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Endemic and opportunistic infections in Brazilian solid organ transplant recipients

BATISTA, M. V.; PIERROTTI, L. C.; ABDALA, E.; CLEMENTE, W. T.; GIRAO, E. S.; ROSA, D. R. T.; IANHEZ, L. E.; BONAZZI, P. R.; LIMA, A. S.; FERNANDES, P. F. C. B. C.; PADUA-NETO, M. V.; BACCHELLA, T.; OLIVEIRA, A. P. P.; VIANA, C. F. G.; FERREIRA, M. S.; SHI
Fonte: WILEY-BLACKWELL Publicador: WILEY-BLACKWELL
Tipo: Artigo de Revista Científica
ENG
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OBJECTIVE To evaluate the frequency and clinical features of endemic and other opportunistic infections in liver or kidney transplant recipients in four transplant centres in different geographical areas of Brazil. METHODS Retrospective analysis of medical and laboratory records of four transplant centres on endemic and other opportunistic infections in liver or kidney transplant recipients. Analyses were performed with spss statistical software. RESULTS From 2001 to 2006, 1046 kidney and 708 liver transplants were registered in all centres. The average age was 42 years. Among 82 (4.7%) cases with infections, the most frequent was tuberculosis (2.0%), followed by systemic protozoal infections (0.7%), toxoplasmosis (0.4%) and visceral leishmaniasis (0.3%). Systemic fungal infections occurred in 0.6%, of which 0.4% were cryptococcosis and 0.2% were histoplasmosis. Dengue was the only systemic viral infection and was registered in two cases (0.1%), of which one was classified as the classic form and the other as dengue haemorrhagic fever. Nocardiosis was described in one case (0.05%). The infectious agents most frequently associated with diarrhoea were Blastocystis sp., Schistosoma mansoni and Strongyloides stercoralis. CONCLUSIONS Opportunistic Infections in transplant patients have a wide spectrum and may vary from asymptomatic to severe infections with high mortality. A better understanding of the epidemiology of endemic pathogens and clinical manifestations can contribute to the establishment of an early diagnosis as well as correct treatment aimed at decreasing morbidity and mortality.

False-positive results of a rapid K39-based strip test and Chagas disease

NETO, Vicente Amato; AMATO, Valdir Sabbaga; TUON, Felipe Francisco; GAKIYA, Erika; MARCHI, Claudia Regina de; SOUZA, Regina Maia de; FURUCHO, Celia Regina
Fonte: ELSEVIER SCI LTD Publicador: ELSEVIER SCI LTD
Tipo: Artigo de Revista Científica
ENG
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Background: The definitive diagnosis of visceral. leishmaniasis (VL) requires invasive procedures with demonstration of amastigotes in tissue or promastigotes in culture. Unfortunately, these approaches require laboratory materials not available in poor countries where the disease is endemic. The correct diagnosis of VL is important, and made more difficult by the fact that several common tropical diseases such as malaria, disseminated tuberculosis, and enteric fever share the same clinical presentation. Serological tests have been developed to replace parasitological diagnosis in the field. A commercially available K39-based strip test for VL has been developed for this purpose. The endemic area of leishmaniasis in Brazil overlaps the endemic area of Chagas disease, a disease that can cause false-positive serological test results. The aim of this study was to evaluate the incidence of false-positive exams using a rapid test for VL in patients with Chagas disease. Methods: A rapid test based on the recombinant K39 antigen of Leishmania was used in: (1) 30 patients with confirmed Chagas disease, (2) 30 patients with a serological diagnosis of Chagas disease by ELISA, indirect immunofluorescence, indirect hemagglutination, and chemiluminescence...

Avaliação da imunorreatividade contra desmogleína 1 e Trypanosoma cruzi em população de área endêmica para pênfigo foliáceo; Evaluation of immunoreactivity against desmoglein 1 and Trypanosoma cruzi in population from endemic area for pemphigus foliaceus

