Segurança Alimentar e Nutricional e comportamento de usuários em Unidades de Alimentação e Nutrição / Food and Nutrition Security and user behavior in Food and Nutrition Units

O estudo buscou identificar a existência de relação entre diferentes modelos de distribuição das refeições em unidades de alimentação e nutrição e comportamentos de risco de usuários. No restaurante denominado “Usuário” o comensal serve todas as preparações em seu prato; no restaurante identificado como “Manipulador” os consumidores têm toda sua refeição servida pelos manipuladores de alimentos; já no restaurante “Misto” os manipuladores e os usuários servem a refeição. O estudo foi do tipo exploratório, com utilização da técnica de observação não participante. Os responsáveis pelos restaurantes foram previamente contatados e somente foram incluídos após a autorização, concordância e assinatura do termo de consentimento.   Por meio de análise estatística foi verificado se houve diferença significativa na ocorrência dos comportamentos de risco dos usuários entre os restaurantes, utilizando a regressão de Poisson nas variáveis explicativas (tipo de serviço) e resposta (comportamentos de risco). Para analisar a significância da diferença estatística foi utilizado o teste Qui-Quadrado (p < 0,05). Apesar da ocorrência, não houve diferença estatística significativa entre os restaurantes em relação às variáveis: conversar sobre a comida, deixar a roupa tocar na comida, tossir sobre a comida e espirrar sobre a comida. No restaurante Usuário houve maior chance de ocorrer comportamentos de risco em relação aos restaurantes Manipulador e Misto.

Detection of Trypanosoma cruzi DTUs TcI and TcIV in two outbreaks of orally-transmitted Chagas disease in the Northern region of Brazi

This study describes the laboratory investigation of two acute Chagas disease outbreaks that occurred in the riverside communities of Marimarituba and Cachoeira do Arua, in the Santarem municipality, Para State, located in the Northern region of Brazil, and occurred in March 2016 and August 2017, respectively. The generation of data regarding the diversity of Trypanosoma cruzi parasites circulating in the Amazon region is key for understanding the emergence and expansion of Chagas disease. This study aimed to identify T. cruzi Discrete Typing Units (DTUs) involved in two outbreaks of acute Chagas disease (ACD) directly from the patient’s biological sample. Nested and multiplex PCR targeting the 24Sα (rRNA) and mini-exon genes, respectively, were used to identify T. cruzi DTU in blood samples from patients diagnosed with ACD. The samples with positive cPCR were submitted for analysis for T. cruzi DTUs, which included 13 samples from the patients with ACD by oral transmission and two samples collected from two newborns of two women with ACD, from Marimarituba and Cachoeira do Arua. The samples were classified as T. cruzi TcIV, from Marimarituba’s outbreak, and T. cruzi TcI, from Cachoeira do Arua’s outbreak. The molecular identification of T. cruzi may increase understanding of the role of this parasite in Chagas disease’s emergence within the Amazon region, contributing to the improvement of the management of this important, but also neglected, diseas

Suspected vertical transmission of Chagas disease caused by DTU TcIV in an infection probably transmitted orally, during anoutbreak in the Brazilian Amazo

This study describes difficulties in the monitoring of a child born during an oral outbreak of Chagas disease, in which there are several indications that the transmission occurred through the congenital route: 1. the mother was in the third trimester of pregnancy when she was infected; 2. She presented high parasitemia at the time of delivery; 3. In both, the mother and her daughter, T. cruzi was classified as DTU TcIV. The parasites were not found in the blood at birth and the infection was detected only three months later in an asymptomatic infant. As the mother and her child live in a highly endemic area, vector transmission could not be excluded during this period

Avaliação do perfil bioquímico, hematológico e imunológico em pacientes com diagnóstico recente para HIV de um Centro de Referência em Santarém, Pará, Brasil

