Mestrado em Doenças Infecciosas
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Navegando Mestrado em Doenças Infecciosas por Assunto "AIDS (Doença)"
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- ItemAnálise histopatológica e imuno-histoquímica da erupção papular prurítica associada ao vírus da imunodeficiência humana(Universidade Federal do Espírito Santo, 2012-06-22) Tozzi, Brunela Bastos; Deps, Patrícia Duarte; Oliveira, Norma Suely; Miranda, Angélica Espinosa BarbosaIntroduction: Papular pruritic eruption (PPE) is characterized by the presence of pruritic erythematous papules as chronic disease that affects oftenly seropositive patients. The lesions are seen in different stages, preferably in the trunk and extremities, and end with post inflammatory hyperpigmentation and / or scars resulting from scratching. Objectives: To evaluate the hitopathological and immunohistochemical features of the PPE. Methods: The study enrolled HIV-positive patients with clinical diagnosis of PPE carried out at University Hospital Cassiano Antonio Moraes of the Federal University of Espirito Santo in Vitória, ES. Patients were dermatological examinated and skin lesions photographed. Skin biopsies were obtained to evaluate the histopathological and immunohistochemical features. Results: Thirty-nine patients with EPP were biopsied, 17 were women and 22 men, mean age was 40.2 years ranging from 25 to 63 years. Among the histopathological biopsies, 6 patterns were found and these often: 1) dermal perivascular inflammatory infiltrate, 2) inflammatory infiltrate affecting the follicular unit; 3) interstitial inflammatory infiltrate, 4) inflammatory infiltrate in the subcutaneous tissue, 5) inflammatory infiltrate affecting at least one nerve, 6) signal of the scratching in the epidermis. About immunohistochemistry features, Langerhans cells are found in normal amounts in the epidermis and relatively increased in dermal inflammatory infiltrate. There are predominantly CD8 + T lymphocyte and macrophages in the inflammatory infiltrate compared with CD4 + T lymphocytes. No microorganisms were found using the Ziehl-Neelsen staining and Grocott. Conclusions: It was identified six patterns present in biopsy, in order to obtain a set of histopathologic and immunohistochemical to describe and characterize the PPE histopathological diagnosis. The dermal perivascular inflammatory infiltrate is essential for diagnosis, and other tissue alterations are not mandatory that may be present together or separately, at different stages of the skin lesions.
- ItemPrevalência de DST, padrão de comportamento e aspectos relacionados à saúde reprodutiva das mulheres atendidas em unidade básica de saúde em Vitória, ES(Universidade Federal do Espírito Santo, 2005-09-05) Barcelos, Mara Rejane Barroso; Vargas, Paulo Roberto Merçon de; Miranda, Angelica Espinosa Barbosa; Maciel, Ethel Leonor Noia; Passos, Mauro Romero LealIntroduction: Preventive measures and assistance for women are important for public health. The risks associated with women s health include pregnancy and higher rate of contracting STD, including AIDS. Objectives: To describe STD prevalence, behavior profile and reproductive health aspects of women attended in a basic unit of health of Vitoria Municipality, Brazil. Methods: Cross-sectional study from July 2003 to March 2004 in an area assisted by Family Health Program. The study was performed among women, 15 to 49 years old. A face-to-face interview with sociodemographic, clinical and behavioral data was performed. A blood sample was collected for HIV, HBV, HCV and syphilis tests; genital specimens were collected for Pap smear, Gram stain and culture, and a sample of urine was collected for PCR-Chlamydia tracomatis. The statistical analysis used descriptive methods and multivariate methods. This study was submitted and approved by Ethics committee from Federal University of Espírito Santo State. Results: During the study, 300 women were included. Median age was 30.0 (interquartile range (IQR) 24; 38) years old; mean age of the first intercourse was 17.3 (SD 3.6) years and mean age of first pregnancy was 19.2 (SD 3.9) years. About 70% of them had up to 8 years of education; 5.0% reported previous STD; 8.0% illicit drug use and 11.0% rape. Only 23.7% reported consistent condom use. Clinical problems reported: genital ulcer (3.0%); dysuria (7.7%); vaginal discharge (46.6%); itching (20.0%) and pelvic pain (18,0%). Previous HIV test was reported by 46.3% and 15.3% had never been submitted of Pap smear. The prevalence of infections were: Chlamydia tracomatis was 7.4%; gonorrhea 2.0%; trichomoniasis 2.0%; vaginosis 21.3%; candidiasis 9.3%; HPV-related cytological changes 3.3%; syphilis 3.0%; HIV 0.3%; HBV 0.7% and HCV 1.7%. Conclusions: Women are vulnerable population related to sexuality. They do not feel themselves at risk for STD and they do not protect themselves. These results found high frequency of STD and show the needs for prevention measures, including, among others, screening for STD and programs of risk reduction.