Sousa Júnior, Joaquim Xavier de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 06/09/2012 PT
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Introdução: O pênfigo foliáceo endêmico (PFE) ou Fogo Selvagem (FS) é uma dermatose bolhosa autoimune com auto-anticorpos IgG patogênicos, principalmente da subclasse IgG4, direcionados contra epítopos da desmogleína 1 (Dsg1), uma glicoproteína desmossômica que desempenha papel na adesão celular da epiderme. Os auto-anticorpos ligam-se a domínios específicos da Dsg1, gerando acantólise (perda da adesão celular) através de mecanismos diversos, tais como sinalização intracelular de moléculas e impedimento estérico. A etiopatogenia do FS é multifatorial, apresentando interações entre fatores imunológicos, genéticos e ambientais. Em algumas regiões do Brasil, detectou-se alta prevalência de FS (3%), sugerindo importante participação de fatores ambientais como desencadeantes da resposta autoimune. Indivíduos saudáveis de áreas endêmicas de FS reconhecem epítopos não-patogênicos da Dsg1, e exposição a insetos hematófagos é um fator de risco para FS. FS e doença de Chagas compartilham algumas regiões geográficas, e anticorpos anti- Dsg1 foram detectados em doentes de Chagas. Na reserva indígena Terena (Limão Verde), onde a prevalência de FS é alta, a população está exposta a picadas de simulídeos...

Condicionantes sociais na delimitação de espaços endêmicos de hanseníase; Social conditions in the delimitation of areas endemic for leprosy

Souza, Luis Roberto de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 21/09/2012 PT
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INTRODUÇÃO: A hanseníase é uma doença infecciosa crônica granulomatosa, cujo agente etiológico é uma bactéria de vida intracelular obrigatória, o Mycobacterium leprae, que tem no homem seu principal reservatório. A doença possui distribuição universal, predominando atualmente, em latitudes tropicais e tem sido enquadrada entre as enfermidades negligenciadas, atingindo desproporcionalmente populações pobres e marginalizadas. O bacilo é altamente contagioso, de baixa patogenicidade e acomete primordialmente pele e nervos, com grande potencial incapacitante. A doença grassou no Velho Mundo durante a Idade Média e praticamente desapareceu da Europa ainda no início do século XX, antes que qualquer recurso terapêutico eficaz estivesse disponível. Introduzida com os primeiros colonizadores europeus, a hanseníase é doença endêmica no Brasil e um problema de saúde pública. A hanseníase é hiperendêmica em muitos municípios, notadamente nos estados das regiões Norte e Centro-Oeste, que abrangem biomas de cerrado, pântano e floresta amazônica, em vastas áreas de baixa densidade demográfica; estas áreas vêm sofrendo enorme pressão antrópica relacionada ao incremento de atividades agropecuárias e extrativistas...

Diagnostico molecular de doença de Chagas em pacientes soronegativos portadores de megaesofago; Molecular diagnosis of Chagas disease in seronegative patients with megaesophagus

Angelica Martins Batista
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 07/08/2009 PT
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A doença de Chagas, cujo agente etiológico é o protozoário Trypanosoma cruzi, completa 100 anos de descoberta. Apesar da implementação de programas visando ao controle da transmissão vetorial, a infecção chagásica segue como um importante problema de saúde pública na América Latina. A globalização da doença de Chagas, consequente à migração de pessoas infectadas para países onde a doença não é endêmica, traz à tona a necessidade de instituição de medidas de controle e vigilância em algumas áreas da Europa e da América do Norte. A patologia caracteriza-se por uma fase aguda geralmente assintomática com elevada parasitemia e uma fase crônica, em que os parasitos dificilmente são detectados no sangue periférico por métodos parasitológicos convencionais. O curso clínico da infecção por T. cruzi é variável, sendo que boa parte dos infectados permanece na formaindeterminada da doença enquanto outros desenvolvem a forma cardíaca, digestiva ou nervosa. A prevalência do comprometimento do trato digestivo na doença de Chagas varia conforme a área endêmica, podendo alcançar até 14% no Brasil central. A forma digestiva caracteriza-se por lesão dos plexos nervosos intramurais e disfunção motora principalmente do esôfago e do cólon...

Epidemiology and Anthropology: an integrated approach dealing with bio-socio-cultural aspects as strategy for the control of endemic diseases

Barbosa,Constança Simões
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/1998 EN
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The control of endemic diseases has not attained the desired level of effectiveness in spite of the use of modern efficient thecnologies. The classic interventionist approach for the control of schistosomiasis is centered on systemic control of the snail hosts combined to large scale medical treatment and is usually carried out without social preocupation due to the assisted communities. It is easy to understand the interest and the ethical compromise of public health research while producing studies in which the biological and social determinants as well as the cultural components should be considered and also encompass the historical dimensions and symbolic representations. In face of the recent political decision in favor of decentralizations of health administration to municipal level, we suggest, in the present paper, an integrated approach for the epidemiological diagnosis of an endemic situation at local level. Theoretical and methodological aspects from both, epidemiology and anthropology are discussed. Epidemiological methods can be used to detect the dependent variables (those related to the human infection) and the independent variables (demographic, economic, sanitary and social). Another methodological approach of anthropological /etnographic nature can be conducted in order to make an articulation of the knowledge on the various dimensions or determinant levels of the disease. Mutual comprehension...

