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1.
Rev. ADM ; 80(5): 255-258, sept.-oct. 2023.
Article in Spanish | LILACS | ID: biblio-1531084

ABSTRACT

Introducción: se vive una crisis de confianza en la ciencia y una época de menosprecio a los conocimientos y evidencias. Las opiniones de los líderes políticos y otras figuras públicas ajenas a los problemas de salud tienen una mayor consideración y peso que los juicios emitidos por los expertos. Una evidencia que demuestra la debilidad de México en el campo de la salud son dos hechos en los cuales las autoridades del país son los culpables que son: la desaparición del Seguro Popular y la pobre respuesta a la pandemia de COVID-19. Conclusiones: la pandemia no termina por decreto, se logrará con cuidados y prevención realizada por el gobierno, instituciones y personal de salud y la sociedad (AU)


Introduction: we are living through a crisis of confidence in science and an era of disregard for knowledge and evidence. The opinions of political leaders and other public figures who are not involved in health problems are given greater consideration and weight than the judgments made by experts. Evidence that demonstrates Mexico's weakness in the field of health are two facts in which the country's authorities are to blame: the disappearance of Seguro Popular and the poor response to the COVID-19 pandemic. Conclusions: the pandemic does not end by decree, it will be achieved with care and prevention carried out by the government, health institutions and personnel and society (AU)


Subject(s)
COVID-19 , World Health Organization , Communicable Disease Control/methods , Endemic Diseases , COVID-19 Vaccines , Health Policy/trends , Mexico/epidemiology
2.
Health sci. dis ; 24(1): 77-81, 2023. figures, tables
Article in French | AIM | ID: biblio-1411352

ABSTRACT

Introduction. La limbo-conjonctivite endémique des tropiques (LCET) est une kérato-conjonctivite allergique récidivante du jeune enfant qui s'améliore après la puberté mais peut persister. Le but de cette étude était de déterminer le profil évolutif de la LCETdans notre pratique. Méthodologie. Étude longitudinale descriptive menée dans l'unité d'ophtalmologie de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé. Tous les dossiers de LCET reçus de janvier 2011 à décembre 2019 avec un recul d'aumoins deux ans de suivi ont été recensés. Les patients qui ont accepté de participer après apptéléphonique ont été inclus de janvier à mai 2021.Les variables d'étudeétaient: âge, sexe, acuité visuelle (AV), caractéristiques de la LCET selon Diallo, pronostic fonctionnel et anatomique en post puberté (plus de 15 ans). Résultats. Au total,30 patients (60 yeux) ont été étudiés. Le sex-ratio était de 2. La moyenne d'âge était de 15 ans ± 9 ans. Initialement, le prurit était le maitre symptôme (96,7%). Après un recul moyen de cinq ans, l'AV était utile chez tous les patients (100%) et la LCET stade 2 plus représentée (60%). Le nombre moyen de récidives était de trois. Les patients post pubertaires on eu une amélioration anatomique dans 56.7% des caset une aggravation dans 10%des casConclusion. Notre travail confirme l'amélioration post pubertaire globale de la LCET, nonobstant quelques formes graves depronosticpéjoratif pour la fonction visuelle.


Introduction. Tropical endemiclimbo-conjunctivitis (TELC) is a recurrent allergic kerato-conjunctivitis in young children which improves after puberty but may persist. The aim of this study was to determine the evolutionof TELCin our setting. Methodology. This was a longitudinal descriptive study conducted in the ophthalmology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital. All TELC files received from January 2011 to December 2019 with a follow-up of at least two years of follow-up were identified. Patients who agreed to participate after a phone call were included from January to May 2021. The variables of interest were: age, sex, visual acuity (VA), TELC classification according to Diallo, functional and anatomical prognosis in post puberty (more than 15 years).A totalof30 patients (60 eyes) were recruited. The sex ratio was 2. The average age was 15 ± 9 years. Initially, pruritus was the main symptom (96.7%). After an average follow-up of five years, VA was usefulin all patients (100%) and TELCstage 2 was the most frequent stage (60%). The mean number of recurrences was three. Postpubertal patients had anatomical improvement in 56.7% of cases and worsening in 10%of cases. Conclusion. Our study confirms the overall postpubertal improvement ofTELC, except some serious forms with poor prognosis ofvisual function


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Conjunctivitis, Allergic , Conjunctivitis , Endemic Diseases , Diagnosis, Differential , Epidemiology
3.
São Paulo; s.n; 2023. 111 p.
Thesis in Portuguese | LILACS | ID: biblio-1511076

ABSTRACT

Introdução. A leishmaniose cutânea (LC) representa um desafio significativo na Colômbia, especialmente na região andina. O departamento de Caldas, tem um registro constante de casos e Victoria está entre os municípios mais afetados, apresentando uma média anual de 300 casos por 100.000 habitantes nos últimos cinco anos. No entanto, a identificação das espécies de flebotomíneos responsáveis pela transmissão dos agentes das leishmanioses, geralmente é baseada apenas em evidências epidemiológicas, sendo necessário avaliar os parâmetros de incriminação vetorial para essas espécies. Objetivo. Analisar as evidências de vetores de Leishmania spp. na Colômbia, com base em parâmetros da capacidade vetorial. Material e métodos. Foi conduzida uma revisão narrativa e análise crítica dos estudos de flebotomíneos na Colômbia, seguindo os critérios de incriminação vetorial propostos por Killick-Kendrick. Para avaliar os parâmetros da capacidade vetorial em um foco endêmico de LC no município de Victoria (Caldas), foram realizadas capturas mensais de flebotomíneos durante 18 meses, para analisar a distribuição espaço-temporal desses insetos. A estrutura ecológica da comunidade foi analisada utilizando índices ecológicos de diversidade de Shannon e equitabilidade de Pielou, bem como o índice padronizado de abundância de espécies. A investigação da circulação de Leishmania e a identificação das fontes sanguíneas foram feitas usando métodos moleculares, com análise descritiva das interações. Para comparar as capturas entre diferentes ambientes (intra e peridomiciliar) e a proporção de fêmeas ingurgitadas para cada espécie, foi realizado um teste de χ2. Resultados. Foram analisados 49 artigos relacionados ao estudo de vetores de Leishmania spp., o que permitiu classificar as espécies como vetores comprovados e vetores suspeitos. No estudo do foco endêmico de LC, foram coletados 8.223 flebotomíneos, 7.999 em armadilha tipo CDC (75,8% fêmeas e 24,2% machos) e 198 em armadilha Shannon (88,4% fêmeas e 11,6% machos). Os espécimes pertencem a 23 espécies distribuídas em 13 gêneros. De acordo com o índice padronizado de abundância de espécies, Nyssomyia yuilli yuilli foi a espécie mais abundante, seguida de Psychodopygus ayrozai e Ps. panamensis, que juntas representaram 75,8% dos flebotomíneos capturados. Leishmania panamensis foi identificada como o parasita circulante no foco, com uma taxa mínima de infecção (IMR) de 1,2%, detectada tanto em Ny. yuilli yuilli quanto em Ps. ayrozai. A identificação das fontes sanguíneas permitiu estabelecer a preferência de Ny. yuilli yuilli, por humanos e animais domésticos. Ps. ayrozai apresentou preferência por humanos e tatus. Conclusão. O estudo fornece uma atualização no status dos vetores dos agentes das leishmanioses na Colômbia. As evidências obtidas no foco endêmico de LC sugerem a existência de diferentes padrões de interação vetor-Leishmania-hospedeiro, sugerindo Ny. yuilli yuilli como seu principal vetor no ambiente domiciliar, porém, com Ps. ayrozai atuando na transição entre o ciclo silvestre e o peridomiciliar.


