Brucellosis is one of the neglected diseases in Nigeria. In Lagos, the commercial capital of Nigeria with about twenty one million people, a descriptive cross-sectional study was carried out in order to determine the sero-prevalence of brucellosis among people at risk in some selected abattoirs and secondary health care facilities (hospitals) in the state. Mixed sampling method was employed at the abattoir while convenient sampling method was used in sampling the respondents at the hospitals. Sera samples from three hundred and one (n=301) abattoir-based workers and traders; and one hundred and twenty one (n=121) hospital-based individuals which include people with febrile illnesses and blood donors were tested for brucellosis using Rose Bengal Plate test (RBPT), with indirect ELISA being used as a confirmatory test. Of the 301 abattoir-based workers and traders, 27 (8.97%) were sero-positive to the infection when Rose Bengal Plate test antigen was used. The twenty seven individuals consists of fifteen (15) butchers; four (4) veterinarians; two (2) meat transporters and bone/cow horn dealers each as well as one each of blood meal producer, abattoir engineer, water seller and meat supplier. When blood samples from the sero-positive individuals were subjected to ELISA, 3 (11.1%) were sero-positive to the brucellosis, while one is equivocal. These results confirm that agglutination observed on RBPT might be related to unknown cross-reactions and confirmation with a different test was necessary. None of the hospital-based respondents is sero-positive to the infection. The clinical signs significant for the infection in this study were fever, joint pain, lower backache, regular headache and miscarriage. Brucellosis awareness level among the respondents was very low. Data was analysed using (SPSS) version 20.0 at α0.05 significant level. The significant risk factors for human brucellosis according to this research are consumption of fura (unpasteurized milk) and wara (fresh cheese). The study revealed that brucellosis is not only an occupational disease but can also affect people who trade or live in proximity with infected animals. / Agriculture, Animal Health and Human Ecology / M. Sc. (Agriculture)

Made available in DSpace on 2015-12-06T23:44:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2007 / Objetivo: Investigar se a irradiação toracoabdominal de camundongos induz bloqueio na evolução do LES em camundongos (NZB/NZW) F1 e a possível participação de células B-1 no processo. Métodos: Camundongos das linhagens (NZB/NZW) F1 fêmeos, NZB e NZW foram irradiados com 9 Gy na região toracoabdominal, a partir do terceiro mês de vida; 1 x por mês até 13 meses de idade. A dose total administrada foi de 90 Gy. Os animais foram sacrificados 48 h após a última irradiação, exceto os animais (NZB/NZW) F1 fêmeos não-irradiados (lúpicos), que vieram a óbito com 8, 9 ou 10 meses de idade. Foram realizados experimentos de citometria de fluxo e cultura de células B-1 de animais irradiados ou não. Foi também realizada análise por imunofluorescência indireta, da presença de auto-anticorpos no soro dos animais tratados e controles. Os rins dos animais foram analisados por métodos histológicos convencionais. Resultados: A sobrevida dos camundongos tratados com irradiação foi estatisticamente maior, quando comparada com aquela de camundongos não-tratados. Animais irradiados não apresentaram sinais da doença nem níveis detectáveis de auto-anticorpos circulantes. A análise histopatológica dos rins mostrou diminuição das lesões glomerulares e do infiltrado de células inflamatórias nos animais tratados, em contraposição aos glomérulos dos animais controles não tratados. Células B-1 estão normalmente presentes na cavidade peritoneal de animais (NZB/NZW) F1 e BALB/c, NZB e NZW. A irradiação seletiva desses animais resultou em diminuição significativa de células B-1 da cavidade peritoneal de camundongos BALB/c, NZB...