-GO and Cais Nova Era, Aparecida de Goiânia-GO Serological screening for IgG and IgM antibodies was performed using the Elisa test (BIOLISA® toxoplasmosis IgG and IgM kit). From the total of 1277 samples, two IgM positive samples were detected, in 564 samples (44.1%) the presence of IgG was detected, and the ELISA ≥3.0, 57.67% (327 / 567), 177 pairs of mother and child recolects were performed to confirm the results obtained on filter paper and IgG avidity evaluation. In 167 pairs (94.36%) IgG detection was confirmed by demonstrating good sensitivity of the method, in 4 (2.40%) samples the IgG of the newborn presented low avidity of IgG antibody that is indicative of recent infection. In 17 samples the collection was performed simultaneously on filter paper and peripheral blood, in order to evaluate the efficacy of the avidity technique in filter paper samples, the agreement between the results was 100%. Screening of high IgG NB associated with the avidity test can be performed on filter paper and this method may contribute to the early detection and diagnosis of toxoplasmosis.
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    Diagnóstico da hanseníase paucibacilar: resposta imune celular a proteínas recombinantes do Mycobacterium leprae
    (Universidade Federal de Goiás, 2008-02-28) Sampaio, Lucas Henrique Ferreira; Stefani, Mariane Martins de Araújo;; Stefani, Mariane Martins de Araújo; Mira, Marcelo Távora; Oliveira, Milton Adriano Pelli
    Objetives: To test T cell effector/memory immune response to M leprae recombinant proteins assessed by IFN-y production among leprosy patients and controls. Methods: The following study groups were assessed: A. Paucibacilary leprosy (PB; n=13); B. Multibacilary leprosy (MB; n=10), PB and MB were newly diagnosed untreated patients; C. Pulmonary tuberculosis, HIV negative (TB; n=10); D. Healthy endemic controls (EC; n=10); E. Multibacilary household contacts (HHC; n=13). The following M.leprae recombinant proteins were tested: ML0091; ML0276; ML0398; ML0541; ML0543; ML0840; ML0953; ML1011; ML1213; ML1623; ML2044 and the fusion proteins ML46f and ML56f at 10ug/ml using Whole Blood Assay (WBA), 450mL/well, 37oC, 5%CO2. After 24 hours incubation, plasma was collected to quantitate IFN-y by ELISA (QuantiFERON CMI, Cellestis, Australia). Results- Based on IFN-y levels, M. leprae recombinant proteins were classified into: A - “Immunogenic and Specific”: ML0276, ML1623, ML0091, ML46f, ML0840, ML2044; B - “Immunogenic and not specific”: ML0398; C -“Not Immunogenic”: ML1011, ML57f, ML0541, ML0316, ML0543, ML1213, ML0953. Conclusions- Plasma IFN-y levels among PB leprosy and healthy household contacts indicated six potential candidates for the diagnosis of PB leprosy represented by the following immunogenic and specific M. leprae recombinant proteins: ML0276, ML1623, ML0091, ML46f, ML0840 and ML2044.