Introduction. Cutaneous leishmaniasis (CL) represents a significant challenge in Colombia,especially in the Andean region. The department of Caldas has a constant record of cases, and Victoria is among the most affected municipalities, with an annual average of 300 cases per 100,000 inhabitants in the last five years. However, the identification of sand fly species responsible for transmitting leishmaniasis agentsis often based solely on epidemiological evidence, highlighting the need to evaluate vector incrimination parameters for these species. Objective. To analyze the evidence of Leishmaniaspp. vectors in Colombia based on the vectorial capacity parameters. Material and methods. A narrative review and critical analysis of sand flystudies in Colombia were conducted, following the vector incrimination criteria proposed by Killick-Kendrick. To evaluate the vectorial capacity parameters in an endemic focus of CL in the municipality of Victoria (Caldas), monthly sand fly captures were carried out for 18 months to analyze the spatiotemporal distribution of these insects. The ecological structure of the community was analyzed using Shannon's diversity and Pielous equitability indices, as well as the standardized index of species abundance.Investigation of Leishmania circulation and identification of blood sources were performed using molecular methods with a descriptive analysis of interactions.A χ22 test was madeto compare captures between different environments (intra and peridomiciliary) and the proportion of engorged females for each species. Results. A total of 49 articles related to the study of Leishmaniaspp. vectors were analyzed, enabling the classification of species as proven vectors and suspected vectors. In the study of the CLendemic focus, 8,223 sand flieswere collected, of which7,999 in CDC traps (75.8% females and 24.2% males) and 198 in Shannon traps (88.4% females and 11.6% males). The specimens belong to 23 species distributed across 13 genera. According to the standardized index of species abundance, Nyssomyiayuilli yuilliwas the most abundant species, followed by Psychodopygusayrozai andPs. panamensis,accounting for 75.8% of the total sand flies. Leishmania panamensiswas identified as the circulating species in the focus, with a minimum infection rate (MIR) of 1.2% detected in both Ny. yuilli yuilliand Ps. ayrozai. The identification of blood sources allowed for establishing the preference of Ny. yuilli yuillifor humans and domestic animals, while Ps. ayrozaishowed a preference for humans and armadillos. Conclusion. The study provides an update on the status of leishmaniasis vectors in Colombia. Our findings in the CL endemic focus suggeststhe existence of different patterns of vector-Leishmania-host interaction, with Ny. yuilli yuillibeing the main vector in the domestic environment, but with Ps. ayrozaiplaying a role in the transition between the sylvatic and peridomestic cycles.


Subject(s)
Leishmaniasis, Cutaneous , Endemic Diseases , Biodiversity , Diptera
4.
São Paulo; s.n; 2023. 115 p.
Thesis in Portuguese | LILACS | ID: biblio-1434832

ABSTRACT

Introdução: A leishmaniose pode ocorrer na forma tegumentar (LT) ou visceral (LV). É endêmica em 102 países, e cerca de 350 milhões de pessoas vivem em áreas de risco da infecção. Anualmente, ocorrem 1,3 milhões de novos casos e provocam 20.000 a 30.000 mortes, com impacto na saúde pública. Os flebotomíneos são os vetores dos agentes da leishmaniose, várias espécies do gênero Leishmania (Trypanosomatidae), transmitidos ao homem e animais. No estado de São Paulo (SP), a LV ocorre mais associada ao ambiente urbano e a LT, ao rural. Objetivos: Atualizar os dados da distribuição geográfica das espécies de flebotomíneos em SP e avaliar a frequência dos vetores implicados na transmissão da LT, segundo Divisões Regionais de Saúde (DRS), para detecção de áreas com riscos de infecção, bem como de áreas carentes de informação da presença desses insetos. Método: Pesquisas bibliográficas foram realizadas em artigos científicos, teses, dissertações e em banco de dados sobre flebotomíneos no site da Superintendência de Controle de Endemias (SUCEN). Os dados foram lançados em planilhas com as informações sobre autores, locais de coleta, espécies coletadas e número de espécimes. Os mapas com a distribuição das espécies por município e DRS foram construídos por meio do software de geoprocessamento QGIS 3.16. Também foram levantadas a incidências da LT por DRS de 2018 a 2021. Resultados: São 78 espécies de flebotomíneos com registros em SP; Psathyromyia ribeirensis e Psathyromyia baratai foram descritas após a última revisão (em 2011), e sete outras (Evandromyia costalimai, Evandromyia teratodes, Lutzomyia alencari, Nyssomyia fraihai, Psathyromyia barrettoi barrettoi, Psathyromyia campograndensis e Pintomyia serrana) representam novos registros. A distribuição em mapas por município e DRS foi feita para todas as espécies. Nas 17 DRSs de SP, constatou-se a presença de vetores, de LT com diversidade e frequências variáveis. As espécies do gênero Nyssomyia predominam, isoladamente ou em simpatria, na maioria das regionais. Nas situadas mais a leste do estado, e que incluem a costa, Ny. intermedia domina; em regionais que incluem áreas mais para o interior, em algumas delas, como a de Registro, no Vale do Ribeira, Ny. intermedia e Ny. neivai ocorrem em simpatria. Na DRS da Grande São Paulo, Pi. fischeri prevalesce. Nas DRSs de Campinas e Sorocaba, Ny. neivai, Ny. whitmani, Mg. migonei e Pi. fischeri predominam. Nas mais centrais e a oeste do estado, Ny. neivai prevalesce, em algumas delas, em simpatria com Ny. whitmani. A DRS de Registro se destaca, quanto à incidência de casos de LT. Lutzomyia longipalpis, vetor principal do agente da LV, teve sua distribuição plotada, mas não a frequência. A visualização espacial em mapas da distribuição das espécies pode auxiliar em atividades de vigilância entomológica. Conclusão: A fauna flebotomínea foi acrescida de nove espécies em relação à última revisão. Constatou-se a presença de vetores em todas as regionais, e com exceção da DRS da Grande São Paulo, onde Pi. fischeri, notadamente, predomina, em todas as demais DRSs, as espécies de Nyssomyia, isoladamente, ou em simpatria, predominam. As duas outras vetoras Mg. migonei e Pi. pessoai, não predominaram em qualquer das DRSs. A DRS de Registro se destaca marcadamente em relação à incidência de casos de LT e nela estão presente Ny. intermedia nas áreas litorâneas e em simpatria com Ny. neivai, nas áreas mais afastadas da costa.


