Intestinal protozoa parasites association with anemia in people from Brazilian western Amazon communities

Introduction: Nowadays intestinal parasitic infection remains an important public health trouble in Latin and South America, emphasizing the Amazon region. Furthermore, intestinal parasites have been considered important factors in etiology of nutritional anemia and malnutrition. Objective: This study aimed to evaluate the intestinal parasitic infection and its possible association with anemia in people from Amazon communities. Methods: The study was a research in documentary records, descriptive, retrospective and cross-sectional, with confirmed cases of parasites infection found in State Hospital of Cacoal-Rondônia, Brazilian Western Amazon. The parameters evaluated were gender, age, race, parasites, hematocrit and hemoglobin. Results: Females where slight higher for the number of cases of parasites occurrence (51%) compared to males (49%) and children had higher parasitic index (43%) followed by adults (37%), teenagers (11%) and seniors (9%). With regards to race, pardos (brown skin color) group was the most affected by the parasites with 69% of cases, followed by caucasians (17%), indians (11%) and blacks (3%). The major parasites diagnosed were Endolimax nana (55%), Giardia lamblia (28%), Entamoeba coli (14%) and Iodamoeba bütschlii (3%). In relation to the association of intestinal parasites and anemia, children had a 60% anemia increase when compared to adults (p <0.05) and the indians increased by 100% anemia when paired against caucasians (p <0.05).Conclusion: Thus, it is suggested that attention should be given to the increase in protozoa parasitic infection prevalence in Amazonian communities and expedite the emergency of improvements in political and sanitation programs of water treatment and waste and sewer management

Coprodução de hormônio do crescimento e prolactina em paciente com sela túrcica parcialmente vazia primária: relato de caso

Introduction: The empty sella syndrome is a neuroradiological diagnosis that shows pituitary gland reduction or flattening, with a prevalence of around 8% to 35% in general population. Objective: We report a case in which there is an association between partial primary empty sella syndrome and high levels of growth hormone and prolactin. Methods: A 67-year-old man, from Coronel Mota Hospital, Boa Vista / RR, with no specific complaints, was referred to the Endocrinology ambulatory to investigate a modification in sella area. After anamnesis and physical examination, acromegaly research began. Pituitary hormones and magnetic resonance imaging of the sella turcica with contrast were requested. Results: General physical examination revealed acromegalic face, nasal enlargement, macroglossia and frontal cutis verticis gyrata. Radiological examination showed partial empty sella. Laboratory evaluation confirmed the clinical suspicion of acromegaly and revealed hyperprolactinemia presence. It was decided to treat the patient with cabergoline 1.5 mg / week and to refer him to a center specialized in neuroendocrinology. Conclusion: This report shows a case of partial primary empty sella and co-production of growth hormone and prolactin, making this association interesting, since somatotropinomas are mostly (80%) macroadenomas. In addition, the underdiagnosis of acromegaly is highlighted, since the symptoms are nonspecific and insidious, leading to high morbidity and mortality and reduction of the affected patients life expectancy.Introdução: A síndrome da sela túrcica vazia é um diagnóstico neurorradiológico que evidencia a redução ou o achatamento da glândula pituitária, com prevalência em torno de 8 a 35% na população geral. Objetivo: Este estudo de caso relata a associação entre sela túrcica parcialmente vazia primária e elevados níveis de hormônio do crescimento e prolactina. Métodos: Homem de 67 anos, proveniente do hospital Coronel Mota, Boa Vista/RR, sem queixas específicas, encaminhado ao ambulatório de Endocrinologia para investigação de alteração em região selar. Após realização de anamnese e exame físico, iniciou-se investigação de acromegalia. Foram solicitados basais hipofisários e ressonância magnética de sela túrcica com contraste. Resultados: O exame físico geral evidenciou fácies acromegálica, alargamento nasal, macroglossia e cutis verticis gyrata frontal. O exame radiológico demonstrou sela túrcica parcialmente vazia. A avaliação laboratorial confirmou a suspeita clínica de acromegalia e revelou a presença de hiperprolactinemia. Optou-se por tratar o paciente com cabergolina 1.5mg/semana e encaminhá-lo para centro especializado em neuroendocrinologia. Conclusão: Este relato mostra um caso de sela parcialmente vazia primária e coprodução de hormônio do crescimento e prolactina, tornando esta associação interessante, uma vez que somatotropinomas são em sua maioria (80%) macroadenomas. Além disso, ressalta-se para o subdiagnóstico da acromegalia, uma vez que os sintomas são inespecíficos e insidiosos, acarretando elevada morbimortalidade e redução da expectativa de vida dos pacientes acometidos