Simone Cristina Castanho Sabaini de Melo

Alterações citopatológicas e fatores de risco para a ocorrência do câncer de colo uterino

The aim of the present study was to verify the occurrence of citopathological alterations and risk factors of Uterine Cervical Neoplasm in women attended by SUS--the Public Healthcare System--in a district situated in the North of Paraná State, Brazil from 2001 to 2006. It was a descriptive transversal observational study. The data collection consisted in collection of test results from medical records and interviews. It was achieved 6.356 tests and, 1.02% (65) of the women examined presented alterations. From the tests made 4.869 (70,8%) were from women aged between 25 and 59 years. And 38,5% of the tests presented Cervical Intraepithelial Neoplasm (CIN) I, 32,3% CIN II, 18,5% CIN I and Human Papiloma Virus (HPV). It was interviewed 25 women from the total sample. Most of them presented a risk factor as: smoking habits, sexually transmitted diseases, use of hormonal contraceptive, number of sexual partners, early sexual intercourse. This study concludes that is required educative and more effective actions in order to reduce the alterations, meanly among teenagers.O objetivo deste estudo foi verificar as alteracoes nos resultados dos exames de Papanicolau, e levantar os fatores de risco das usuarias do Sistema Unico de Saude do municipio de Bandeirantes, Parana, no periodo de 2001 a 2006. A coleta de dados consistiu de tres etapas: obtencao dos resultados dos exames nos livros de registro, verificacao dos prontuarios e entrevistas. Foram realizados 6.356 exames e 1,02% (65) das mulheres apresentaram alteracoes, sendo 38,5% referentes a NIC I. A maioria delas (70,8%) tinha idade entre 25 a 59 anos, nao eram tabagistas (52%), faziam uso de anticoncepcional (76%) e haviam iniciado a vida sexual antes dos 19 anos (80%). As equipes de saude precisam desenvolver acoes educativas mais efetivas, visto que o conhecimento e uma das estrategias para a promocao a saude.

Dispersal and Memory of Sand Flies in an Endemic Area of Cutaneous Leishmaniasis, Southern Brazil

ABSTRACT The dispersal of and the existence of memory in sand flies were measured in a transmission area of cutaneous leishmaniasis, in the municipality of Bandeirantes, Paraná, Brazil. Sand flies were caught in a rural area, with Shannon trap installed in the forest and three Falcão traps installed in a human-inhabited environment (HIE) and three others in an impacted environment presently uninhabited by humans (EUH), from 1800 to 0600 hours. The captured sand flies were marked with yellow, blue, or red fluorescent powder, according to the environments where they were captured. All marked sand flies were released at 0700 hours at a point between the three environments. The recaptures were made with 28 Falcâo traps, distributed in the environments from for 10 consecutive days. The sand flies recaptured were examined under a stereomicroscope and later identified. It was concluded that sand flies are able to disperse over an average distance of 73 m, reaching 130 m in 24 h, showing that: 1) the sand flies were attracted with different intensities to each environment, and the ability to move among different environments allows the existence of enzootic cycle of Leishmania; 2) the sand flies possess a spatial memory, olfactory memory, or both, that enable them to return to the environment where they were captured initially, although the distances were different.

Coronary disease risk assessment in men: Comparison between ASCVD Risk versus Framingham☆☆☆