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    Reposicionamento de fármacos para Leishmania spp: estratégias “in silico” e avaliação experimental
    (Universidade Federal de Goiás, 2015-08-04) Silva, Diego Cabral; Andrade, Carolina Horta;; Andrade, Carolina Horta; Cravo, Pedro Vitor Lemos; Silva Junior, Floriano Paes
    Leishmaniases are diseases caused by more than 20 protozoan parasites belonging to the genus Leishmania, and transmitted through the bite of infected female Phlebotomine and Lutzomya. An estimated 20,000 to 30,000 deaths and 1.3 million new cases occur annually. Currently available drugs have serious limitations regarding their efficacy and especially their toxicity, side effects and costs. Thus, there is a pressing need for new therapies that are safer and more effective. Due to the high costs of traditional process of drug discovery and development, alternative strategies have been developed to speed up this process, and reducing its costs. Among them, is drug repositioning, which is the discovery of new therapeutic applications for drugs already on the market. The aim of this work was to search and identify approved and clinically available drugs with potential antileishmanial activity, using bio- and cheminformatics approaches, and experimental validation of these drugs using in vitro assays. Initially, we generated a dataset of Leishmania genes with orthologs in four species (L. major, L. braziliensis, L. infantum e L. mexicana), specific to the genus Leishmania, trying to explore potential molecular targets that could be effective against all species and essential to the process of development and differentiation of the parasite. This dataset was used to interrogate three databases of approved drugs (DrugBank and TTD) aiming to identify homologues of validated targets for other diseases. Furthermore, binary QSAR models were generated from phenotypic assay data, using different descriptors, and two machine learning methods, and then consensus models were built. Homology search allowed the identification of 36 new potential molecular targets that need to be validated experimentally, and 122 drugs. Of these 122 compounds, 28 were previously reported on the literature as actives. Five drugs not yet tested were selected for biological screening in vitro against promastigotes (lansoprazole, ibuprofen, sertaconzole, nilutamide and clomifen). Three of them showed activity at 100 μM and we determined their IC50. Ibuprofen showed an IC50 of 55.08 μM, sertaconazole IC50 < 15 μM and clomifen (IC50 5,75 μM, more potent than the standard drug (pentamidine IC50 = 7,24), suggesting a potential activity. Besides that, the QSAR models generated had adequate statistical parameters, especially for consensus models. One of the models generated by consensus was employed to predict the activity of the drugs identified by the bioinformatics approach. The best models can be used as filters in a virtual screening process. In vitro assays in the promastigote form of L. amazonensis were standardized, and used to successfully identify new potential candidates for drug repositioning.
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    Toxoplasmose gondii: soroprevalência, isolamento e virulência de cepas obtidas de galinhas caipiras (Gallus domesticus) comercializadas em feiras livres do município de Goiânia
    (Universidade Federal de Goiás, 2007-02-27) Aleixo, Eduardo da Costa Alves; Castro, Ana Maria de;; Soares, Joanna Darc Aparecida Herzog;; Soares, Joanna Darc Aparecida Herzog; Gomes, Abraão Garcia; Bezerra, José Clecildo Barreto
    In this study, 50 free-range chickens were obtained from free fairs of the city of Goiânia, its serum were tested for antibodies anti T. gondii with the modified agglutination test (MAT), its heart and brain had been processed and inoculated in groups of 6 mice. Samples of the organs of the birds and the surviving mice had been sectioned and stained with Hematoxylin-Eosin for the search of Toxoplasma-like cysts structures. The serum of the surviving mice was analyzed by the indirect immunofluorescence reaction (RIFI). The isolated ones had been submitted to the study of virulence for mice by inoculations with different concentrations of tachyzoites. 25 birds (50%) had revealed positive (MAT ≥ 1:5) getting a total of three isolated. Toxoplasma-like cysts structures had been found in histologic cuts of eight birds (16%) and organs of mice of two groups (2%). Of the 25 experiments with inoculeted of positives birds, in 11 (44%) it had the detention of IgG anti-Toxoplasma. In the samples of negatives birds, evidences of the presence of Toxoplasma had not been found. Of the three isolated, two had been lethal for mice from concentrations of a thousand tachyzoites., while another one was 100% fatal one from the concentration of ten a thousand tachyzoites.