Chagas disease: control, elimination and eradication. Is it possible?

Coura,Jose Rodrigues
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
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From an epidemiological point of view, Chagas disease and its reservoirs and vectors can present the following characteristics: (i) enzooty, maintained by wild animals and vectors, with broad occurrence from southern United States of America (USA) to southern Argentina and Chile (42ºN 49ºS), (ii) anthropozoonosis, when man invades the wild ecotope and becomes infected with Trypanosoma cruzi from wild animals or vectors or when the vectors and wild animals, especially marsupials, invade the human domicile and infect man, (iii) zoonosis-amphixenosis and exchanged infection between animals and humans by domestic vectors in endemic areas and (iv) zooanthroponosis, infection that is transmitted from man to animals, by means of domestic vectors, which is the rarest situation in areas endemic for Chagas disease. The characteristics of Chagas disease as an enzooty of wild animals and as an anthropozoonosis are seen most frequently in the Brazilian Amazon and in the Pan-Amazon region as a whole, where there are 33 species of six genera of wild animals: Marsupialia, Chiroptera, Rodentia, Edentata (Xenarthra), Carnivora and Primata and 27 species of triatomines, most of which infected with T. cruzi . These conditions place the resident populations of this area or its visitors - tourists...

Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries

Coura,José Rodrigues; Viñas,Pedro Albajar; Junqueira,Angela CV
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2014 EN
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Chagas disease is maintained in nature through the interchange of three cycles: the wild, peridomestic and domestic cycles. The wild cycle, which is enzootic, has existed for millions of years maintained between triatomines and wild mammals. Human infection was only detected in mummies from 4,000-9,000 years ago, before the discovery of the disease by Carlos Chagas in 1909. With the beginning of deforestation in the Americas, two-three centuries ago for the expansion of agriculture and livestock rearing, wild mammals, which had been the food source for triatomines, were removed and new food sources started to appear in peridomestic areas: chicken coops, corrals and pigsties. Some accidental human cases could also have occurred prior to the triatomines in peridomestic areas. Thus, triatomines progressively penetrated households and formed the domestic cycle of Chagas disease. A new epidemiological, economic and social problem has been created through the globalisation of Chagas disease, due to legal and illegal migration of individuals infected by Trypanosoma cruzi or presenting Chagas disease in its varied clinical forms, from endemic countries in Latin America to non-endemic countries in North America, Europe, Asia and Oceania, particularly to the United States of America and Spain. The main objective of the present paper was to present a general view of the interchanges between the wild...

The main sceneries of Chagas disease transmission. The vectors, blood and oral transmissions - A comprehensive review

Coura,José Rodrigues
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2015 EN
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This review deals with transmission of Trypanosoma cruzi by the most important domestic vectors, blood transfusion and oral intake. Among the vectors, Triatoma infestans, Panstrongylus megistus, Rhodnius prolixus, Triatoma dimidiata, Triatoma brasiliensis, Triatoma pseudomaculata, Triatoma sordida, Triatoma maculata, Panstrongylus geniculatus, Rhodnius ecuadoriensis and Rhodnius pallescens can be highlighted. Transmission of Chagas infection, which has been brought under control in some countries in South and Central America, remains a great challenge, particularly considering that many endemic countries do not have control over blood donors. Even more concerning is the case of non-endemic countries that receive thousands of migrants from endemic areas that carry Chagas disease, such as the United States of America, in North America, Spain, in Europe, Japan, in Asia, and Australia, in Oceania. In the Brazilian Amazon Region, since Shaw et al. (1969) described the first acute cases of the disease caused by oral transmission, hundreds of acute cases of the disease due to oral transmission have been described in that region, which is today considered to be endemic for oral transmission. Several other outbreaks of acute Chagas disease by oral transmission have been described in different states of Brazil and in other South American countries.

An Endemic Disease Survey of Bong County, Liberia

Grigsby, Margaret E.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1982 EN
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An endemic disease survey was carried out in Bong County, Liberia by a health survey team of the American Public Health Association in 1977. The results of the survey and recommendations for control and/or elimination of the various diseases are presented.