Introduction: Leishmaniasis can occur in tegumentary (TL)) or visceral (VL) forms. It is endemic in 102 countries, and about 350 million people live in areas at risk of infection. Annually, 1.3 million new cases occur and cause 20,000 to 30,000 deaths, with an impact on public health. Sand flies are the vectors of the agents of leishmaniasis, several species of the genus Leishmania (Trypanosomatidae), transmitted to humans and animals. In the state of São Paulo (SP), VL is more associated with the urban and TL with the rural environments. Objectives: To update data on the geographic distribution of sand fly species in SP and to assess the frequency of vectors involved in LT transmission, according to Regional Health Divisions (DRS), to detect areas at risk of infection, as well as areas lacking information on the presence of these insects. Method: Bibliographic searches were carried out in scientific articles, theses, dissertations and in a database on sandflies, on the website of the Superintendence of Endemic Diseases Control (SUCEN). Data were entered into spreadsheets with information about authors, collection sites, collected species and number of specimens. Maps with the distribution of species by municipality and DRS were constructed using the geoprocessing software QGIS 3.16. The incidence of LT by DRS from 2018 to 2021 was also surveyed. Results: There are 78 species of sand flies with records in SP; Psathyromyia ribeirensis and Psathyromyia baratai were described after the last revision (in 2011), and seven others (Evandromyia costalimai, Evandromyia teratodes, Lutzomyia alencari, Nyssomyia fraihai, Psathyromyia barrettoi barrettoi, Psathyromyia campograndensis and Pintomyia serrana) represent new records. The distribution on maps by municipality and DRS was made for all species. In the 17 DRS's of SP, the presence of vectors of LT agents was verified with variable diversity and frequencies. Species of the genus Nyssomyia predominate, alone or in sympatry, in most regions. In the easternmost parts of the state, which include the coast, Ny. intermedia dominates; in regions that include areas further inland, in some of them, such as Registro, in Ribeira Valley, Ny. intermedia and Ny. neivai occur in sympatry. In the Greater São Paulo DRS, Pi. fischeri prevails. In the DRSs of Campinas and Sorocaba, Ny. neivai, Ny. whitmani, Mg. migonei and Pi. fischeri predominate. In the most central and western parts of the state, Ny. neivai prevails, in some of them, in sympatry with Ny. whitmani. The DRS of Registro stands out in terms of the incidence of TL cases. Lutzomyia longipalpis, the main vector of the VL agent, had its distribution plotted, but not its frequency. Spatial visualization on species distribution maps can help in entomological surveillance activities. Conclusion: The sand fly fauna was increased by nine species compared to the last review. The presence of vectors was found in all regions, with the exception of the Greater São Paulo DRS, where Pi. fischeri, notably, predominates, in all other DRSs, Nyssomyia species, alone or in sympatry, predominate. The two other vectors Mg. migonei and Pi. pessoai, did not predominate in any of the DRSs. TheDRS of Registro stands out markedly in relation to the incidence of TL cases and Ny intermedia is present in coastal areas and in sympatry with Ny. neivai, in the areas furthest from the coast.


Subject(s)
Leishmaniasis , Leishmaniasis, Cutaneous , Endemic Diseases , Vector Control of Diseases , Geographic Information Systems , Diptera , Disease Vectors , Leishmaniasis, Visceral
5.
Psicol. ciênc. prof ; 43: e256659, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1529213

ABSTRACT

Em 2020, o mundo enfrentou uma grave emergência de saúde pública devido à pandemia de COVID-19, que impactou significativamente a mobilidade humana e a vida cotidiana de milhares de imigrantes ao redor do mundo. Este artigo fez uso de entrevistas online e por telefone com imigrantes que chegaram ao Brasil a partir de 2016, para identificar as estratégias de enfrentamento adotadas durante a pandemia. Foi realizada uma análise transversal das entrevistas com o auxílio do software Atlas.ti 9, usando a técnica sistemática de categorização iterativa. Com base em uma perspectiva sociocultural em psicologia, o artigo introduz os impactos iniciais da pandemia em diferentes esferas da vida cotidiana desses imigrantes e apresenta as estratégias mobilizadas para restaurar continuidades funcionais e relacionais em um momento no qual as rupturas provocadas pela migração e pela pandemia se sobrepõem. Entre outros, podese identificar como os entrevistados ativaram rapidamente as redes sociais locais e transnacionais virtualmente, mobilizando competências e habilidades aprendidas durante a migração.(AU)


In 2020, the world faced a serious public health emergency due to the COVID-19 pandemic, which has significantly impacted human mobility and the daily lives of thousands of immigrants around the world. This article uses online and telephone interviews conducted with migrants who arrived in Brazil in 2016, to identify coping strategies employed during the pandemic. A transversal analysis of all interviews was conducted with the aid of the software Atlas.ti 9, using a systematic approach of iterative categorization. From a sociocultural perspective in psychology, the article introduces the initial impacts of the pandemic in different spheres of everyday life of these immigrants. With this everyday context, we present the strategies mobilized by immigrants to restore functional and relational continuities at a moment in which the ruptures caused by migration and the pandemic overlap. In particular, we identify how interviewees rapidly activated local and transnational social networks virtually, mobilizing skills learnt during migration.(AU)


