Sobrecarga de mães com filhos diagnosticados com transtorno do espectro autista: estudo de método misto

Objetivo: Analisar a sobrecarga materna relacionada aos cuidados com filhos diagnosticados com transtorno do espectro autista.Método: Estudo de método misto, sequencial explanatório, realizado na Associação de Pais e Amigos dos Excepcionais e em grupo de WhatsApp® Messenger, com 51 mães (fase quantitativa) e seis (fase qualitativa), entre janeiro e outubro de 2019. Para coleta de dados, utilizaram-se, na fase quantitativa, de formulário de caracterização sociodemográfica, econômica e do cuidado realizado com o filho; e do instrumento Zarit Burden Interview. Na fase qualitativa, empregou-se uma entrevista semiestruturada. Realizaram-se análise descritiva, bivariada e multivariada (dados quantitativos) e análise de conteúdo de Bardin (dados qualitativos).Resultados: 64,7% das mães se sentiam sobrecarregadas, com sobrecarga leve a moderada (52,9%). Emergiram quatro categorias analíticas sobre elementos desencadeadores da sobrecarga materna.Conclusões: Urge identificação da sobrecarga materna relacionada aos cuidados de crianças com transtorno do espectro autista, durante a assistência na Atenção Primária à Saúde. Palavras-chave: Transtorno autístico. Relações mãe-filho. Cuidadores

Molecular study of hepatitis C virus isolated from patients of a reference hospital in Fortaleza, Ceara.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorO vÃrus da hepatite C à considerado como o principal agente causador de hepatite nÃo-A, nÃo-B e, desde sua descoberta em 1989, tem sido reconhecido como a principal causa de doenÃa crÃnica do fÃgado em todo o mundo. O VHC possui um genoma de RNA de sentido positivo e à classificado como um flavivÃrus. O vÃrus apresenta considerÃvel variabilidade em sua seqÃÃncia e as variantes do VHC podem ser divididas em seis genÃtipos principais (numerados de 1 a 6) e diversos subtipos. A distribuiÃÃo dos genÃtipos varia tanto geograficamente, quanto entre os grupos de risco. Este estudo teve como objetivo analisar a distribuiÃÃo dos genÃtipos do VHC entre pacientes atendidos em um hospital de referÃncia em Fortaleza, CearÃ. Cento e vinte pacientes com sorologia positiva para anti-VHC ou histÃria clÃnica sugestiva de infecÃÃo pelo vÃrus foram estudados. O RNA viral foi extraÃdo a partir do soro dos pacientes e a detecÃÃo molecular do vÃrus foi feita por PCR, utilizando iniciadores especÃficos para a regiÃo 5 (linha) nÃo-codificadora do genoma viral. A genotipagem foi baseada em tÃcnica de RFLP utilizando as enzimas de restriÃÃo HaeIII, RsaI, MvaI e HinfI. Noventa e seis pacientes (80%) foram positivos no teste qualitativo para VHC. A mÃdia de idade desses pacientes foi de 44 anos. HistÃria clÃnica de cirurgia foi o fator de risco mais presente, seguido por transfusÃo sangÃÃnea, DST, uso de drogas, tatuagem, diÃlise e exposiÃÃo ocupacional. A relaÃÃo entre o resultado do teste qualitativo e o uso de drogas apresentou significÃncia estatÃstica, com 96% dos usuÃrios de drogas positivos para VHC. NÃo houve diferenÃa significativa no resultado do teste qualitativo quando transfusÃes sangÃÃneas feitas antes ou depois de 1993 foram analisadas. ManifestaÃÃes clÃnicas ou Ãndices de ALT alterados tambÃm nÃo foram preditivos de positividade para VHC. O genÃtipo 1 foi o mais prevalente na populaÃÃo estudada (46,9%), seguido pelos genÃtipos 3 (34,4%) e 2 (8,3%). O genÃtipo 4 viral foi detectado em um paciente. Em nove amostras nÃo foi possÃvel a genotipagem do VHC. Esses casos foram denominados indeterminados. CaracterÃsticas epidemiolÃgicas como idade, sexo, fatores de risco, Ãndices de ALT e manifestaÃÃes clÃnicas foram relacionadas com os diversos genÃtipos virais. A distribuiÃÃo dos genÃtipos virais entre as categorias estudadas ocorreu de forma homogÃnea na maioria dos casos. Foi observada significÃncia estatÃstica apenas na relaÃÃo entre genÃtipo e exposiÃÃo ocupacional ao VHC, com predominÃncia do genÃtipo 1 neste grupo de risco. NÃo foram observadas co-infecÃÃes com mais de um genÃtipo viral.Hepatitis C virus is considered as the main causative agent of non-A non-B hepatitis and has been recognised as the major cause of chronic liver disease worldwide, since its discovery in 1989. It has a positive-sense RNA and belongs to the flavivirus family. The HCV shows considerable sequence variability and its variants can be divided into six main genotypes (numbered from 1 to 6) and several subtypes. The genotypes distribution varies from the geographic area and among risk groups. This study had the main aim to study HCV genotypes distribution in patients from a reference hospital in Fortaleza, Ceara. It was investigated a hundred and twenty patients with anti-HCV positive or clinical history suggesting virus infection. Viral RNA was extracted from patients serum and the virus molecular detection was made by PCR, using specific primers to the 5â non-coding region of viral genome. Genotyping was based in a RFLP technique, using the restriction enzymes HaeIII, RsaI, MvaI and HinfI. Ninety six patients (80%) were positive in the qualitative test for HCV. The mean age of these patients was 44 years old. Surgery clinical history was the most frequent risk factor, followed by blood transfusion, sexual transmitted disease, drugs use, tattoos, dialysis, and occupacional exposure. The relation between qualitative test result and drug users showed statistical significance, with 96% of drugs users being positive for HCV. There was no significant difference in qualitative test result when we analysed blood transfusions done after or before the year 1993. Clinical symptoms and ALT levels also were not predictive of HCV positive result. Genotype 1 was the most prevalent in the studied population (46,9%), followed by genotype 3 (34,4%) and 2 (8,3%). There was also a molecular characterization of one patient with genotype 4 whereas nine samples were not HCV genotyped and were called as undetermined. The epidemiological characteristics such as age, gender, risk factors, ALT levels and clinical manifestations were related with viral genotypes. The HCV genotypes had a homogeneous distribution, in the majority of cases, among the different categories. A statistical significance was observed only when genotype 1 was related to HCV occupational exposure. Co-infections with more than one viral genotype were not observed