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    Avaliação clínica, laboratorial e histopatológica do efeito de drogas imunossupressoras na reativação da toxoplasmose crônica em modelo murino com a cepa ME 49 no camundongo BALB/c
    (Universidade Federal de Goiás, 2008-03-28) Alves, Fabiana Santiago Aleixo; Lino Junior, Ruy de Souza;; Soares, Joanna Darc Aparecida Herzog;; Garciazapata, Marco Tulio Antonio;; Garciazapata, Marco Tulio Antonio; Lacerda, Elisângela de Paula Silveira; Carvalhaes, Mara Silva
    This work was evaluated for the potential reactivation of Toxoplasmosis in murine model similar to human immunosuppression being developed in BALB/c mice, which were 40 days infected with 20 cysts of ME 49 strain of Toxoplasma gondii and after 60 days was initiated treatment with immunosuppressant drugs, Azathioprine in dosage of 10mg/kg five times a week in days, Dexametasone in dosage 2.5mg/kg per day per mouse, three times per week on alternate days, Cortisone acetate in 50mg twice a week in subcutaneous injection of cortisone acetate alone, or associated with its proper controls. Treatment was continued for 28 days. The use of the Dexametasona or Azathioprine isolated or associated with, a factor not caused by reactivation of serological tests, clinical or histopathological but associated with cortisone acetate led to a clinical diagnostic framework of a voluntary recall because of injuries in epidermal 62.5% of the mice that lot compared to its proper controls, however mortality was not observed in any of the groups tested
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    Avaliação da produção de BMP2 no intestino de camundongos infectados com Trypanosoma cruzi
    (Universidade Federal de Goiás, 2020-03-12) Carmo Neto, José Rodrigues do; Silva, Juliana Reis Machado e;; Silva, Juliana Reis Machado e; Oliveira, Milton Adriano Pelli; Campos, Helioswilton Sales de; Freitas, Aline de Araújo
    One of the main late complications of Chagas' disease (CD) is the megacolon, affecting approximately 10% of symptomatic patients. However, studies are needed to understand mechanisms involved in the progression of this condition in the chronic phase of CD. Myenteric plexus neurons are known to be essential for the control of intestinal motility. Through infection by Trypanosoma cruzi (T. cruzi), the inflammatory profile that sets in is involved in neural destruction. One of the proteins related to the maintenance of nerve cells in the myenteric plexus is the type 2 morphogenetic protein (BMP2), produced mainly by muscle macrophages. The homeostasis of the BMP2/macrophage ratio is directly involved with intestinal motility and the maintenance of organ function. Thus, the aim of this study was to correlate the production of intestinal BMP2 with the production of cytokines and histopathological changes in C57Bl / 6 mice. infected by the T. cruzi Y strain in the periods of 30 and 90 days of infection. The mice were infected with 1000 blood trypomastigote forms. After the infection period, the mice were euthanized and the spleen and intestine were collected. The intestine was divided in two, one fragment was used for histological analysis and the other for quantification of TNF-α, IFN-γ, IL-10 and BMP2, as well as the spleen. Infection with strain Y induced an increase in the production of TNF-α, IFN-γ and BMP2 in the intestine after 30 days of infection, as well as an increase in the inflammatory infiltrate and a decrease in the number of neurons in the myenteric plexus. Collagen deposition increased gradually throughout the infection, demonstrated at 90 days of infection. It was observed that the increase in BMP2 after 30 days of infection has a positive correlation with the increase of IFN-γ and TNF-α in the intestine. However, BMP2 and IFN-γ showed a negative correlation with the number of neurons in the myenteric plexus in the same period in the organ. As a first report of the alteration of BMP2 production after infection by T. cruzi, it is suggested that this imbalance may represent a new pathway in maintaining the intestinal pro-inflammatory profile, as well as being related to the neuronal damage that the infectious process establishes.