En 2020, el mundo se enfrentó a un grave estado de emergencia en salud pública debido a la pandemia del COVID-19, que impactó significativamente la movilidad humana y la vida cotidiana de miles de inmigrantes en todo el mundo. Este artículo realizó entrevistas en línea y por teléfono con inmigrantes quienes llegaron a Brasil a partir de 2016, con el fin de identificar sus estrategias de afrontamiento adoptadas durante la pandemia. Se realizó un análisis transversal de las entrevistas con la ayuda del software Atlas.ti 9, utilizando la técnica sistemática de categorización iterativa. Desde una perspectiva sociocultural en Psicología, este artículo expone los impactos iniciales de la pandemia en diferentes ámbitos de la vida cotidiana de estos inmigrantes y presenta las estrategias movilizadas para restaurar las continuidades funcionales y relacionales en un momento en que se superponen las rupturas causadas por la migración y la pandemia. Entre otros aspectos, se puede identificar cómo los entrevistados activaron virtualmente las redes sociales locales y transnacionales movilizando habilidades y destrezas aprendidas durante la migración.(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Adaptation, Psychological , Cultural Characteristics , Emigration and Immigration , COVID-19 , Anxiety , Aptitude , Politics , Psychology , Psychology, Social , Public Policy , Quality of Life , Refugees , Safety , Salaries and Fringe Benefits , Social Change , Social Desirability , Social Isolation , Social Mobility , Social Problems , Social Sciences , Social Work , Socioeconomic Factors , Unemployment , Viruses , Behavior and Behavior Mechanisms , Brazil , Career Mobility , Economic Development , Quarantine , Communicable Disease Control , Family Characteristics , Adjustment Disorders , Hygiene , Mental Health , Disease Outbreaks , Mortality , Immunization , Population Growth , Universal Precautions , Clinical Competence , Workplace , Interview , Disease Transmission, Infectious , Disease Notification , Refugee Camps , Endemic Diseases , Credentialing , Crisis Intervention , Affective Symptoms , Culture , Terrorism , Capitalism , Internationality , Disasters , Economics , Employment , Environment and Public Health , Job Market , Ethics , Products Distribution , Cultural Competency , Resilience, Psychological , Fear , Economic Recession , Policy , Remuneration , Forecasting , Faith-Based Organizations , Expression of Concern , Right to seek Asylum , Respect , Psychological Distress , Transtheoretical Model , Physical Distancing , Food Insecurity , Social Vulnerability , Disaster Operations , Human Development , Human Rights , Income , Sleep Initiation and Maintenance Disorders , Learning , Leisure Activities , Life Change Events , Loneliness
6.
Rev. epidemiol. controle infecç ; 12(4): 143-149, out.-dez. 2022. ilus
Article in English, Portuguese | LILACS | ID: biblio-1425968

ABSTRACT

Background and objectives: human visceral leishmaniasis (HVL) are a persistent public health problem, configuring a challenge to reduce its lethality. In order to evaluate the factors associated with lethality, this study emphasizes the time elapsed from suspicion to treatment of HVL, in the years 2015 to 2019, in the municipality of Araguaína-TO, an area of intense transmission. Methods: an epidemiological study of case series with longitudinal follow-up with information extracted from HVL notification and investigation forms. The relative risk (RR) was used as a measure of the strength of association for death, being calculated with confidence intervals (95% CI) estimated by the Wald test. Time intervals were represented in days by box plot as medians (Md). Results: of the 191 cases of HVL, 179 (93.72%) were cured and 12 (6.28%) had a fatal outcome. There was no association of risk of death by sex, education, race, being significant only by age in the age groups of young (RR= 16.09) and older adults (RR=7.08). The time from suspicion to treatment in children was shorter (0-35 days, Md=12) than that of older patients (4-44 days, Md=18) and in those who died (7-65 days, Md=20) highlighting greater inopportunity of healing in these last two groups. Conclusion: late diagnosis was a determining indicator for worse outcomes, five days made the difference between the group with an outcome for cure with the group of those who died, highlighting the need to shorten the wait for treatment.(AU)


Justificativa e objetivos: a leishmaniose visceral humana (LVH) constitui-se em persistente problema de saúde pública, configurando-se um desafio à redução de sua letalidade. Para avaliação dos fatores associados à letalidade, este estudo tem ênfase no tempo decorrido da suspeição ao tratamento de LVH, nos anos de 2015 a 2019, no município de Araguaína-TO, área de transmissão intensa. Métodos: estudo epidemiológico de série de casos com acompanhamento longitudinal, com informações extraídas das fichas de notificação e investigação de LVH. Utilizou-se o risco relativo (RR) como medida de força de associação para o óbito, sendo calculado com intervalos de confiança (IC 95%) estimados pelo Teste de Wald. Os intervalos de tempo foram representados em dias por box plot em medianas (Md). Resultados: dos 191 casos de LVH, 179 (93,72%) obtiveram cura e 12 (6,28%) apresentaram desfecho fatal. Não houve associação de risco de morte por sexo, escolaridade, raça ou cor, sendo significativa apenas por idade nas faixas etárias de adultos jovens (RR= 16,09) e idosos (RR=7,08). O tempo da suspeição ao tratamento em crianças foi mais curto (0-35 dias, Md= 12) que o de pacientes mais velhos (4-44 dias, Md=18) e naqueles que evoluíram ao óbito (7-65 dias, Md=20), realçando maior inoportunidade de cura nesses dois últimos grupos. Conclusão: o diagnóstico tardio foi um indicador determinante para piores desfechos, e cinco dias fizeram a diferença entre o grupo com desfecho para cura e o grupo dos que vieram a óbito, destacando a necessidade de encurtamento da espera para tratamento.(AU)


Justificación y objetivos: la leishmaniasis visceral humana (HVI) constituye un problema persistente de salud pública, configurando un desafío para reducir su letalidad. Con el objetivo de evaluar los factores asociados a la letalidad, este estudio enfatiza el tiempo transcurrido desde la sospecha hasta el tratamiento de la VLH, en los años 2015 a 2019, en el municipio de Araguaína-TO, zona de transmisión intensa. Métodos: estudio epidemiológico de serie de casos con seguimiento longitudinal con información extraída de los formularios de notificación e investigación LVH. Se utilizó el riesgo relativo (RR) como medida de la fuerza de asociación para muerte, siendo calculado con intervalos de confianza (IC 95%) estimados por la prueba de Wald. Los intervalos de tiempo se representaron en días mediante diagrama de caja como medianas (Md). Resultados: los 191 casos de LVH, 179 (93,72%) se curaron y 12 (6,28%) tuvieron un desenlace fatal. No hubo asociación de riesgo de muerte por sexo, educación, raza o color, siendo significativo solo por edad en los grupos de edad de adultos jóvenes (RR= 16,09) y ancianos (RR=7,08). El tiempo desde la sospecha hasta el tratamiento en los niños fue menor (0-35 días, Md=12) que en los pacientes mayores (4-44 días, Md=18) y en los que fallecieron (7-65 días, Md=20) destacando mayor inoportunidad de curación en estos dos últimos grupos. Conclusión: el diagnóstico tardío fue un indicador determinante de peor desenlace, los cinco días marcaron la diferencia entre el grupo con resultado de curación con el grupo de los que fallecieron, destacando la necesidad de reducir la espera para el tratamiento.(AU)


Subject(s)
Humans , Endemic Diseases , Delayed Diagnosis , Leishmaniasis, Visceral/mortality , Public Health
7.
San Salvador; MINSAL; dic. 15, 2022. 43 p. ilus, graf.
Non-conventional in Spanish | BISSAL, LILACS | ID: biblio-1426006