Malaria: a reemerging disease in Africa.

Nchinda, T. C.
Fonte: Centers for Disease Control Publicador: Centers for Disease Control
Tipo: Artigo de Revista Científica
Publicado em //1998 EN
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A recent upsurge of malaria in endemic-disease areas with explosive epidemics in many parts of Africa is probably caused by many factors, including rapidly spreading resistance to antimalarial drugs, climatic changes, and population movements. In Africa, malaria is caused by Plasmodium falciparum and is transmitted by Anopheles gambiae complex. Control efforts have been piecemeal and not coordinated. Strategies for control should have a solid research base both for developing antimalarial drugs and vaccines and for better understanding the pathogenesis, vector dynamics, epidemiology, and socioeconomic aspects of the disease. An international collaborative approach is needed to build appropriate research in a national context and to effectively translate research results into practical applications in the field. The Multilateral Initiative for Malaria in Africa can combine all of the above strategies to plan and coordinate partnerships, networking, and innovative approaches between African scientists and their Northern partners.

Norovirus Disease in the United States

Hall, Aron J.; Lopman, Ben A.; Payne, Daniel C.; Patel, Manish M.; Gastañaduy, Paul A.; Vinjé, Jan; Parashar, Umesh D.
Fonte: Centers for Disease Control and Prevention Publicador: Centers for Disease Control and Prevention
Tipo: Artigo de Revista Científica
Publicado em /08/2013 EN
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Although recognized as the leading cause of epidemic acute gastroenteritis across all age groups, norovirus has remained poorly characterized with respect to its endemic disease incidence. Use of different methods, including attributable proportion extrapolation, population-based surveillance, and indirect modeling, in several recent studies has considerably improved norovirus disease incidence estimates for the United States. Norovirus causes an average of 570–800 deaths, 56,000–71,000 hospitalizations, 400,000 emergency department visits, 1.7–1.9 million outpatient visits, and 19–21 million total illnesses per year. Persons >65 years of age are at greatest risk for norovirus-associated death, and children <5 years of age have the highest rates of norovirus-associated medical care visits. Endemic norovirus disease occurs year round but exhibits a pronounced winter peak and increases by ≤50% during years in which pandemic strains emerge. These findings support continued development and targeting of appropriate interventions, including vaccines, for norovirus disease.

Evaluating the role of vaccine to combat peste des petits ruminants outbreaks in endemic disease situation

Abubakar, Muhammad; Manzoor, Shumaila; Ali, Qurban
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 20/01/2015 EN
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Among the main intimidation to the sheep and goat population, PPR outbreaks are causing huge losses especially in endemic areas. During recent times, six outbreaks of PPR were confirmed at semi-organized goat farms/herds in various regions of Punjab province and Islamabad capital territory (ICT), Pakistan. The disease started after introduction of new animals at these farms with no history of previous PPR vaccination. The clinical signs appeared affecting respiratory and enteric systems and spread quickly. Disease caused mortality of 10-20% and morbidity of 20-40% within a time period of four weeks. Morbidity and mortality rates were 30.38% (86/283) and 15.55% (44/283), respectively. Three treatment regimes were executed to demonstrate the role of vaccination during outbreak at these farms. First was to use only the broad spectrum antibiotics (Penicillin & Streptomycin and/ or Trimethoprim and Sulfadiazine) at two farms (Texilla and Attock). Second treatment regime was to use the same broad spectrum antibiotic along with extensive fluid therapy (Farms at ICT-1 and ICT-2). The third regime was to use of broad spectrum antibiotic plus fluid therapy along with vaccinating the herd against PPR during first week of outbreak (ICT-3 and ICT-4). The third scheme of treatment gave the better results as there was no mortality in third week post-outbreak. Therefore...

Estudo Retrospectivo da Doen??a de Chagas em doadores de sangue daregi??o noroeste do Rio Grande do Sul, Brasil; A Retrospective Study of Chagas Disease In Blood Donors from Northwest of Rio Grande do Sul State, Brazil