- ItemStrongyloides stercoralis e infecção pelo HIV : prevalência em pacientes HIV positivos em Vitória, Espírito Santo e revisão sistemática dos casos de estrongiloidíase grave em pacientes com HIV/AIDS(Universidade Federal do Espírito Santo, 2011-08-12) Gonçalves, Flávio Lofêgo; Pereira, Fausto Edmundo Lima; Dietze, Reynaldo; Ferreira, Marcelo SimãoIntroduction. Data on prevalence of Strongyloides stercoralis in HIV-infected patients are conflicting, both in Brazil and other countries. Despite the profound immunodeficiency, disseminated strongyloidiasis occurs incidentally in patients with HIV/AIDS, but the factors that trigger it are not known. Objectives (a) To search the prevalence of S. stercoralis in HIV-positive patients treated at Hospital CA Moraes in the period 2009-2011 and to compare with the prevalence in samples of the HIV negative patients at the same Hospital; (b) To investigate factors that may be associated with prevalence of Strongyloides, especially the excessive use of ethanol; (c) To review AIDS deaths in the Espírito Santo State between 1996 and 2010, to identify Strongyloides-related deaths; (d) To review the published cases of disseminated strongyloidiasis in AIDS patients, published since the beginning of the epidemic. Methods. Examination of stools, by the method of spontaneous sedimentation in the routine laboratory of the Hospital. Research habits and living conditions (use of footwear, type of occupation, use of treated water and sewerage and excessive use of ethanol (> 80 g / day of ethanol). Revision of deaths certificates between 1996 and 2010, to identify AIDS deaths and deaths related to Strongyloides. A systematic review of all cases of severe strongyloidiasis in AIDS patients, published in journals indexed in Pubmed, was performed. Results. The prevalence of S. stercoralis in 167 HIVpositive patients (13/167; 7,78%, 95% CI 3,7 to 11,7) did not differ significantly from the prevalence in a sample of HIV-negative patients at the same hospital, during the same period (9/220, 4.1%, 95% CI 1,5 to 6,8). In HIV-positive patients, alcoholics, the prevalence was significantly higher than in HIV positive non-alcoholics (respectively, 7/42, 16% and 6/123, 4,8%, p = 0.044) and than in a sample of non-alcoholics, HIV negative patients, at the same hospital (respectively 7/42, 16% and 26/491, 5.3% p = 0.010). The analysis of AIDS deaths revealed no deaths associated with Strongyloides among deaths occurred from 1996 to 2010 in the Espírito Santo State. Beyond severe immunodeficiency, the systematic review of published cases does not identify other frequent associated factors that would be associated with the spread of the parasite, explaining it in most cases. Conclusion: The prevalence of Strongyloides is similar in HIV positive and HIV negative patients at the same Hospital, but is significantly higher when chronic alcoholism is present. In the systematic review of published cases of Strongyloides hyperinfection or dissemination, beyond the immunodeficiency, no factor was reported in many cases, that would explain the dissemination of the parasite.