ABSTRACT

El manual de organización y funciones representa un esquema metodológico, que permite la formalización de la estructura organizacional del Hospital Nacional El Salvador, creado para la atención de la Pandemia por COVID-19, la cual se encuentra en proceso de convertirse en Enfermedad endémica en nuestro país. En él se determinan las funciones específicas y estructurales, de cada grupo orgánico y constituye una de las herramientas con que cuenta la organización, para facilitar el desarrollo de sus funciones administrativas, asistenciales u operativas, constituyendo un instrumento de organización, ya que describe y establece las funciones básicas, específicas, requisitos y relaciones de autoridad, dependencia y coordinación de los cargos y puestos de trabajo


The organization and functions manual represents a methodological scheme, which allows the formalization of the organizational structure of the El Salvador National Hospital, created for the care of the COVID-19 Pandemic, which is in the process of becoming an endemic disease in our country. country. It determines the specific and structural functions of each organic group and constitutes one of the tools available to the organization, to facilitate the development of its administrative, assistance or operational functions, constituting an organizational instrument, since it describes and establishes the basic and specific functions, requirements and relationships of authority, dependency and coordination of positions and jobs


Subject(s)
COVID-19 , Hospitals, Public , Manuals as Topic , Publishing , Attention , Endemic Diseases , El Salvador , Pandemics , Hospitals
8.
Bol. malariol. salud ambient ; 62(6): 1227-1236, dic. 2022. tab., ilus.
Article in Spanish | LILACS, LIVECS | ID: biblio-1427364

ABSTRACT

La malaria es producida por parásitos del género Plasmodium y transmitida por Anopheles. Es considerada un problema de salud pública; a pesar de la reducción significativa de los casos, a nivel mundial, persisten tasas de morbi-mortalidad elevadas. En las Américas, recientemente, se registró brotes palúdicos importantes en seis países, el Perú fue uno de ellos, generando la iniciativa para crear el Plan hacia la Eliminación de la Malaria en el Perú (PEMP), partiendo de la experiencia en el Departamento de Loreto en marco del Plan Malaria Cero. El PEMP, tiene la finalidad de reducir el 90% los casos de malaria antes de 2030, con un enfoque comunitario. El objetivo de este estudio fue evaluar la integralidad del PEMP referidas a los ámbitos biológico, social, tecnológico, económico, normativo y político. Se conformó un grupo de expertos, quienes realizaron la validez aparente de cada uno de los conceptos (DDP< 2,4). Posteriormente, la congruencia de causas por ámbitos y, la contribución por objetivos específicos dentro de cada ámbito. Encontrándose coherencias entre los objetivos específicos, planes y/o acciones dentro de cada ámbito. Se corroboró el enfoque integral del PEMP, encaminando en trabajo multidisciplinario y de comprensión integral de los desafíos actuales para la eliminación de la malaria. Se identifica como debilidad la falta de abordaje de los reservorios de malaria; se recomienda realizar búsqueda activa de casos e investigaciones en hospedadores no humano, especialmente en zonas de alta transmisión; e implementarse un diseño de enfoque holístico como parte del abordaje integral(AU)


Malaria is produced by parasites of the genus Plasmodium and transmitted by Anopheles. It is considered a public health problem; Despite the significant reduction in cases, worldwide, high morbidity and mortality rates persist. In the Americas, important malaria outbreaks were recently registered in six countries, Peru was one of them, generating the initiative to create the Plan for the Elimination of Malaria in Peru (PEMP), based on the experience in the Department of Loreto within the framework of the Zero Malaria Plan. The PEMP aims to reduce malaria cases by 90% before 2030, with a community approach. The objective of this study was to evaluate the integrality of the PEMP referring to the biological, social, technological, economic, regulatory and political fields. A group of experts was formed, who carried out the apparent validity of each one of the concepts (DDP < 2.4). Subsequently, the congruence of causes by areas and the contribution by specific objectives within each area. Finding coherence between the specific objectives, plans and/or actions within each area. The integral approach of the PEMP was confirmed, leading to multidisciplinary work and a comprehensive understanding of the current challenges for the elimination of malaria. The lack of approach to malaria reservoirs is identified as a weakness; It is recommended to carry out active search for cases and investigations in non-human hosts, especially in areas of high transmission; and a holistic approach design implemented as part of the comprehensive approach(AU)


Subject(s)
Humans , Endemic Diseases/prevention & control , Malaria/epidemiology , Peru , Public Policy , National Health Strategies
10.
Actual. SIDA. infectol ; 30(109): 11-29, 20220000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1392440

ABSTRACT

El virus de la viruela símica es un orthopoxvirus de características zoonóticas endémico en las regiones de África Central y África Occidental, donde causa brotes desde 1970. En las últimas décadas se registró un aumento exponencial de casos, probablemente asociado a la disminución en la inmunidad conferida por la vacuna antivariólica, discontinuada luego de la erradicación de la viruela. En los últimos años se registraron casos esporádicos fuera del continente africano, siempre relacionados epidemiológicamente a la permanencia en áreas endémicas o contacto con animales infectados. Desde el 13 de mayo de 2022 se encuentra en curso el mayor brote de viruela símica registrado fuera de las áreas endémicas de África, con casos en los cinco continentes. La extensión, el impacto y la duración del brote permanecen aún inciertos.


Monkeypox virus is an orthopoxvirus with zoonotic characteristics endemic in Central and West Africa regions, where it has caused outbreaks since 1970. An exponential increase in cases has been registered in the last decades, probably associated with a decrease in the immunity conferred by the smallpox vaccine, discontinued after smallpox eradication. In recent years, sporadic cases have been reported outside the African continent, always epidemiologically related to permanence in endemic areas or contact with infected animals. Since May 13, 2022, the largest monkeypox outbreak ever reported outside Africa endemic areas, with cases on the five continents, is unfolding. The extent, impact and duration of this outbreak still remain uncertain


Subject(s)
Humans , Vaccines , Orthopoxvirus/immunology , Poxviridae Infections/therapy , Endemic Diseases , Communicable Diseases, Emerging/immunology , Monkeypox/prevention & control , Monkeypox/therapy , Monkeypox/transmission , Monkeypox/epidemiology
11.
Cogit. Enferm. (Online) ; 27: e82221, Curitiba: UFPR, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1394307

ABSTRACT

RESUMO Objetivo: analisar o perfil sociodemográfico e clínico dos casos notificados de hanseníase em menores de 15 anos, no município de São Luís - Maranhão - Brasil. Método: estudo descritivo realizado com 826 casos notificados no Sistema de Informação de Agravos de Notificação, em São Luís - Maranhão, no período de 2010 a 2019. Os dados foram analisados por meio de estatística descritiva e foram expressos em frequências absolutas e relativas. Resultados: faixa etária entre 10 e 14 anos (60,29%), masculino (51,09%), cor parda (69,59%), ensino fundamental incompleto (39,58%), multibacilar (62,71%), forma clínica dimorfa (54,24%), até cinco lesões (74,45%), zero a dois nervos afetados (83,23%), sem baciloscopia (46,28%), casos novos (93,70%), demanda espontânea (46,38%) e grau zero de incapacidade no diagnóstico (78,98%). Conclusão: foram demostrados parâmetros hiperendêmicos com elevado risco para a doença. Destaca-se a importância de criar estratégias de controle e prevenção para reduzir a transmissão da hanseníase em crianças.


