Eliana Setti Albuquerque Aguiar

Paracoccidioidomicose: estudo clínico e epidemiológico de 422 casos observados no Estado de Mato Grosso do Sul

Clinical and epidemiological features of 422 cases of paracoccidioidomycosis attended at University Hospital of Universidade Federal de Mato Grosso do Sul (Campo Grande, Mato Grosso do Sul, Brazil) from January 1980 to August 1999, were analysed. The mean age was 43.4 years old and the male: female ratio was 10:1. Nearly half (45.5%) of the patients were agricultural workers at the moment of diagnosis. In the acute/subacute form (juvenile type) the phagocytic-monocytic system was very much impaired and mainly marked by lymphadenopathy (95.4%), hepatomegaly (40%), splenomegaly (23.1%). The chronic form (adult type) presents more lesions in oropharynx (66.4%), dysphonia (31.4%) and cough (50.7%). Mycological diagnosis was obtained by direct microscopy of wet mounts in 185/365 (50.7%) patients and by histopathological examination of biopsies in 294/302 (97.3%) patients. The treatment of choice was Sulfamethoxazole/ trimethoprim (Co-trimoxazole), used in 90.3% patients. Sequelae occurred in 30.3% and death in 7.6% of the cases.

Prevalence of antibodies to hepatitis B core antigen in blood donors in the middle west region of Brazil

The prevalence of antibodies to hepatitis B core antigen in 552 prime blood donors was of 9.4%. The majority (71.2%) has antibodies to hepatitis B surface antigen. The hepatitis B surface antigen was present in 0.7%, all of them antibodies to hepatitis B core antigen positive.

Prevalência da infecção tuberculosa entre profissionais de um hospital universitário

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yatess correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.Varios estudios han demostrado la gran existencia tanto de la infeccion tuberculosis como de la propiaenfermedad, entre profesionales de salud. Este estudio realizado en un Hospital Universitario, ubicado en laciudad de Campo Grande-MS tuvo como objetivo conocer la existencia de la infeccion causada por elMycobacterium tuberculosis. En el analisis de 194 personas, fue encontrada la existencia de la prueba tuberculinilladel 38,7%. Fue observada una asociacion con el tabaquismo (p 0,01, y RP 1,72 (1,20-2,45) corregido porYates). Concluimos que es necesario un programa de seleccion tuberculinilla de rutina para acompanar latriaje tuberculinica, junto a intervenciones para reducir el riesgo de transmision nosocomial.DESCRIPTORES: prueba de tuberculina; prevalencia; personal de salud; epidemiologia

Prevalence of mycobacterium tuberculosis among professionals in a university hospital, Mato Grosso do Sul, 2004

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yatess correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.Varios estudios han demostrado la gran existencia tanto de la infeccion tuberculosis como de la propiaenfermedad, entre profesionales de salud. Este estudio realizado en un Hospital Universitario, ubicado en laciudad de Campo Grande-MS tuvo como objetivo conocer la existencia de la infeccion causada por elMycobacterium tuberculosis. En el analisis de 194 personas, fue encontrada la existencia de la prueba tuberculinilladel 38,7%. Fue observada una asociacion con el tabaquismo (p 0,01, y RP 1,72 (1,20-2,45) corregido porYates). Concluimos que es necesario un programa de seleccion tuberculinilla de rutina para acompanar latriaje tuberculinica, junto a intervenciones para reducir el riesgo de transmision nosocomial.DESCRIPTORES: prueba de tuberculina; prevalencia; personal de salud; epidemiologia

Low prevalence of hepatitis B and C markers in a Non-Amazonian indigenous population