INTRODUCTION This study evaluated the risk of men developing coronary heart disease and its determinant variables, comparing these results through two validated coronary risk scales. METHODS A cross sectional epidemiological analytical study in which data were collected by spontaneous demand, through a semi-structured questionnaire, clinical examination, and blood collection. The Chi-square test, logistic regression and Kappa for statistical analysis were performed. RESULTS The study included 637 men. Age was a determining factor (p<0.05) in blood pressure (BP) changes, central obesity, BMI, glycemia, total cholesterol, LDL and triglycerides. From this group of 637, 252 presented BP above the recommended values. It was found that 34.54% of men had high total cholesterol, 19.94% had high LDL, 46.78% presented HDL below normal values and 36.42% had elevated triglycerides. Metabolic syndrome was found in 24.96% of the men. With the Framingham scale, 637 men were evaluated, 12.56% were at intermediate-risk and 5.49% elevated risk, while on the ASCVD Risk scale 553 men were evaluated, and 7.05% had moderate risk and none had high coronary risk. In this study, 50.43% of men still had no previous diagnosis for any disease that increases the risk factors. CONCLUSIONS The determinant clinical variables were age, blood pressure, smoking, central obesity, race and education. The Framingham scale allowed the assessment of cardiac risk of all men in the study, with no age restriction or cholesterol value, so in population studies it shows advantages over the ASCVD Risk due to its comprehensive feature of including all individuals.

PHLEBOTOMINE SANDFLIES IN RURAL LOCATIONS IN THE STATE OF PARANA, SOUTHERN BRAZIL

SUMMARY This study reports the fauna and frequency of sandflies in domestic animal shelters, residences and other ecotopes in rural areas of the municipality of Bandeirantes, Paraná State. Sandflies were collected twice in eight rural villages by using Falcon traps from 8pm to 6am in 2008. In these localities 4,790 sandflies were collected, which were represented by ten sandfly species, prevailing of Nyssomyia neivai and Nyssomyia whitmani species. It was observed that animal shelters are the domestic ecotopes where there is the greatest frequency of these insects. The localities where the collections were made had the environmental characteristics that allow the persistence of transmission of parasites from the American tegumentary leishmaniasis. Although the fauna and the behavior of sandflies species are similar in different localities, the method of controlling these insects should be adjusted to the environmental characteristics of each one of the most diverse endemic areas of American tegumentary leishmaniasis in the municipalities of Paraná State.

Performance of Hitchens-Pike-Todd-Hewitt medium for group B streptococcus screening in pregnant women.

Group B streptococcus (GBS), which commonly colonizes the female genital tract and rectum, can cause infections in newborns with varying severity, possibly leading to death. The aim of the present study was to evaluate Hitchens-Pike-Todd-Hewitt (HPTH) medium performance for GBS screening in pregnant women. A descriptive analytical cross-sectional study was performed with 556 pregnant women, of which 496 were at 35-37 weeks of gestation and 60 were at ≥ 38 weeks of gestation. The study was conducted from September 2011 to March 2014 in northern Paraná, Brazil. Vaginal and anorectal clinical specimens from each pregnant woman were plated on sheep blood agar (SBA) and seeded on HPTH medium and Todd-Hewitt enrichment broth. Of the 496 pregnant women at 35-37 weeks of gestation, 141 (28.4%) were positive for GBS, based on the combination of the three culture media and clinical specimens. The GBS colonization rates that were detected by each medium were 22.2% for HPTH medium, 21.2% for SBA, and 13.1% for Todd-Hewitt enrichment broth. Of the 60 pregnant women at ≥ 38 weeks of gestation, seven (11.7%) were positive for GBS. These results demonstrate that HPTH medium and SBA were more sensitive than Todd-Hewitt enrichment broth for GBS screening in pregnant women and good GBS recovery in culture, indicating that the two media should be used together for vaginal and anorectal specimens.

Flebotomíneos de localidades rurais no noroeste do Estado do Paraná, Brasil

This study reports the results from sandfly captures at six sites in a rural area of Japurá, Paraná State, Brazil, showing the vectors presence indoors, outdoors, and in residual forest. Sandfly captures were performed with Falcão traps from 8:00 AM to 3:00 PM. At sites 195, 223, 236, and 527, three captures were performed at different times from December 2007 to January 2009. At sites 175 and 218, captures were performed from January to December 2008. 8,453 sandflies were captured, with an average of 155.40 specimens per hour. Nyssomyia neivai was the predominant species. Most sandflies were captured in domestic animal shelters (75.91 per hour) and in ciliary forest (38.45 per hour) during the hottest and rainiest months, in the outdoor environment with accumulation of organic matter and inadequate disposal of household wastewater. The study emphasizes the need for regular outdoor cleaning around households and building domestic animal shelters far from residences.