ABSTRACT Objective: to analyze the sociodemographic and clinical profile of reported cases of Hansen´s disease in children under 15 years old in the municipality of São Luís - Maranhão - Brazil. Method: descriptive study conducted with 826 cases reported in the Notifiable Diseases Information System, in São Luís - Maranhão, in the period from 2010 to 2019. Data were analyzed using descriptive statistics and were expressed in absolute and relative frequencies. Results: age group between 10 and 14 years (60.29%), male (51.09%), brown (69.59%), incomplete elementary education (39.58%), multibacillary (62.71%), dimorphic clinical form (54.24%), up to five lesions (74.45%), zero to two nerves affected (83.23%), no bacilloscopic (46.28%), new cases (93.70%), spontaneous demand (46.38%) and zero degree of disability at diagnosis (78.98%). Conclusion: hyper-endemic parameters with high risk for the disease were demonstrated. It is important to create control and prevention strategies to reduce Hansen´s disease transmission in children.


RESUMEN Objetivo: analizar el perfil sociodemográfico y clínico de los casos notificados de lepra en niños menores de 15 años, en el municipio de São Luís - Maranhão - Brasil. Método: estudio descriptivo realizado con 826 casos notificados en el Sistema de Información de Enfermedades de Declaración Obligatoria, en São Luís - Maranhão, en el período de 2010 a 2019. Los datos se analizaron mediante estadísticas descriptivas y se expresaron en frecuencias absolutas y relativas. Resultados: edad entre 10 y 14 años (60,29%), sexo masculino (51,09%), color marrón (69,59%), educación elemental incompleta (39,58%), multibacilar (62,71%), forma clínica dimórfica (54,24%), hasta cinco lesiones (74,45%), de cero a dos nervios afectados (83,23%), sin baciloscopia (46,28%), casos nuevos (93,70%), demanda espontánea (46,38%) y cero grado de discapacidad en el momento del diagnóstico (78,98%). Conclusión: se demostraron parámetros hiperendémicos con alto riesgo de enfermedad. Destaca la importancia de crear estrategias de control y prevención para reducir la transmisión de la lepra en los niños.


Subject(s)
Endemic Diseases , Leprosy , Malpractice
12.
Hist. ciênc. saúde-Manguinhos ; 29(2): 317-336, abr.-jun. 2022.
Article in Portuguese | LILACS | ID: biblio-1385079

ABSTRACT

Resumo O artigo analisa como a dengue se apresentou como desafio virológico na década de 1980. O objetivo é entender o papel dos estudos virológicos na compreensão da doença e a construção de uma expertise em arboviroses. Embora surtos da doença já tivessem sido relatados ao longo do século XX, a dengue era pouco conhecida nas Américas até a epidemia de dengue hemorrágica em Cuba, em 1981. Quando em 1986 a doença atingiu a cidade de Nova Iguaçu (RJ), a equipe de virologistas liderada por Hermann Schatzmayr tomaria a doença como objeto, mobilizando esforços a partir da criação do Laboratório de Flavivírus do Instituto Oswaldo Cruz.


Abstract This article analyzes how dengue presented a virological challenge during the 1980s in order to explore the role of virological studies in understanding this disease and constructing expertise in arboviral diseases. Although outbreaks were reported throughout the twentieth century, dengue was barely known in the Americas until the epidemic of dengue fever in Cuba in 1981. When the disease reached the Brazilian city of Nova Iguaçu (RJ) in 1986, it became the focus of attention for a team of virologists led by Hermann Schatzmayr, who mobilized efforts after the creation of the Flavivirus Laboratory at the Oswaldo Cruz Institute.


Subject(s)
Virology , Endemic Diseases , Health Research Plans and Programs , Brazil , Dengue/history , History, 20th Century
13.
Lima; Perú. Ministerio de Salud. Centro Nacional de Epidemiología, Prevención y Control de Enfermedades; 1 ed; Jun. 2022. 1121-56 p. ilus.(Boletín Epidemiológico, 31, SE-23).
Monography in Spanish | MINSAPERU, LILACS, LIPECS | ID: biblio-1379437

ABSTRACT

Realizar el análisis espacial de un brote de enfermedades metaxénicas, es uno de los pasos importantes en el proceso del análisis epidemiológico, y un insumo para el abordaje de la investigación epidemiológica, control y evaluación de intervenciones. Asimismo, brinda información relevante en el análisis de "determinantes del proceso de salud-enfermedad" Históricamente, el primer análisis espacial en enfermedades metaxénicas se dio el año 1789 con los mapas de casos de fiebre amarilla en Nueva York, realizados por Seamon y Pascalis. Actualmente, este tipo de análisis cobra relevancia frente al contexto epidemiológico que se presenta por enfermedades emergentes como zika y chikungunya; enfermedades endémicas que ocasionan altas tasas de severidad como dengue y malaria; y enfermedades que ocasionan secuelas discapacitantes como leishmaniosis


Subject(s)
Yellow Fever , Epidemiologic Studies , Epidemiologic Measurements , Endemic Diseases , Epidemiological Monitoring , Chikungunya Fever , Epidemiological Investigation , Malaria
15.
Rev. bras. ciênc. vet ; 29(2): 81-84, abr./jun. 2022. il.
Article in English | LILACS, VETINDEX | ID: biblio-1399547

ABSTRACT

The objective of this work was to describe the first record of antibodies to the Bluetongue Virus (BTV) in ewe, in the state of Amazonas. The ewe, which was in twin pregnancy, gave birth on May 9, 2015, but a lamb died hours after delivery. Veterinary service was then requested by the owner, where emaciation, loss of wool, pyrexia, apathy, dyspnea, mucoid nasal secretion, facial, lingual and submandibular edema were observed. There was a visit by the Agricultural Defense Agency of the State of Amazonas to the property and blood samples were collected from the animal. The whole blood and serum were sent to the National Agricultural Laboratory, where it was possible to detect the presence of specific antibodies to BTV, through the Agar Gel Double Immunodiffusion. The ewe was submitted to a new blood collection, following the same protocols and the samples were sent to the Biological Institute of São Paulo, confirmed diagnosis. The animal in a serious clinical condition, could not resist and died in July 2015. The occurrence of an allochthonous case, in an area where vector insects occur, can trigger an endemic process in the Amazon region. With this, the epidemiological control of these occurrences is necessary, in order to avoid the spread of the disease in the country.