Applicability of Oral Fluid and Dried Blood Spot for Hepatitis B Virus Diagnosis

Submitted by Sandra Infurna ([email protected]) on 2019-08-27T15:51:28Z No. of bitstreams: 1 GeaneFlores_HelenaCruz_etal_IOC_2019.pdf: 1644866 bytes, checksum: a657dc768b5410107e82a737c8a12990 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-08-27T15:58:16Z (GMT) No. of bitstreams: 1 GeaneFlores_HelenaCruz_etal_IOC_2019.pdf: 1644866 bytes, checksum: a657dc768b5410107e82a737c8a12990 (MD5)Made available in DSpace on 2019-08-27T15:58:16Z (GMT). No. of bitstreams: 1 GeaneFlores_HelenaCruz_etal_IOC_2019.pdf: 1644866 bytes, checksum: a657dc768b5410107e82a737c8a12990 (MD5) Previous issue date: 2019Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Instituto Federal de Educação, Ciência e Tecnologia do Ceará. Campus Fortaleza. Fortaleza, CE, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Hepatitis B virus (HBV) is one of the major causes of chronic liver disease worldwide; however most of individuals are not aware about the infection. Oral fluid and dried blood spot (DBS) samples may be an alternative to serum to HBV diagnosis to increase the access to diagnosis in remote areas or high-risk groups. The main objective of this review is to give an insight about the usefulness of oral fluid and DBS for detecting HBV markers. Several groups have evaluated the detection of HBsAg, anti-HBc, and anti-HBs markers in oral fluid and DBS samples demonstrating 13 to 100% of sensitivity and specificity according different groups, sample collectors, and diagnosis assays. In the same way, HBV DNA detection using oral fluid and DBS samples demonstrate different values of sensitivity according type of collection, studied group, extraction, and detection methods. Thus, serological and molecular diagnostic tests demonstrated good performance for detecting HBV using oral fluid and DBS according some characteristics and could be useful to increase the access to the diagnosis of HBV

Update on hepatitis B and C virus diagnosis

Submitted by sandra infurna ([email protected]) on 2016-05-24T11:37:08Z No. of bitstreams: 1 leticia2_scallioni_etal_IOC_2015.pdf: 1136205 bytes, checksum: bba3b1ce61d8f9bc835a25c8f1ceb040 (MD5)Approved for entry into archive by sandra infurna ([email protected]) on 2016-06-02T12:55:21Z (GMT) No. of bitstreams: 1 leticia2_scallioni_etal_IOC_2015.pdf: 1136205 bytes, checksum: bba3b1ce61d8f9bc835a25c8f1ceb040 (MD5)Made available in DSpace on 2016-06-02T12:55:21Z (GMT). No. of bitstreams: 1 leticia2_scallioni_etal_IOC_2015.pdf: 1136205 bytes, checksum: bba3b1ce61d8f9bc835a25c8f1ceb040 (MD5) Previous issue date: 2015Made available in DSpace on 2016-06-03T12:34:15Z (GMT). No. of bitstreams: 2 leticia2_scallioni_etal_IOC_2015.pdf: 1136205 bytes, checksum: bba3b1ce61d8f9bc835a25c8f1ceb040 (MD5) license.txt: 2991 bytes, checksum: 5a560609d32a3863062d77ff32785d58 (MD5) Previous issue date: 2015Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Viral hepatitis B and C virus (HBV and HCV) are responsible for the most of chronic liver disease worldwide and are transmitted by parenteral route, sexual and vertical transmission. One important measure to reduce the burden of these infections is the diagnosis of acute and chronic cases of HBV and HCV. In order to provide an effective diagnosis and monitoring of antiviral treatment, it is important to choose sensitive, rapid, inexpensive, and robust analytical methods. Primary diagnosis of HBV and HCV infection is made by using serological tests for detecting antigens and antibodies against these viruses. In order to confirm primary diagnosis, to quantify viral load, to determine genotypes and resistance mutants for antiviral treatment, qualitative and quantitative molecular tests are used. In this manuscript, we review the current serological and molecular methods for the diagnosis of hepatitis B and C