PEDROSO, D??bora
Fonte: Universidade Federal de Pelotas; Biologia; Programa de P??s-gradua????o em Parasitologia; UFPel; BR Publicador: Universidade Federal de Pelotas; Biologia; Programa de P??s-gradua????o em Parasitologia; UFPel; BR
Tipo: Dissertação Formato: application/pdf
POR
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Chagas Disease was discovered by Carlos Chagas in 1909. It is an hematological and tissue infection caused by flagellate protozoan Trypanosoma cruzi, which is transmitted by an hematophagous insect. In addition to transmission by the vector this parasitic infection can be acquired by humans in other ways, such as blood transfusion, laboratory accidents, organ transplants, oral transmission by penetration of trypomastigotes through oral mucosa or through placenta. Although blood transmission shows a decline after implementation of donor screening this is still present, and therefore needs constant vigilance. In view of this, the study aims to describe from a retrospective analysis a serological profile for Chagas disease in blood donors from the municipality of Santiago located in the northwestern state of Rio Grande do Sul, in which high levels of endemic disease appeared in past decades. The results of serological blood donors from the Blood Bank of municipality of Santiago were analyzed during the period 2001-2011. Of the 10,164 units of blood collected, with an average of 1,016 units per year, 2.68% were reactive to T. cruzi, being the main cause of discarding blood bags. The higher frequency of positive cases occurred in men, with mean age of 38.84 years old...

A survey of farmer attitudes to endemic disease management in South Australia, with a focus on bovine viral diarrhoea (bovine pestivirus)

Lanyon, S.R.; Anderson, M.L.; Reichel, M.P.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
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Objective: We aimed to establish the attitudes of South Australian cattle farmers towards endemic animal disease prevention and control, with a particular focus on the awareness of and attitudes towards bovine viral diarrhoea (BVD). Methods: This cross-sectional postal survey involved mailing a questionnaire to all South Australian cattle owners with 35 or more head of cattle. Results: Worms and lice were the most common animal disease concerns. Less than half of responding farmers were adequately vaccinating their herds against clostridial diseases, but 53.0% stated that they utilised quarantine procedures. Less than 20% of respondents had actively taken part in BVD educational opportunities, or had vaccinated or tested their herd for BVD; less than 20% of respondents were actively involved in any systematic control of Johne's disease. Overall, farmers’ actual knowledge of BVD was lower than their perceived understanding, although their interest in BVD and its control was high. Conclusions: Disease prevention measures such as vaccination, quarantine and participation in systematic control schemes were used by a minority of respondents. The results suggest that respondents acknowledge BVD as an important and relevant disease, despite many believing it was not a problem in their herd. Interest in BVD appears to be high and it is likely that an education program would be well received.; SR Lanyon...

Aspectos geográficos e epidemiológicos da hanseníase em Cuiabá e Várzea Grande - MT; Geographical and epidemiological aspects of Hansens disease in Cuiabá and Várzea Grande - MT

Santos, Emerson Soares dos
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 31/05/2012 PT
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A hanseníase é um importante problema de saúde pública nas cidades de Cuiabá e Várzea Grande. O coeficiente de detecção para as duas cidades, em 2010, era de 6,97 casos por 10.000 habitantes, o que caracteriza a forte presença endêmica da doença nesta área. A hipótese é de que os casos de hanseníase estariam agrupados, formando focos de contato e disseminação relacionados ao ambiente geográfico e fatores sociais e econômicos. Com isso, se objetiva analisar a distribuição espacial e os aspectos epidemiológicos da doença sob a perspectiva da Geografia. Trata-se de um estudo ecológico, tanto do ponto de vista da metodologia proposta por Maximilien Sorre quanto pelo seu delineamento epidemiológico, utilizando técnicas baseadas em Análise Espacial de Dados Geográficos e Análise Multivariada de Dados. Foram georreferenciados os casos de hanseníase registrados em Cuiabá e Várzea Grande entre os anos de 1999 a 2010, e posteriormente submetidos a testes estatísticos de dependência espacial entre casos, de existência de focos espaciais e de áreas de risco, e da possível influência de fatores sócio-econômicos e ambientais na presença ou ausência deste risco. Os resultados indicam a formação de focos endêmicos durante o período do estudo...

Variabilidad genética y antigénica del virus de la fiebre aftosa, serotipo O, entre aislamientos recuperados durante la replicación del virus en animales persistentemente infectados, y entre cepas de campo; Genetic and antigenic variability of foot-and-mouth disease virus, serotype o, among isolates recovered during viral replication in persistently infected cattle, and among field isolates

