Esquistosomiasis en la ciudad de Belo Horizonte en el período de 2007 a 2011 / Schistosomiasis in Belo Horizonte, Minas Gerais, Brazil in the 2007-2011 period

Introducción: la esquistosomiasis mantiene una situación de atención epidemiológica en algunas zonas de Brasil. Objetivo: conocer la situación epidemiológica de la esquistosomiasis en la ciudad de Belo Horizonte, mediante indicadores epidemiológicos. Métodos: se hizo un estudio de carácter descriptivo, se utilizó como instrumento el sistema de información y los errores de notificación de los residentes de casos en Belo Horizonte, Estado de Minas Gerais en Brasil, en el período de enero de 2007 a julio de 2011; se registraron 496 casos de esquistosomiasis, confirmada por el criterio de laboratorio (técnica Kato-Katz). Resultados: se observó que en este período hubo un aumento considerable de casos en 2007, la incidencia fue de 1,96/100 000 habitantes; en 2011, hasta el mes de julio resultó de 7,29/100 000 habitantes. Conclusiones: el creciente número de casos recientes hace pensar en la necesidad del desarrollo de nuevas estrategias, para el control de esta enfermedad endémica que continúa en la región.

Introduction: schistosomiasis is kept under epidemiolotical surveillance in some areas of Brazil. Objective: to evaluate the epidemiological situation of schistosomiasis in the city of Belo Horizonte in Minas Gerais, Brazil, through epidemiological indicators. Methods: a descriptive study was conducted by using the System of Information and Notification of Grievances (SINAN) that contains the cases occurred in the residents of Belo Horizonte in the period of January-2007 to July-2011. Four hundred ninety six lab confirmed cases of schistosomiasis(Kato-Katz technique) were recorded. Results: in this period, there was a considerable increase of the number of cases in 2007 when the incidence was 1.96/100 000 habitants; the incidence was 7.29/100 000 habitants until July, 2011. Conclusions: the increasing number of recent cases points to the need of developing new strategies to control this endemic disease in our region.

Epidemiological analysis of eosinophilia and elevation of immunoglobulin E as a predictable and relative risk of enteroparasitosis / Análisis epidemiológico de eosinofilia y la elevación de inmunoglobulina E como riesgo relativo y predecible de enteroparasitosis

Introduction: among the intestinal parasites, the helminthiasis occupies a prominent position in Brazil, since it worsens malnutrition and the gives rise to neurovegetative disorders. Helminths like Ascaris lumbricoides, Enterobius vermicularis, hookworm, Trichuris trichiura and Strongyloides stercoralis stand out due to several factors that modulate the immune response of individuals. Among the protozoa are Giardia lamblia, Entamoeba histolytica/E. dispar. Parasitic helminth antigens are important to stimulate the production of cytokines such as interleukin-4 and interleukin-5, which act through the induction of IgE synthesis and activation of eosinophils. Eosinophilia is usually detectable in pre-patent period of parasitism, initially linked to B lymphocytes, under the command of Th-2 lymphokines (IL-4 and IL-5), producing IgE in response to initial exposure to an antigen or allergen. Serum IgE high levels occur in tissue migration of larvae or harboring of parasites in tissues. Objective: to determine the presence of eosinophils and IgE elevation in children with intestinal parasites. Methods: high levels of IgE and eosinophils were observed in groups infected and not infected (allergic) to calculate the relative risk of intestinal parasites presumptive differentiated between protozoa and helminths and check what values of these indicators are observed in the epidemiological profile of the surveyed population. Results: the values obtained by calculating the relative risk for eosinophilia, compared with helminths and allergies was 11.71, but when examined by giardiasis compared with other diseases, the relative risk was 0.75. Since the comparison of helminths and giradiase, the relative risk was 27.33. Since IgE and its parameters were appropriate commit Helminth relative risk 0.39; Giardiasis had relative risk 8.18 and Helminths compared with giardiasis had 0.03. Conclusion: in this study it was possible to observe that helminthiasis is connected with cases of eosinophilia with alteration of IgE, which in turn contributes to the presence of IgE eosionofilia and has an effector response against helminths that provides the expulsion of its larvae.