O objetivo do trabalho foi descrever o primeiro registro de anticorpos para o Vírus da Língua Azul (VLA) em ovino, no estado do Amazonas. A ovelha, que se encontrava em gestação gemelar, pariu no dia 9 de maio de 2015, porém um cordeiro faleceu horas após o parto. Foi então solicitado serviço veterinário por parte do proprietário, onde foi observado emaciação, perda de lã, pirexia, apatia, dispneia, secreção nasal mucoide, edema facial, lingual e submandibular. Houve visita da Agência de Defesa Agropecuária do Estado do Amazonas na propriedade e coletadas amostras de sangue do animal. O sangue total e soro foram enviados ao Laboratório Nacional Agropecuário, no qual foi possível detectar a presença de anticorpos específicos para VLA, através do teste de Imunodifusão Dupla em Gel de Ágar. A ovelha foi submetida a uma nova coleta de sangue, seguindo os mesmos protocolos e as amostras foram enviadas ao Instituto Biológico de São Paulo, confirmando diagnóstico. O animal em estado clínico grave, não resistiu e veio a óbito em julho de 2015. A ocorrência de um caso alóctone, em uma área de ocorrência de insetos vetores, pode desencadear um processo de endemia na região amazônica. Com isso, o controle epidemiológico destas ocorrências, se fazem necessários, afim de se evitar a disseminação da doença no país.


Subject(s)
Animals , Sheep/abnormalities , Immunodiffusion/veterinary , Bluetongue virus/immunology , Endemic Diseases/veterinary , Antibodies, Viral/analysis
16.
An. bras. dermatol ; 97(1): 89-92, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1360083

ABSTRACT

Abstract Cutaneous leishmaniasis represents a public health problem that affects 85 countries. It is an endemic disease in Brazil, having an important socioeconomic impact. An exuberant case of cutaneous leishmaniasis is reported herein. A 28-year-old male patient with Down syndrome had had verrucous plaques on the back for over a year, with progressive growth. PCR of a lesion sample was positive for Leishmania braziliensis. The patient's condition was classified as atypical cutaneous leishmaniasis. He was successfully treated with amphotericin B and miltefosine. The treatment remains a challenge, given the toxicity and low cure rate of the currently recommended drugs.


Subject(s)
Humans , Male , Adult , Leishmania braziliensis , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Cutaneous/epidemiology , Antiprotozoal Agents/therapeutic use , Amphotericin B/therapeutic use , Endemic Diseases
17.
Acta sci., Health sci ; 44: e58157, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1366147

ABSTRACT

Some mycoses are endemic. They develop through hematogenous spread, causing a generalized infection, usually with secondary mucosal involvement.The aim of this observational and retrospective study was to report the prevalence and characteristics of oral lesions in patients diagnosed with systemic fungal infections (SFI) over a 25-year period in southern Brazil. Demographic (age, sex, ethnicity, occupation) and clinical (anatomical location, symptoms,histopathological diagnosis and management) data from the medical records of patients with SFI were collected from 1995 to 2019. 34 cases of SFI were found, of which 31 (91.18%) were diagnosed as paracoccidioidomycosis (PCM) and 3 (8.82%) as histoplasmosis. Men were much more affected (n = 31; 91.18%), with an average age of 46.9 years. Most patients (n = 18; 58.06%) were Caucasian; 48% (n = 15) were farm/rural workers and the most affected region was the jugal mucosa (n = 13; 25.49%) followed by the alveolar ridge (n = 12; 23.52%). All patients with histoplasmosis were immunocompetent men (mean age: 52.67 years), and the palate was the most affected. All patients underwent incisional biopsy and were referred to an infectologist. The dentist has an essential role in the recognition of SFI, whose oral manifestations may be the first sign. SFI should be included in differential diagnosis in patients from endemic areas. In addition, the inevitable human mobility and globalization make knowledge of these mycosesnecessary worldwide, especially since advanced cases in immunocompromised patients can be fatal.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Oral Manifestations , Endemic Diseases/prevention & control , Mycoses , Palate/pathology , Paracoccidioidomycosis/pathology , Tongue/pathology , Medical Records/statistics & numerical data , Retrospective Studies , Dentists/education , Alveolar Process/pathology , Health Services Research/statistics & numerical data , Histoplasmosis/pathology , Mucous Membrane/pathology
18.
Bol. malariol. salud ambient ; 62(3): 479-488, 2022. graf, tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1397124

ABSTRACT

La leptospirosis es una enfermedad clasificada como zoonótica, y también es una de las más olvidadas. Como enfermedad endémica zoonótica, permanece en los lugares menos favorecidos afectando la salud humana y tambien de los ciertos animales domésticos. Tal afectación ocasiona pérdidas sustanciales económicas y sanitarias en las poblaciones vulnerables. La incidencia, se estima que afecta a un millón de seres humanos ocasionando la muerte a casi 59.000 de ellas. La transmisión de la leptospirosis humana es debida a la exposición directa o indirecta de las fuentes de infección primaria como animales infectados (orina o tejidos), y también por el contacto con alimentos o aguas contaminadas. En este trabajo se estudió la prevalencia y los factores de riesgos de leptospirosos en la industria porcícola en diferentes regiones del Estado Peruano. Los resultados mostraron que los trabajadores, en su mayoría, masculinos, con edades comprendidas entre 20 y 50 años fueron los más vulnerables a estos serovares de Leptospira, lo cual se relaciona con el contacto directo con porcinos y sus derivados. Por otra parte, las condiciones de vida de los trabajadores influyen en la mayor prevalencia de este servar. Condiciones rurales, falta de higiene, el contacto con mascotas sin tratamiento son factores de riego para la propagación de la leptospirosis(AU)


Leptospirosis is a disease classified as zoonotic, and it is also one of the most neglected. As an endemic zoonotic disease, it remains in the least favored places, affecting human health and also that of certain domestic animals. Such damage causes substantial economic and health losses in vulnerable populations. The incidence is estimated to affect one million human beings, causing the death of almost 59,000 of them. Transmission of human leptospirosis is due to direct or indirect exposure to primary infection sources such as infected animals (urine or tissues), and also by contact with contaminated food or water. In this work, the prevalence and risk factors of leptospirosis in the pig industry in different regions of the Peruvian State were studied. The results showed that workers, mostly male, aged between 20 and 50 years were the most vulnerable to these Leptospira serovars, which is related to direct contact with pigs and their derivatives. On the other hand, the living conditions of the workers influence the higher prevalence of this servar. Rural conditions, lack of hygiene, contact with untreated pets are risk factors for the spread of leptospirosis(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Zoonoses , Risk Factors , Vulnerable Populations , Industry , Animals, Domestic , Endemic Diseases , Pets , Infections , Leptospirosis/complications
19.
São Paulo; s.n; s.n; 2022. 113 p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: biblio-1415035

