Blood parasite load by qPCR as therapeutic monitoring in visceral leishmaniasis patients in Brazil: a case series study

ABSTRACT Background: This study aimed to describe the kinetics of Leishmania parasite load determined using kinetoplast DNA (kDNA)-based quantitative polymerase chain reaction (qPCR) in visceral leishmaniasis (VL) patients. Methods: Parasite load in blood was assessed by qPCR at five time points, up to 12 months post-diagnosis. Sixteen patients were followed up. Results: A significant reduction in the parasite load was observed after treatment (P < 0.0001). One patient had an increased parasite load 3 months post-treatment and relapsed clinically at month six. Conclusions: We have described the use of kDNA-based qPCR in the post-treatment follow-up of VL cases.

Transtorno mental no puerpério: riscos e mecanismos de enfrentamento para a promoção da saúde / Mental disorder in the puerpério: risks and mechanisms of counseling for the promotion of health / Transtorno mental en el puerto: riesgos y mecanismos de enfrentamiento para la promoción de la salud

Objetivo: Compreender os riscos e os mecanismos de enfrentamento apresentados pelas puérperas diante dos transtornos mentais no pós-parto. Métodos: Pesquisa qualitativa, de caráter descritivo, realizada com 12 puérperas, na faixa etária de 16 a 35 anos, que fizeram o acompanhamento do pré-natal na unidade de Atendimento Multiprofissional Especializado em Petrolina/PE, por meio de entrevista semiestruturada e observação dos conteúdos implícitos no comportamento das puérperas. A coleta dos dados ocorreu em novembro e dezembro de 2016. Resultados: Identificou-se que fatores como gravidez precoce ou não planejada, carência de apoio do companheiro, instabilidade familiar e baixas condições socioeconômicas podem contribuir como agentes facilitadores no surgimento de algum transtorno mental na puérpera. Conclusão: Considerando que os transtornos mentais são comuns no puerpério, quanto mais precocemente detectar os fatores de risco, melhor assistência poderá ser oferecida à puérpera

Objective: To understand the risks and coping mechanisms presented by puerperal women in the face of postpartum mental disorders. Methods: A descriptive qualitative study was carried out with twelve puerperae, in the age group of 16 to 35 years old who underwent prenatal follow-up at the Multiprofessional Specialized Care Unit in Petrolina-PE, through a semi-structured interview and observation of the contents implicit in the behavior of puerperal women. Data collection took place in November and December 2016. Results: It was identified that factors such as early or unplanned pregnancy, lack of support from the partner, family instability and low socioeconomic conditions can contribute as facilitating agents in the emergence of some mental disorder in the puerpera. Conclusion: Considering that chronic disorders are common in the puerperium, the earlier the risk factors are detected, the better care can be given to the woman

Objetivo: Comprender los riesgos y mecanismos de enfrentamiento presentados por las puérperas ante los trastornos mentales en el posparto. Métodos: Investigación cualitativa, de carácter descriptivo, realizada con doce puérperas, en el grupo de edad de 16 a 35 años que hicieron el seguimiento del prenatal en la unidad de Atención Multiprofesional Especializado en Petrolina-PE, por medio de entrevista semiestructurada y observación de los contenidos implícitos en el comportamiento de las puérperas. La recolección de los datos ocurrió en noviembre y diciembre de 2016. Resultados: Se identificó que factores como embarazo precoz o no planificado, carencia de apoyo del compañero, inestabilidad familiar y bajas condiciones socioeconómicas pueden aportar como agentes facilitadores en el surgimiento de algún trastorno mental en la puérpera. Conclusión: Considerando que los trastornos mentales son comunes en el puerperio, cuanto más precozmente detecte los factores de riesgo, mejor asistencia podrá ser ofrecida a la puérpera

Epidemiology of human visceral leishmaniasis in the urban centers of the lower-middle São Francisco Valley, Brazilian semiarid region