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    Infecção por Stenotrophomonas maltophilia em hospital terciário em Goiânia: características clínicas e microbiológicas e fatores de risco para letalidade
    (Universidade Federal de Goiás, 2014-07-08) Silva, Claudia Neto Gonçalves Neves da; Araújo Filho, João Alves de;; Araújo Filho, João Alves de; Kipnis, André; Pereira, Milca Severino
    Stenotrophomonas maltophilia is a Gram-negative bacillus found in natural and in hospital environments. S maltophilia’s high level intrinsic resistence to antibiotics and heavy metals justifies the importance of this bacteria in the nosocomial environment. The aim of this study was to describe the clinical and epidemiological characteristics, and the outcome of infection due to S. maltophilia; describe the antibiotic sensitivity and the genetic relatedness from this bacteria from january 2010 to july 2013 in Hospital das Clínicas – UFG (HC/UFG). Clinical and epidemiological data were obtained from medical records of patients; antimicrobial sensitivity was determined by the methodology Vitek 2®; and the genetic similarity was determined by Pulsed-Field Gel Eletrophoresis (PFGE). Over the study period, 75 isolates of S. maltophilia were indentified in 56 patients, with mean of 1.34 isolates per patient (range 1-8). Among the total, 34.6% were in the clinical intensive care unit, and 17.3% in the clinical infirmary. The 3 intensive care unit accounted for 56% of all isolates. The mean age of patientes was 45.75 years (range 0-83 years), and 51.8% were male. All cases of infection were considered health care-associated. The most comom coexisting condition were haematological malignancy, in 18 (32.1%) patientes. The most frequent clinical manifestations was fever in 47 (83.9%) patients, and leukocytosis or leukopenia in 31 (55.4%). Invasive devices were frequently used, and central venous cateter, and mechanical ventilation were the most. Most patients (94.6%) used broad spectrum antibiotics before the acquisition of the bacteria. The most frequent type of infection was ventilator-associated pneumonia (42.9%) followed by cateter-associated bacteremia (16.1%). Trimethoprim-sulfamethoxazole was the treatment of choice in 32 (57.1%) patients. The outcome of infection due to S. maltophilia was infection-related death in 62.5%. The risk factors related to mortality in this study were shock, acute renal failure, use of mechanical ventilation, use of urinary device and feeding tube. Trimethoprim-sulfamethoxazole resistance, the treatment of choice for infection by S. maltophilia, and levofloxacin resistence were detected in HC / UFG. Twenty isolates were assessed for genetic variability by pulsed-field gel eletrophoresis (PFGE) with observation of high variability between strains. We conclude that S. maltophilia is a nosocomial bacteria of clinical importance mainly due to high associated mortality, and few therapeutic options. Resistance to trimethoprim/sulfamethoxazole was low, but must be monitored in HC / UFG.
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    Características clínicas e laboratoriais de uma doença neurológica rara e hereditária em uma família do Brasil central
    (Universidade Federal de Goiás, 2016-06-09) Medeiros, Rodrigo Parente; Caixeta, Leonardo Ferreira;; Caixeta, Leonardo Ferreira; Teixeira, Kim Ir Sen Santos; Mendonça, Helena Rezende Silva
    A rare disease is defined by the World Health Organization as diseases that affect up to 65 people / 100,000. To evaluate these diseases it is required to be performed a lot of tests and it is often not possible to reach a definitive diagnosis. The aim is to describe the clinical and neuroimaging aspects in a countryside Goiás’ family that carries a rare neurodegenerative disease. It’s a descriptive study about five brothers. It’s conducted physical examinations, laboratory, MRI of the cervical column, dorsal and lumbar besides the skull. Made neurophysiological diagnosis, Through genetic sequencing to make exome. We were subjected to neuropsychological assessment, the MEEM and FIM. The five brothers have in common the tetraparesia of crural predominance , muscular atrophy of the lower limbs , severe mental retardation early onset , cerebellar atrophy , paravertebral atrophy and motor axonal neuropathy. Made sequencing the exome for research related genes hereditary spastic paraparesis and not found any gene related to this disease. A probable diagnosis would be the spinocerebellar ataxia type 13, due to the reported clinical picture. But it is necessary a genetic study to proof it. Continuous genetic evaluation of these patients is important because of the description of new genes.
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    Dengue no Brasil: tendências, vigilância e as epidemias de 2008
    (Universidade Federal de Goiás, 2009-03-27) Fonseca, Gisele Folador da; Siqueira Júnior, João Bosco;; Siqueira Júnior, João Bosco; Laval, Cristina Aparecida Borges Pereira; Maciel, Ivan José; Silva, Kariny Vieira Soares e
    To characterize the current trends and scenarios of dengue in Brazil, with emphasis on the 2008 epidemics and to evaluate the timeliness of the dengue surveillance system in the study period.