In Brazil, there is a high prevalence of markers ofinfection with the hepatitis B virus among groups livingin the Western Amazon. Neighboring countries andindigenous peoples should also be included in thatcontext [1-6].There are virtually no data available on theprevalence of viral hepatitis markers among indigenousgroups living outside the Amazon region or aboutparenterally transmitted hepatitis.Figueiredo et al. [7] reported the prevalence of HBVand HCV markers among the native Xacriaba peopleliving in the northern part of the State of Minas Gerais;they found 0.5%, 2.9%, 62.5, and 0.5% for HBsAg,anti-HBc, anti-HBs and anti-HCV, respectively. Thisgroup is just as acculturated as the Terena and has along history of contact with modern Brazilian society.To assess this situation, a sero-epidemiological studywas conducted in August 1999, involving 312Amerindians from the Buriti, Corrego do Meio andAgua Azul reservations, located in the municipalities ofSidrolândia and Dois Irmaos do Buriti, 100km fromCampo Grande, the state capital of Mato Grosso doSul (Brazil). The samples were randomly selected, andfamily groups were included.This study included all age groups, from childrenunder 1 year to individuals older than 65. Each agegroup was stratified according to gender (Table 1).The material was collected, centrifuged, andseparated into varying aliquots. Tests for anti-HBc, antiHBs and anti-HCV markers were conducted at theOswaldo Cruz Foundation (Fiocruz-RJ) National ViralHepatitis Center. There were small differences in thenumber of tests for each marker due to limitations inthe quantity of material.None of the samples were positive for HBsAg oranti-HCV. Anti-HBc gave positive results in 2.2% ofthe samples and anti-HBs in 13.6%. The highpercentage found for anti-HBs positivity could be aresult of immunity that was artificially acquired throughvaccination.We found very low positivity rates for the abovemarkers in this population. There are discrepanciesbetween our data and findings previously reported forthe same region. Aguiar et al. [8] found prevalencerates of 0.7%, 9.4% and 2.5% for HBsAg, anti-HBcand anti-HCV, respectively among first-time donors inCampo Grande. In a study of people of African descentliving 65 km from Campo Grande and 40 km from themunicipality of Jaraguari (Mato Grosso do Sul), Castro[9] found rates of 9% and 43% for HBsAg and anti-HBc, respectively.These variations in prevalence need to be betterexplained; it may be necessary to use an approachinvolving other components. Authors such as Brabinet al. [10], Passos et al. [11], and Coimbra et al. [12]have suggested that other variables can influence HBVprevalence rates, which would mean that a simpleepidemiological model of this disease is not realistic.It is sometimes necessary to take into accountpecularities of certain population groups in whichdifferent values, norms and cultural standards may beinvolved in health/illness processes [13].

Efeito booster na prova tuberculínica em um hospital universitário de Mato Grosso do Sul

A triagem tuberculinica tem por objetivo realizar o rastreio da infeccao tuberculosa. Uma retestagem em uma a tres semanas tem sido recomendada quando a prova tuberculinica for 10 mm com aumento de pelo menos 6 mm em relacao a primeira dose, tem-se, entao, o efeito booster. Este estudo teve como sujeitos os profissionais de saude de um hospital universitario e foi realizado na cidade de Campo Grande-MS com o objetivo de estimar a taxa de efeito booster. Dentre os 194 participantes, 65 (33,5%) foram reatores fortes ao PPD na primeira testagem e 129 foram reatores fracos ou nao-reatores. Estes foram submetidos a uma segunda testagem, na qual, em 10 (7,8%) observou-se o efeito booster. A prevalencia da infeccao tuberculosa, avaliada em dois tempos, foi de 38,7%. Conclui-se que identificar o efeito booster na triagem tuberculinica e importante sob pena de obter-se taxas subestimadas de infeccao tuberculosa. Util tambem no acompanhamento da infeccao recente e na avaliacao segura da viragem tuberculinica, reduzindo a probabilidade de falsos negativos, que de outra forma seriam erroneamente interpretados como profissionais recem-infectados.

Leiomioma intrabrônquico: relato de um caso com sete anos de evolução

Os autores relatam caso raro de tumor pulmonar benigno, o LEIOMIOMA INTRABRONQUICO, em paciente masculino de 33 anos de idade. O diagnostico foi realizado por broncoscopia com biopsia do tumor, que apresentou intensa proliferacao de celulas musculares lisas. A escolha terapeutica, apos sete anos de evolucao do tumor, foi a pneumectomia.

Existencia de la infección tuberculosis entre profesionales de un hospital universitario en Mato Grosso do Sur, 2004

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yatess correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.Varios estudios han demostrado la gran existencia tanto de la infeccion tuberculosis como de la propiaenfermedad, entre profesionales de salud. Este estudio realizado en un Hospital Universitario, ubicado en laciudad de Campo Grande-MS tuvo como objetivo conocer la existencia de la infeccion causada por elMycobacterium tuberculosis. En el analisis de 194 personas, fue encontrada la existencia de la prueba tuberculinilladel 38,7%. Fue observada una asociacion con el tabaquismo (p 0,01, y RP 1,72 (1,20-2,45) corregido porYates). Concluimos que es necesario un programa de seleccion tuberculinilla de rutina para acompanar latriaje tuberculinica, junto a intervenciones para reducir el riesgo de transmision nosocomial.DESCRIPTORES: prueba de tuberculina; prevalencia; personal de salud; epidemiologia