Malirat, Viviana
Fonte: Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires Publicador: Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires
Tipo: info:eu-repo/semantics/doctoralThesis; tesis doctoral; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em //1996 SPA
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La variación genética y antigénica en el virus de la fiebre aftosa, O1 Campos Brasil 1/58 (O1 C/58) se ha analizado en aislamientos consecutivos, recuperados durante un periodo de uno o dos años, a partir de cuatro bovinos con infección persistente, establecida en forma experimental. La comparación de los mapas bidimensionales de fragmentos resistentes a Rnasa T1, y de la secuencia de nucleótidos de la región que codifica para la proteína inmunogénica VP1, revelaron un aumento irregular de las fijaciones de mutaciones a medida que la infección avanzaba. El grado de variación con respecto a la cepa O1 C/58, usada originalmente para establecer la infección persistente, alcanzó valores máximos de 2,4 por ciento para el genoma total y de 1,4 por ciento para la secuencia de nucleótidos que codifica para la proteína VP1. La mayoría de los cambios no eran conservados entre aislamientos consecutivos. Estos resultados, junto con los valores substanciales de velocidad de variación genómica observados entre algunos pares de aislamientos recuperados con intervalos de tiempo muy cortos, indicaron la coexistencia de poblaciones heterogéneas, que predominaban unas sobre las otras en periodos irregulares, y que evolucionaban independientemente entre sí. No se observaron padrones de variación relacionados entre los cuatro animales. También fue evaluada la diversificación genética de cepas representativas de brotes de campo...

Australia's century of meningococcal disease: development and the changing ecology of an accidental pathogen

Patel, Mahomed
Fonte: Australasian Medical Association Publicador: Australasian Medical Association
Tipo: Artigo de Revista Científica
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• Trends in meningococcal disease (MD) over the 20th century in Australia, as in other industrialised countries, have been characterised by epidemics during the two World Wars, a transient rise in incidence in the 1950s followed by endemic disease, and

New features of the endemic diseases in urban centers; Novas características das endemias em centros urbanos

Shikanai-Yasuda, Maria Aparecida; Sartori, Ana Marli Christovam; Guastini, Cristina Maria de Fátima; Lopes, Marta Heloísa
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion;
Publicado em 03/02/2000 PT
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A invasão desordenada de ecótopos naturais, a falta de controle de vetores biológicos de doenças infecciosas, as mudanças nas interações-hospedeiro-parasito em condição de imunodepressão e as alterações dos agentes infecciosos são alguns dos fatores relacionados a emergência de várias doenças infecto-parasitárias, entre as quais a dengue, a infecção por hantavírus, a leishmaniose, a tuberculose, a infecção por Trypanosoma cruzi. A migração de grandes contigentes populacionais do campo para as metrópoles propiciou a endemização de algumas doenças tipicamente de ambientes rurais como a Doença de Chagas. Estima-se que cerca de 60% de 5 000 000 de brasileiros infectados por Trypanosoma cruzi vivam em centros urbanos principalmente São Paulo, Rio de Janeiro e Belo Horizonte. Como consequência da urbanização da endemia e do controle do principal vetor da doença no Brasil, Triatoma infestam, a transmissão por transfusão de sangue e hemoderivados adquiriu grande importância como mecanismo de perpetuação da moléstia no país. ; The unordered invasion of natural hosts, the lack of control of biological vectors of infectious illnesses, the changes in the interaction-host-parasite in imunodepression condition and the alterations of the infectious agents are some of the factors related to the emergency of some infectum-parasitic illnesses...

Leprosy: too complex a disease for a simple elimination paradigm

Lockwood,Diana N.J.; Suneetha,Sujai
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2005 EN
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Can leprosy be eliminated? This paper considers the question against the background of the WHO programme to eliminate leprosy. In 1991 the World Health Assembly set a target of eliminating leprosy as a public health problem by 2000. Elimination was defined as reaching a prevalence of < 1 case per 10 000 people. The elimination programme has been successful in delivering highly effective antibiotic therapy worldwide. However, despite this advance, new-case detection rates remain stable in countries with the highest rates of endemic leprosy, such as Brazil and India. This suggests that infection has not been adequately controlled by antibiotics alone. Leprosy is perhaps more appropriately classed as a chronic stable disease than as an acute infectious disease responsive to elimination strategies. In many countries activities to control and treat leprosy are being integrated into the general health-care system. This reduces the stigma associated with leprosy. However, leprosy causes long-term immunological complications, disability and deformity. The health-care activities of treating and preventing disabilities need to be provided in an integrated setting. Detecting new cases and monitoring disability caused by leprosy will be a challenge. One solution is to implement long-term surveillance in selected countries with the highest rates of endemic disease so that an accurate estimate of the burden of leprosy can be determined. It is also critical that broad-based research into this challenging disease continues until the problems are truly solved.