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    Avaliação bioquímica in vivo do tratamento anti-helmíntico de cisticercos de Taenia crassiceps
    (Universidade Federal de Goiás, 2011-02-21) Fraga, Carolina Miguel; Lino Junior, Ruy de Souza;; Vinaud, Marina Clare;; Vinaud, Marina Clare; Oliveira, Valéria de; Bezerra, José Clecildo Barreto
    Taenia crassiceps cysticercosis is a rare disease in humans and domestic animals, however there are reports of cases of humans as paratenic hosts, especially immunocompromised ones which indicates this parasite as of zoonotic risk. Albendazole and praziquantel are widely used drugs in cysticercosis treatment as they are well tolerated by patients. Biochemically, the active forms of albendazole inhibit the glucose uptake which leads to energy production breakdown and death of the parasite. The active forms of praziquantel induce muscle contractions, tegument damages and metabolic alterations. Throughout the life cycle, the energetic metabolism of T. crassiceps varies accordingly to nutrient sources and oxygen tension. Cysticerci use glucose and glycogen as energy source and reserve substances, respectively, and the products generated from their degradation are used in other metabolic pathways. Besides, the parasite is capable of fatty acid oxidation and amino acids breakdown as alternative energy production sources. The aim of this study was to evaluate the biochemical alterations, in vivo, in T. crassiceps cysticerci after treatment with low doses of albendazole and praziquantel. The cysticerci were inoculated into the peritoneal cavity of female BALB/c mice which after 30 days of infection received treatment with one of the following dosages: 5,75 or 11,5 mg/kg of albendazole or 3,83 or 7,67 mg/kg of praziquantel. After 24h the animals were euthanized and the cysticerci removed and classified as belonging to initial, larval or final stage accordingly to their morphologic characteristics. The cysticerci were analyzed through high performance liquid chromatography aiming the detection of organic acids from glycolisis, tricarboxylic acid cycle and fatty acid oxidation, and through spectrophotometry aiming the quantification of glucose, urea and creatinine. The low dosage treatment induced a partial blockage of the glucose uptake by the cysticerci. The concentrations of the drugs used were capable of activation of the tricarboxylic acid cycle which are considered energetically more profitable which was reflected by the increase in the concentrations of citrate, malate and α-cetoglutarato, which was reported in cysticerci for the first time. The used dosages of the drugs induced alterations in the parasite’s metabolism increasing the use of alternative energy production pathways such as the fatty acid oxidation, detected by the presence of propionate and β-hydroxibutyrate, and the aminoacids breakdown, detected by the urea production.
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    Avaliação de recrutamento de células da resposta imune inata por BCG Moreau na ausência de citocinas IL-17 e IL-22
    (Universidade Federal de Goiás, 2015-01-28) Resende, Danilo Pires de; kipnis, André; Junqueira-Kipnis, Ana Paula;; Junqueira-Kipnis, Ana Paula; Nagib, Patrícia Resende Alo Loyola; Dorta, Miriam Leandro
    Tuberculosis is an infectious disease responsible for millions of deaths every year. BCG (Bacille Calmette-Guérin) is the only licensed vaccine for the prevention of human tuberculosis (TB). Early production of IL-17 and IL-22 as induced by BCG is important for protective memory cells formation in TB. In this context, we evaluated the role of these cytokines in the recruitment and activation of cells of the innate immunity induced by BCG vaccine. C57BL/6, IL22 _ /_ and IL17_ /_ mice were used. Cells obtained after peritoneal lavage were evaluated by flow cytometry and citospin 24 hours, 2, 3, 5 and 7 days after infection with BCG, intraperitoneally (1x106/ml). The macrophages recruitment (F4/80 + CD11+) to the peritoneum was similar for all animals, but in IL17_ /_ mice, these cells expressed more MHCII molecules. Neutrophils (Gr1+), initially presented higher percentage in IL17_/_ and IL22_/_ mice compared with C57BL/6 (50.9 ± 5.4, 31.7 ± 1.7). These cells where more activated (Gr1+CD11b+) in the IL17_/_ mice at 5 days post inoculation. NK cells (NK1.1+) was recruited in C57BL/6, mice whereas few NK cells migrated to the peritoneum in IL22_ /_ and IL17_/_ mice, two days after inoculation. Again, these cells were also more activated in IL17_/_ than in other animals (NK1.1+ CD11b+). In summary, intraperitoneal immunization with BCG recruit macrophages, neutrophils and NK cells into the peritoneum. In the absence of IL17 these cells are more activated than in the other mice, indicating a higher activated profile, although these cells were reduced.