Introducción: entre los parásitos intestinales, la helmintiasis ocupa un lugar destacado en Brasil, porque causa malnutrición y la instalación de cuadros de trastornos neurovegetativos. Helmintos como Ascaris lumbricoides, Enterobius vermicularis, anquilostoma, Trichuris trichiura y Strongyloides stercoralis se destacan debido a varios factores que modulan la respuesta inmune de los individuos. Entre los protozoos, los más destacados son Giardia lamblia y Entamoeba histolytica/E. dispar. Los antígenos de helmintos parásitos son importantes para estimular la producción de citocinas como la interleucina-4 e interleucina-5, que actúan a través de la inducción de la síntesis de IgE y la activación de los eosinófilos. La eosinofilia es detectable por lo general en el período pre-patente de parasitismo, inicialmente vinculada a los linfocitos B, bajo el mando de Th-2 linfocinas (IL-4 e IL-5), la producción de IgE en respuesta a la exposición inicial a un antígeno o alergeno. Los niveles séricos de IgE se producen en la migración de las larvas de los tejidos o la acogida de los parásitos en estos. Objetivo: determinar la presencia de eosinófilos y la elevación de IgE en niños con parásitos intestinales y cuantificar el riesgo relativo de estos parámetros biológicos. Methods: se observaron altos niveles de IgE y de eosinófilos en grupos infectados y no infectados (alergias) a fin de calcular el riesgo relativo (RR) de parásitos intestinales presuntamente diferenciados entre protozoos y helmintos, así como chequear qué valores de estos indicadores se observan en el perfil epidemiológico de la población estudiada. Resultados: los valores obtenidos mediante el cálculo del riesgo relativo para la eosinofilia, en comparación con helmintos y otras enfermedades fue 11,71, pero cuando se examina por la giardiasis en comparación con alergias resultó de 0,75. En la comparación de los helmintos y la giardiasis, el riesgo relativo fue de 27,33. Dado que la IgE y sus parámetros eran adecuados, entonces helmintos RR 0,39; giardiasis RR 8,18; y helmintos en comparación con giardiasis 0,03. Conclusión: con este estudio se pudo observar que las helmintiasis están relacionadas con casos de eosinofilia con alteración de la IgE; este último, que a su vez contribuye a la presencia de IgE eosionofilia y a tener una respuesta efectora frente a helmintos que causan la expulsión de sus larvas.

Incidência de insuficiência renal aguda e crônica como complicações de pacientes internados em uma unidade de terapia intensiva / Incidence of acute and chronic renal failure as complications of patients hospitalized in an intensive care unit

Introdução: A insuficiência renal aguda (IRA) ou crônica (IRC) são complicações frequentes de indivíduos internados em Unidade de Terapia Intensiva (UTI). Objetivo: Quantificar nesses pacientes a incidência de IRC e IRA e das doenças de base que podem evoluir para essas condições clínicas, visando fornecer informações para a sistematização dos cuidados aos acometidos por essas disfunções e reduzir o tempo de internação e dos custos dos procedimentos. Método: Realizou-se avaliação prospectiva dos prontuários de pacientes admitidos na UTI, no período de 1 a 10/2/2010. Resultados: Do total de admissões, 17% evoluíram para IRC, 29% para IRA. Dos voluntários, 60% eram hipertensos, e 26%, diabéticos. Conclusão: A quantificação pontual dos motivos de admissão nas UTIs fornece informações sobre o perfil dos pacientes admitidos em cada Serviço, podendo contribuir para a criação de programas que visem reduzir os índices de morbi-mortalidade e os custos associados ao tratamento da IRA e IRC.

Introduction: Acute (ARF) or chronic (CRF) renal failure are frequent complications of individuals hospitalized in the Intensive Care Unit (ICU). Objective: To quantify in these patients the incidence of ARF and CRF, and underlying diseases that may progress to these conditions in order to provide information for a systematization of care for patients who suffer from it, and to reduce hospitalization time and costs of procedures. Methods: We conducted a prospective evaluation of medical records of patients admitted to the ICU from 1 to 10/2/2010. Results: Of the total admissions, 17% progressed to CRF, and 29% developed ARF. We observed that 60% of the volunteers were hypertensive, and 26% were diabetics. Conclusion: The punctual quantification of ICU admission reasons provides information on the profile of patients in each service, which may contribute to the creation of programs aimed at reducing the morbidity, mortality and costs associated with the treatment of ARF and CRF.