ABSTRACT

As doenças negligenciadas são causadas por agentes infecciosos e parasitários, como vírus, bactérias, protozoários e helmintos. Essas doenças são prevalentes em populações de baixa renda que vivem em países em desenvolvimento e são responsáveis por incapacitar e levar milhares de pessoas à morte. Este nome se dá pois, apesar de sua grande relevância médica, recebem pouca atenção dos governos e indústrias farmacêuticas. Dentre essas doenças podemos destacar a Doença de Chagas, doença infecciosa causada pelo parasita hemoflagelado Trypanosoma cruzi. Endêmica em 21 países, com 6 a 7 milhões de pessoas infectadas resultando em 7500 mortes por ano. A quimioterapia disponível contra essa parasitose é baseada em apenas dois medicamentos, o benznidazol e o nifurtimox, ativos principalmente na fase aguda da doença e com efeitos adversos graves que comprometem a adesão ao tratamento e, além disso, apesar dos enormes esforços na pesquisa de novos agentes antichagásicos em nível nacional e internacional, na maioria realizada academicamente, ainda não foram encontradas alternativas terapêuticas para a doença, persistindo, assim, a necessidade de descoberta e desenvolvimento de novos fármacos. O início de um planejamento de um novo fármaco se dá pela definição de um alvo bioquímico a ser utilizado na busca de moléculas que possam exercer a função de inibidores ou moduladores, conforme a atividade biológica desejada. Neste sentido, as sirtuínas 2 (Sir2) são enzimas que se mostraram essenciais para o crescimento in vitro do T. cruzi em suas formas amastigota e epimastigota. No caso de tripanossomatídeos, em geral, a superexpressão de Sir2 está relacionada à sobrevivência de formas amastigotas. Assim, essas evidências indicam que a Sir2 de tripanosomatídeos tem grande potencial como alvo biológico na busca e desenvolvimento de novos fármacos antichagásicos. O objetivo principal deste projeto foi identificar moléculas que apresentaram atividade inibitória para a sirtuína 2 de T. cruzi por meio da utilização da estratégia de Planejamento de Fármacos Baseada no Ligante - Ligand Based Drug Design (LBDD) e o desenvolvimento de análogos dos inibidores da Sir2. A modificação molecular está entre algumas das técnicas tradicionais usadas no desenvolvimento racional de um fármaco, e é usada principalmente no desenvolvimento de análogos, e busca melhorar as propriedades farmacocinéticas e/ou farmacodinâmicas de um protótipo, obter propriedades de interação semelhantes ao alvo e, em alguns casos, revelar uma atividade biológica. Com este intuito, análogos do sirtinol e da salermida foram sintetizados e uma nova rota sintética utilizando o microrreator em fluxo contínuo foi desenvolvida e apresentou rendimento superior quando comparado à síntese em bancada. A partir desta metodologia foram obtidos 20 compostos. Os ensaios in vitro contra formas amastigotas do T. cruzi indicaram que 8 compostos inibiram a atividade parasitária em mais de 50%, na dose de 10 µM, sendo que alguns destes apresentaram maior inibição parasitária quando comparados ao benznidazol, o fármaco de referência e único disponível no Brasil. Com estes resultados preliminares, novos ensaios estão sendo realizados para identificar potência e mecanismo de ação destes candidatos a agentes tripanomicidas


Neglected diseases are caused by infectious and parasitic agents such as viruses, bacteria, protozoa and helminths. These diseases are prevalent in low-income populations living in developing countries and are responsible for disabling and killing thousands of people. They get this name because, despite their great medical relevance, they end up receiving little attention from governments and pharmaceutical industries. Among these diseases, we can highlight Chagas disease, an infectious endemic disease caused by the hemoflagellate parasite Trypanosoma cruzi. This disease is endemic in 21 countries, with 6 to 7 million people infected resulting in 7,500 deaths per year. Chemotherapy is based on just two drugs, benznidazole and nifurtimox, which are mainly active in the acute phase of the disease. These drugs have adverse effects that compromise adherence, even more, considering that they are not effective from the point of view of the chronic phase of the disease. Despite the enormous efforts in researching new anti-chagasic agents at the national and international level, and mostly carried out academically, therapeutic alternatives for the disease have not yet been found, thus, the need for the discovery and development of new drugs persists. Sirtuins 2 (Sir2) are enzymes that have been shown to be essential for the in vitro growth of T. cruzi in its amastigote and epimastigote forms. In the case of trypanosomatids in general, Sir2 overexpression is related to the survival of amastigote forms. Sir2 inhibitors, such as sirtinol, have shown efficacy in leishmanicides. Thus, these evidences indicate that Sir2 from trypanosomatids can be considered as a biological target in the search and development of new anti-chagasic drugs. The beginning of a new drug planning study is the definition of a biochemical target to be used in the search for molecules that can play the role of inhibitors or modulators, according to the desired biological activity. The main objective of this project was to identify molecules that presented inhibitory activity to sirtuin 2 of T. cruzi using the Ligand Based Drug Design (LBDD) strategy of planning and the development of analogues of Sir2 inhibitors. Molecular modification is a traditional technique used in the rational development of a drug, as well as the use of natural products, combinatorial chemistry, high-throughput screening (HTS), among others. Mainly used in the development of analogues, molecular modification is applied for different purposes, among them, it seeks to improve the pharmacokinetic and/or pharmacodynamic properties of a prototype, obtain target-like interaction properties and, in some cases, reveal an activity biological. For this purpose, analogues of sirtinol and salermide were synthesized and a new synthetic route using the microreactor in continuous flow was developed and presented superior yield when compared to benchtop synthesis. From this methodology, 20 compounds were obtained. in vitro assays against amastigote forms of T. cruzi indicated that 8 compounds inhibited parasitic activity by more than 50% at a dose of 10 µM, and some of these showed greater parasitic inhibition when compared to benznidazole, the reference drug, and only available in Brazil. With these preliminary results, new assays are being carried out to identify the potency and mechanism of action of these candidate trypanocidal agents


Subject(s)
Pharmaceutical Preparations/analysis , Chemistry , Health Strategies , Drug Therapy/classification , Sirtuin 2/antagonists & inhibitors , In Vitro Techniques/methods , Drug Design , Continuous Flow , Communicable Diseases/complications , Chagas Disease/pathology , Endemic Diseases/prevention & control , Drug-Related Side Effects and Adverse Reactions , Methodology as a Subject , High-Throughput Screening Assays/instrumentation , Neglected Diseases/complications , Epigenomics/classification , Treatment Adherence and Compliance
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