Introdução: Alterações hematológicas, bioquímicas e imunológicas podem estar presentes no paciente infectado pelo HIV, no momento do diagnóstico, antes ou depois de iniciar com os antirretrovirais. Objetivo: Analisar o perfil bioquímico, hematológico e imunológico de pacientes com diagnóstico recente para HIV. Método: O estudo avaliou 321 prontuários de pacientes recém diagnosticados com a infecção pelo HIV. A coleta de dados envolveu informações sociodemográficas (data de nascimento, idade, sexo, escolaridade, estado civil, vínculo empregatício e procedência), clínicas (data do diagnóstico para a infecção pelo HIV, situação de imunodeficiência e tipo de exposição), bioquímicas (glicose, triglicerídeos, colesterol total e frações), hematológicas (hemoglobina e plaqueta) e imunológicas (linfócitos T CD4+ e carga viral). Os dados foram analisados por estatística descritiva e inferencial, adotando-se p<0,05. Resultados: Notou-se predominância do sexo masculino (67%), faixa etária de 18-27 anos (39,9%), solteiros (58,6%) e com 32% dos pacientes apresentando Aids. Das variáveis analisadas, o sexo masculino apresentou, em relação às mulheres, maior quantidade de hemoglobina e menores valores para contagem de linfócitos T CD4+, glicose e colesterol total (p<0,05). Além disso, ressalta-se que 69% da amostra apresentou alguma alteração lipídica, 96% tinha carga viral detectável e 29% apresentou linfócitos T CD4+ <200 cel/mm3. Conclusão: Pessoas vivendo com o HIV, no momento do diagnóstico, podem apresentar alterações imunológicas, hematológicas e bioquímicas, tornando imprescindível a avaliação, acompanhamento e orientação multiprofissional, tanto antes como posterior introdução dos antirretrovirais, a fim de evitar futuros agravos a saúde.Introduction: Hematological, biochemical, and immunological alterations may already be present in HIV-infected patients at the time of diagnosis or before, or after starting antiretroviral therapy. Objective: Analyze the biochemical, hematological, and immunological profile of patients with a recent diagnosis of HIV. Method: The study evaluated 321 medical records of patients newly diagnosed with HIV infection. Data collection involved sociodemographic (date of birth, age, gender, education, marital status, employment relationship, and origin), clinical (date of diagnosis for HIV infection, immunodeficiency status, and type of exposure), biochemical (glucose, triglycerides, total cholesterol, and fractions), hematological (hemoglobin and platelet) and immunological (CD4+ T lymphocytes and viral load) information. Data were analyzed by descriptive and inferential statistics, adopting p<0.05. Results: There was a predominance of males (67%), aged 18-27 years (39.9%), single (58.6%), and 32% of patients had AIDS. Of the variables analyzed, males presented higher amounts of hemoglobin and lower values for CD4+ T lymphocyte count, glucose, and total cholesterol in relation to females (p<0.05). In addition, it is noteworthy that 69% of the sample presented a lipid alteration, 96% had a detectable viral load, and 71% had CD4+ T lymphocytes <200 cells/mm3. Conclusion: People living with HIV, at the time of diagnosis, may present immunological, hematological, and biochemical alterations, making multidisciplinary evaluation, follow up, and guidance essential, both before and after the introduction of antiretroviral therapy, in order to avoid future health problems

HIV infection in the west region of Pará: Clinical and socioeconomic characterization

Aims: knowledge of the patient’s profile, for the evaluation and suggested behaviors, promotes a favorable outcome. Thus, the objective of the study is to analyze the socioeconomic, clinical, and immunological characteristics of patients infected by the human immunodeficiency virus in the western region of the state of Pará.Methods: were analyzed 1966 medical records of patients whose first visit to a reference center, in the municipality of Santarém-PA, was between 1998 and 2018. Socioeconomic, clinical, and immunological information was collected from patient medical records. Data were analyzed using descriptive and inferential statistics, adopting p 35 years. Immunosuppression was shown to be positively associated with men and age >35 years, as well as favoring the onset of tuberculosis, toxoplasmosis, and detectable viral load.Objetivo: o conhecimento sobre o perfil do paciente para a avaliação e as propostas de condutas colabora com um desfecho favorável. Assim, o objetivo deste estudo é analisar as características socioeconômicas, clínicas e imunológicas de pacientes infectados pelo vírus da imunodeficiência humana na região Oeste do Estado do Pará.Métodos: foram analisados 1.966 prontuários de pacientes que tiveram seu primeiro atendimento em um centro de referência, no município de Santarém (Pará), no período de 1998 a 2018. Levantaram-se informações socioeconômicas, clínicas e imunológicas nos referidos prontuários. Os dados foram analisados por estatística descritiva e inferencial, adotando-se p35 anos. A imunossupressão demonstrou estar associada positivamente aos homens e idades >35 anos, bem como, favorece a instalação da tuberculose, da toxoplasmose e da carga viral detectável

Unusual case of lagochilascariasis with breast involvement: the first case report in pregnancy

ABSTRACT Lagochilascariasis is a neglected neotropical helminthiasis, responsible for human infections through the ingestion of raw or undercooked meat from wild animals infected by larvae encysted in their tissues. It is characterized by a chronic evolution with periods of remission and recurrences, affecting mainly the head and neck regions. It can progress to death by invasion of the central nervous system. It is caused by the Lagochilascaris minor nematode, first described in 1909 and mainly found in the Brazilian Amazon ecosystem, notably in Para State. In May 2010, a 15-year-old female, born in the city of Aveiro, Para State, was hospitalized in the city of Santarem, Para State, presenting with cervical and spinal abscesses and osteolytic lesions at T3-T5 level. During hospitalization, white larvae identified as L. minor were observed in a cervical subcutaneous fistula. After the surgical drainage of abscesses, albendazole 400 mg/day was started, with improvement of symptoms. The patient abandoned the follow-up and in January 2016, during the 20th week of pregnancy, she was readmitted to the Santarem Municipal Hospital with new cervical abscesses in the infra-mammary region, with numerous larvae exiting by subcutaneous left breast fistulas. The antiparasitic treatment was restarted due to possible reactivation of the infection in the spine and dissemination to the central nervous system. Ten weeks after hospital discharge, the patient had resolution of the fistulas and decreased abscesses, without gestational complications. This is the first case report of lagochilascariasis during pregnancy, as well as of involvement of mammary glands