Avaliação dos principais fatores etiológicos em indivíduos portadores de insuficiência renal crônica em hemodiálise / Evaluation of main etiologic factors in individuals with chronic renal failure on hemodialysis

Introdução: A Insuficiência Renal Crônica (IRC) caracteriza-se pela redução progressiva das funções renais. Quando seu estágio terminal se instala, torna-se necessária a instituição de alguma das modalidades de Terapia Renal Substitutiva, por exemplo, a hemodiálise (HD). Objetivo: Identificar as etiologias mais prevalentes em pacientes portadores de IRC em HD. Método: Foram analisados 80 prontuários e observados dados, tais como etnia, sexo, idade, grau de escolaridade e doença de base que evoluiu para IRC. Resultados: Do total da amostra, 72,5% eram portadores de Hipertensão Arterial Sistêmica (HAS); 32,5%, de Diabetes Melito (DM) tipo 2, e 25% apresentavam as duas patologias. Quanto à escolaridade, apenas 27,5% possuíam o Ensino Fundamental completo. Conclusão: A criação ou a drástica reformulação de campanhas que visem prevenir as complicações da HAS e do DM, sobretudo entre indivíduos com baixa escolaridade, talvez possa contribuir para a redução do número de casos de IRC, reduzindo os custos aos sistemas de saúde e, principalmente, melhorando a qualidade de vida de seus portadores, que podem prevenir ou, pelo menos, retardar a sua admissão em programas de TRS.

Introduction: Chronic Renal Failure (CRF) is characterized by progressive reduction of kidney function. When his terminal stage settles, it becomes necessary to implement some of the modalities of Renal Replacement Therapy (RRT) as, for example, hemodialysis (HD). Objective: To identify the most prevalent etiologies in patients with CRF in HD. Method: We reviewed 80 medical records and observed data such as ethnicity, gender, age, educational level and etiology of CRF. Results: Of the total sample, 72.5% suffered from High Blood Pressure (HBP), 32.5% with Diabetes Mellitus (DM) type 2, and 25% had both diseases. With respect to the level of education, only 27.5% had completed elementary school. Conclusion: The creation or drastic overhaul of campaigns aimed at preventing the complications of HBP and DM, especially among individuals with low education, could possibly contribute to reducing the number of cases of CRF, reducing costs to health systems and especially improving quality of life of affected individuals, which may prevent or at least delay their admission into programs of RRT.

Análisis comparativo de los métodos para la detección de parásitos en las hortalizas para el consumo humano / Comparative analysis of parasite detection methods in vegetables for human consumption

INTRODUCIÓN: la contaminación de los vegetales es un persistente problema de salud. Las diferentes técnicas de diagnóstico y de procesamiento dificultan determinar qué técnica es más eficiente y sensible. OBJETIVO: efectuar una comparación entre la sensibilidad de las técnicas parasitológicas en muestras de vegetales. MÉTODOS: se recogieron 30 muestras de vegetales - lechuga (Lactuca sativa), rúcula (Eruca sativa) y berro (Nasturtium officinale) - y se investigaron por las técnicas de Hoffman, Pons y Janer (HPJ) y Faust (F). Los datos fueron analizados utilizando la prueba de Bland-Altman para evaluar la correlación y la prueba de Mann-Whitney para comparar las medianas. RESULTADOS: de las muestras analizadas, 46,6 por ciento resultó positivo, se observó Balantidium coli (20,0 por ciento de la contaminación), Entamoeba coli (21,6 por ciento), Entamoeba histolityca (5,0 por ciento), Trichuris trichiura (3,3 por ciento) y Strongyloides stercoralis (2,5 por ciento). La prueba de Bland-Altman mostró correlación significativa entre los métodos examinados. Hubo una diferencia significativa (p< 0,05) entre los resultados, al evaluar individualmente el promedio. CONCLUSIÓN: este estudio demostró que la técnica HPJ fue más eficaz en la detección de huevos, larvas de helmintos y quistes de protozoos en las plantas estudiadas.

INTRODUCTION: vegetable contamination is a persistent health problem. The different methods of processing and diagnosis make it difficult to determine the most effective and sensitive technique. OBJECTIVE: a comparative analysis of parasitological technique sensitivity in vegetable samples. METHODS: a total of 30 samples were harvested lettuce (Lactuca sativa), rocket (Eruca sativa) and watercress (Nasturtium officinale) and later analyzed using Hoffman, Pons, and Janer (HPJ) and Faust (f) techniques. Data were analyzed, using the Bland-Altman test to evaluate the correlation and the Mann-Whitney test to compare the medians. RESULTS: of the analyzed samples, 46.6 percent were positive for intestinal parasites; Balantidium coli, accounting for 20 percent of contamination, Entamoeba coli (21.6 percent) and Entamoeba histolityca (5 percent), Trichuris trichiura(3,3 percent) and Strongyloides stercoralis (2.5 percent) The Bland-Altman test showed significant correlation between the analyzed methods. When evaluating the averages separately, there was significant difference (pd¼ 0.05) among the results. CONCLUSIONS: this study proved that the HPJ technique was more effective for the detection of eggs, helminth larvae and protozoan cysts in the plants under study.