Abstract INTRODUCTION: Visceral leishmaniasis (VL) is a zoonosis caused by parasites of the Leishmania genus. VL is present in countries with tropical climates, being endemic in Brazil,, including the region of the lower-middle São Francisco Valley which includes the urban centers of Petrolina (Pernambuco state) and Juazeiro (Bahia state). METHODS: This retrospective and descriptive epidemiological study analyzed secondary data obtained from the mandatory visceral leishmaniasis notification forms of the Ministry of Health, which were compiled in the Information System for Notifiable Diseases (SINAN) database. We analyzed 181 autochthonous cases reported in the two aforementioned cities between 2010 and 2016. Data collection occurred in June 2017. RESULTS: Of the 181 VL cases in the study area, 40.9% (n=74) occurred in Juazeiro and 59.1% (n=107) occurred in Petrolina. The average numbers of cases per year were 9.5 in Juazeiro and 14 in Petrolina; respectively, the incidence ranges were 2-8.6 cases and 2.8-6.1 cases per 100,000 inhabitants. Fever, weakness, weight loss, and pallor were the most commonly observed clinical manifestations. Coinfection with human immunodeficiency virus (HIV) was observed in 16.8% and 5.4% of cases in Petrolina and Juazeiro, respectively. The lethality rates were 2.8% and 5.4% in Petrolina and Juazeiro, respectively. CONCLUSIONS: Both cities had a high incidence of VL during the studied period. The findings of this study contribute to a better understanding of the behavior of VL during recent years and may help to direct regional disease control measures.

Prevalência de depressão maior em pacientes com câncer de mama / Prevalence of major depression in patients with breast cancer

INTRODUÇÃO: o câncer de mama é uma das principais causas de morte entre as mulheres no Brasil e no mundo. O diagnóstico de neoplasia mamária geralmente representa uma sobrecarga emocional, podendo desencadear reações de ajustamento ou mesmo ser gatilho de quadros afetivos (principalmente depressão), ansiedade ou até mesmo psicoses. O Inventário de Depressão de Beck (IDB) é um dos instrumentos mais usados para avaliação de depressão, tanto em pesquisa quanto em clínica. A prevalência de depressão em pacientes com câncer tem variado bastante em diferentes trabalhos, de 3 a 55%. A falta de padronização, especialmente no que diz respeito aos métodos de avaliação, escore/ponto de corte, tipo de entrevista e critérios para diagnóstico contribuem para a grande discrepância nos achados desses estudos. No geral, quanto mais especificamente o termo depressão é definido e avaliado, menores índices de prevalência são reportados. Vários trabalhos falharam em mostrar significância estatística entre depressão e variáveis relacionadas ao câncer, sugerindo que os fatores de risco para depressão parecem estar mais relacionados à própria paciente, como variáveis contextuais e fatores pré-mórbidos inerentes à sua personalidade, do que ao câncer em si ou ao seu tratamentoOBJETIVO: determinar a prevalência de depressão maior em mulheres com câncer de mama...

INTRODUCTION: breast cancer is one of the main causes of death among women in Brazil and worldwide. The diagnosis of breast neoplasms usually represents an emotional burden, and it may lead to adjustment reactions and even be the trigger for affective disorders (mainly depression), anxiety or psychosis. The Beck Depression Inventory (BDI) is one of the most used mechanisms for the evaluation of depression in research and in clinics. Depression prevalence in patients with cancer varies from 3% to 55% among different studies. Methodological variation, different instruments to assess depression and different cut-off points for diagnosis contribute to the huge discrepancy in current findings. In general, the more specifically depression is defined and evaluated, the lower the rates of prevalence are reported. Many articles fail to demonstrate a statistical significance in the relationship between depression and cancer-specific factors. This suggests that risk factors for depression in those patients are more related to the patient as contextual variables and premorbid factors of personality - and not to the cancer or its treatment OBJECTIVE: to determine the prevalence of major depression in women with breast cancer...