ANTIMICROBIAL SUSCEPTIBILITY OF Streptococcus agalactiae ISOLATED FROM PREGNANT WOMEN

SUMMARY Introduction: Group B streptococcus (GBS) or Streptococcus agalactiae can colonize the gastrointestinal and genitourinary tracts and has been considered one of the most important risk factors for the development of neonatal disease. The present study evaluated the antimicrobial susceptibility of GBS isolates from pregnant women who were attended at a public health service in Northern Paraná, Brazil. Methods: A descriptive analytical cross-sectional study was performed with 544 pregnant women, at ≥ 35 weeks of gestation. One hundred and thirty-six GBS isolates from pregnant women were tested for antimicrobial susceptibility. Results: All of the GBS isolates showed susceptibility to the drug that is most frequently used for intrapartum prophylaxis: penicillin. Resistance to clindamycin and erythromycin was detected, thus decreasing the options of prophylaxis in women who are allergic to penicillin. Conclusions: Additional studies should be conducted to increase the knowledge of GBS sensitivity profile to antimicrobials in other health centers.

Seventeen years of American cutaneous leishmaniasis in a Southern Brazilian municipality

We reviewed the records of 151 patients diagnosed with American cutaneous leishmaniasis (ACL) from 1993 to 2009 in the municipality of Japura, Paraná, Brazil. Gender, age, occupation, place of residence, location of lesions, type and number of lesions were analyzed. The prevalence rate of ACL was 11.5/10,000 hab, of which 84.7% were male, 58.3% lived in rural area and 49.0% were farmers. The most frequent age group was between 30 to 39 years (26.6%). Skin lesions occurred in 92.7% of the patients with predominance in the lower limbs (23.9%) and 49.1% of the records did not include the number of lesions location due to incomplete filling. A single ulceration was present in 44.4%. Japurá is an endemic area for ACL, requiring public actions and preventive education.

Alteraciones citopatológicas y factores de riesgo para la ocurrencia del cáncer de cuello de útero

The aim of the present study was to verify the occurrence of citopathological alterations and risk factors of Uterine Cervical Neoplasm in women attended by SUS--the Public Healthcare System--in a district situated in the North of Paraná State, Brazil from 2001 to 2006. It was a descriptive transversal observational study. The data collection consisted in collection of test results from medical records and interviews. It was achieved 6.356 tests and, 1.02% (65) of the women examined presented alterations. From the tests made 4.869 (70,8%) were from women aged between 25 and 59 years. And 38,5% of the tests presented Cervical Intraepithelial Neoplasm (CIN) I, 32,3% CIN II, 18,5% CIN I and Human Papiloma Virus (HPV). It was interviewed 25 women from the total sample. Most of them presented a risk factor as: smoking habits, sexually transmitted diseases, use of hormonal contraceptive, number of sexual partners, early sexual intercourse. This study concludes that is required educative and more effective actions in order to reduce the alterations, meanly among teenagers.O objetivo deste estudo foi verificar as alteracoes nos resultados dos exames de Papanicolau, e levantar os fatores de risco das usuarias do Sistema Unico de Saude do municipio de Bandeirantes, Parana, no periodo de 2001 a 2006. A coleta de dados consistiu de tres etapas: obtencao dos resultados dos exames nos livros de registro, verificacao dos prontuarios e entrevistas. Foram realizados 6.356 exames e 1,02% (65) das mulheres apresentaram alteracoes, sendo 38,5% referentes a NIC I. A maioria delas (70,8%) tinha idade entre 25 a 59 anos, nao eram tabagistas (52%), faziam uso de anticoncepcional (76%) e haviam iniciado a vida sexual antes dos 19 anos (80%). As equipes de saude precisam desenvolver acoes educativas mais efetivas, visto que o conhecimento e uma das estrategias para a promocao a saude.