Genetic diversity of hepatitis B virus quasispecies in different biological compartments reveals distinct genotypes

Abstract The selection pressure imposed by the host immune system impacts hepatitis B virus (HBV) quasispecies variability. This study evaluates HBV genetic diversity in different biological fluids. Twenty paired serum, oral fluid, and DBS samples from chronic HBV carriers were analyzed using both Sanger and next generation sequencing (NGS). The mean HBV viral load in serum was 5.19 ± 4.3 log IU/mL (median 5.29, IQR 3.01–7.93). Genotype distribution was: HBV/A1 55% (11/20), A2 15% (3/20), D3 10% (2/20), F2 15% (3/20), and F4 5% (1/20). Genotype agreement between serum and oral fluid was 100% (genetic distances 0.0–0.006), while that between serum and DBS was 80% (genetic distances 0.0–0.115). Two individuals presented discordant genotypes in serum and DBS. Minor population analysis revealed a mixed population. All samples displayed mutations in polymerase and/or surface genes. Major population analysis of the polymerase pointed to positions H122 and M129 as the most polymorphic (≥ 75% variability), followed by V163 (55%) and I253 (50%). Neither Sanger nor NGS detected any antiviral primary resistance mutations in the major populations. Minor population analysis, however, demonstrated the rtM204I resistance mutation in all individuals, ranging from 2.8 to 7.5% in serum, 2.5 to 6.3% in oral fluid, and 3.6 to 7.2% in DBS. This study demonstrated that different fluids can be used to assess HBV diversity, nonetheless, genotypic differences according to biological compartments can be observed

Sobrecarga de mães com filhos diagnosticados com transtorno do espectro autista: estudo de método misto

Objetivo: Analisar a sobrecarga materna relacionada aos cuidados com filhos diagnosticados com transtorno do espectro autista.Método: Estudo de método misto, sequencial explanatório, realizado na Associação de Pais e Amigos dos Excepcionais e em grupo de WhatsApp® Messenger, com 51 mães (fase quantitativa) e seis (fase qualitativa), entre janeiro e outubro de 2019. Para coleta de dados, utilizaram-se, na fase quantitativa, de formulário de caracterização sociodemográfica, econômica e do cuidado realizado com o filho; e do instrumento Zarit Burden Interview. Na fase qualitativa, empregou-se uma entrevista semiestruturada. Realizaram-se análise descritiva, bivariada e multivariada (dados quantitativos) e análise de conteúdo de Bardin (dados qualitativos).Resultados: 64,7% das mães se sentiam sobrecarregadas, com sobrecarga leve a moderada (52,9%). Emergiram quatro categorias analíticas sobre elementos desencadeadores da sobrecarga materna.Conclusões: Urge identificação da sobrecarga materna relacionada aos cuidados de crianças com transtorno do espectro autista, durante a assistência na Atenção Primária à Saúde. Palavras-chave: Transtorno autístico. Relações mãe-filho. Cuidadores

Cross-Sectional Study to Determine the Prevalence of Hepatitis B and C Virus Infection in High Risk Groups in the Northeast Region of Brazil

Background: HBV (Hepatitis B Virus) and HCV (Hepatitis C Virus) infections are more prevalent in vulnerable populations than the general population. The objective of this study was to investigate the prevalence of HBV and HCV infection in HIV-positive patients (GI), chronic renal failure (CRF) patients (GII) and coagulation disorder individuals (GIII). Methods: A cross-sectional study was conducted from June 2014 to March 2015. Serum samples were tested for markers of hepatitis B and C by enzyme-linked immunosorbent assay (ELISA). Sociodemographic, epidemiological, clinical and laboratory data and accompanying statistical analyses were performed using Epi Info™ 7. Results: A total of 348 individuals were recruited, i.e., 154 HIV-positive, 143 CRF and 51 coagulopathy patients. Among them, more than 66% were men, and the predominant age group was 26–35 years in GI and 56–65 years in GIII. Most patients had more than 8 years of education (66.2% in GI, 60.6% in GIII and 46.1% in GII), with a family income between 100–400 dollars in more than 48% of patients. The prevalence of the HBsAg marker was 3.9%, 7% and 3.9%, total anti-HBc was 28.6%, 55.9% and 31.4%, and anti-HCV was 1.3%, 12.6% and 47% for GI, GII and GIII, respectively. However, the prevalence of anti-HBs was greater than 70% in all groups. Conclusions: This study shows a high prevalence of HBV and HCV among specific groups compared to the general population. Factors such as age, income, number of sexual partners, sexually transmitted disease burden, blood transfusion history or blood products and blood transfusions before 1994 were associated with a higher prevalence for these infections