RESUMO
Leishmaniasis is a disease caused by protozoa of the genus Leishmania. Treatment options are limited, and there are frequent cases of treatment failure and clinical relapse. To understand these phenomena better, a systematic review was conducted, considering studies published between 1990 and 2021 in Portuguese, English, and Spanish. The review included 64 articles divided into three categories. Case reports (26 articles) focused on treatment failure and clinical relapse in cutaneous leishmaniasis patients (47.6%), primarily affecting males (74%) and children (67%), regardless of the clinical manifestation. Experimental studies on the parasite (19 articles), particularly with L. major (25%), indicated that alterations in DNA and genic expression (44.82%) played a significant role in treatment failure and clinical relapse. Population data on the human host (19 articles) identified immunological characteristics as the most associated factor (36%) with treatment failure and clinical relapse. Each clinical manifestation of the disease presented specificities in these phenomena, suggesting a multifactorial nature. Additionally, the parasites were found to adapt to the drugs used in treatment. In summary, the systematic review revealed that treatment failure and clinical relapse in leishmaniasis are complex processes influenced by various factors, including host immunology and parasite adaptation.
RESUMO
Objetivo: Avaliar os indicadores antropométricos e o consumo alimentar de pessoas com diabetes mellitus tipo 2 atendidas em uma unidade básica de saúde na cidade de São Luís, Maranhão.Métodos:Trata-se de um estudo do tipo transversal, descritivo, com abordagem quantitativa realizado com 46 pacientes portadores de diabetes mellitus tipo 2,atendidos em uma unidade básica de saúde da capital maranhense. Foram utilizados formulários semiestruturados para a coleta de dados sociodemográficos, antropométricos e relacionados aos hábitos alimentares. As análises foram realizadas por meio de estatística descritiva, com dados sendo representados através de média, frequência e seus respectivos desvios padrões além do teste de correlação de Pearson entre as variáveis quantitativas. Resultados:A amostra foi representada em maioria por mulheres(54,4%), idosos (59,6%), sedentários (63,1%), que apresentavam alta obesidade abdominal (80,4%),ingeriam baixa quantidade de fibras (93,5%) e consumiam em grande quantidade proteínas (67,4%), gorduras saturadas (69,6%) esacarose (57,5%).Conclusão: Fatores como peso inadequado e alimentação desregulada podem representar risco para o controle glicêmico e contribuir para o agravamento do diabetes mellitus. Descritores: Diabetes mellitus. Estado nutricional. Ingestão de alimentos.
Objective: To evaluate the anthropometric indicators and food consumption of people with Type2 Diabetes Mellitustreated at a Basic Health Unit in the city of São Luís, Maranhão. Methods: This is a cross-sectional and descriptive study with a quantitative approach conducted with 36patients who have Type2 Diabetes Mellitus, treated at a BasicHealth Unit in the capital city of Maranhão. Semi-structured forms were used to collect sociodemographic and anthropometric data, as well as related to eating habits. The analyses were performed using descriptive statistics, with data represented as mean,frequency and their respective standard deviations, in addition to Pearson's correlation test between the quantitative variables. Results: The sample was mostly representedby women (54.4%), older adults(59.6%), sedentary people (63.1%), who had high abdominal obesity (80.4%), ingested a low amount of fiber (93.5%) and consumed a large amount ofprotein (67.4%), saturated fat(69.6%) and sucrose (57.5%). Conclusion: Factors such as inadequate weight and unregulated eating habits can represent risks for glycemic control and contribute to worsening of Diabetes Mellitus. Descriptors:Diabetes mellitus. Nutritional status. Eating.