(au). / The New Zealand Black x New Zealand White F1 [(NZB/NZW) F1] mouse develops an autoimmune condition in all similar to the systemic lupus erythematosus that occurs in humans. Among all the cellular alterations described, the number of B-1 cells increases in (NZB/NZW) F1 mice and in patients with rheumatoid arthritis and Sjögren disease. Considering evidences that B-1 cells could play a role in the development of lupus-like condition in female (NZB/NZW) F1 mice, a lead device was developed in order to deplete the animals of B-1 cells by selective irradiation. Apparatus protects the front and hind limbs of the animals against radiation, living the thoracic and abdominal region exposed. Cells were characterized by FACS. Survival of irradiated mice was significantly higher when compared with non-irradiated animals. Histological analysis of kidneys of irradiated animals showed milder lesions. Further, autoantibody was lower in irradiated mice when compared to controls. Radiation lead to marked reduction of B-1 cells in BALB/c but not in (NZB/NZW) F1 female mice. The radioresistance observed in B-1 cells from (NZB/NZW) F1 female mice is probably due to the overexpression of Bcl-2. The possible relationship between the radioresistance of these cells and the impairment of SLE is discussed. / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2015-12-06T23:47:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2007 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: K. pneumoniae e um importante patogeno no ambiente hospitalar. Os antimicrobianos da classe dos carbapenens tem sido amplamente utilizados para o tratamento das infeccoes causadas por amostras de K. pneumoniae produtoras de β-lactamases de amplo espectro. As metalo-β-Iactamases (MβL) sao enzimas bacterianas com habilidade de hidrolisar os carbapenens e, embora, ainda sejam raras, amostras de K. pneumoniae produtoras de MβL tem sido reportadas com uma frequencia cada vez maior. Objetivo: Avaliar os mecanismos de resistencia a carbapenens em amostras de K. pneumoniae. Metodologia: Nove amostras de K. pneumoniae isoladas ate o momento na cidade de São Paulo foram avaliadas. A relacao genetica entre estas amostras foi estudada utilizando-se a tecnica de PFGE. Os testes de sensibilidade aos antimicrobianos foram realizados pela tecnica de diluicao em agar, segundo as padronizacoes do NCCLS. A tecnica da reacao em cadeia da polimerase (PCR) foi utilizada para determinar a presenca dos genes responsaveis pela codificacao das MβL, assim como para 0 contexto genetico que abriga estes genes. A deteccao de outros mecanismos de resistencia, como alteracoes da permeabilidade da membrana externa e a presenca de efluxo, tambem foi realizada em todas as amostras. Resultados: Todas as amostras foram altamente resistentes a ceftazidima (MIC, 128 µg/ml), apresentando tambem resistencia a imipenem (MIC, 128 µg/ml) e a meropenem (MIC, 64 µg/ml). Dentre as nove amostras de K. pneumoniae, todas apresentaram produto de amplificacao de PCR positivo para o gene blaIMP-1. A resistencia aos carbapenens tambem foi correlacionada a ausencia de uma proteina de membrana externa de aproximadamente 36 kDa. A diminuicao da expressao...(au) / Background: The increasing prevalence of multi-drug resistant Klebsiella pneumoniae (KPN) isolates is an emerging problem worldwide. Integrons are common among these bacteria and play an important role in the development, capture and expression of resistance genes. Methods: The genetic context around the blaIMP-1 gene was evaluated in 8 clonally related KPN isolates, recovered from a hospital from the city of Sao Paulo (SP), Brazil. The integron was revealed by a walking sequencing strategy. The plasmid obtained from the index isolate was electroporated into Escherichia coli XL1 Blue. Selection of recipient cells was performed in 5 µg/ml ceftazidime plates. Plasmid size was calculated based on the size of the plasmid restriction fragments. The amplicon of the dfr gene was cloned in TOPO vector and transformed into E. coli host. Trimethoprim MICs were performed by NCCLS agar dilution. Results: PCR and sequence analysis revealed that the strain carried two different class 1 integrons, a copy of the previously described In86 and a new integron, named In87. In86 carried blaIMP-1 in the first position, followed by aacA30 and aadA1 genes. The second integron, In87, carried a single gene cassette closely related to dfr22. The product of dfr23 showed 99% of amino-acid homology with DFR22 (one amino-acid substitution, Ser121-Tyr). Further characterization of the isolates revealed that In86 was likely to be located in a non-transferable 30 Kb plasmid. Conclusions: IMP-1 producing Acinetobacter spp. recently isolated in SP was the likely source of In86 acquisition since they carry an identical integron to those encountered in the studied KPN isolates. The presence of trimethoprim resistance gene cassettes in class 1 integrons which normally harbor sul1 gene at the 3’CS is most likely driven by the use of trimethoprimsulfamethoxazole combination. / Fundação de Amparo à Pesquisa do Estado de São Paulo – FAPESP / BV UNIFESP: Teses e dissertações

My thesis is that the tendency of modern medicine to reduce patients into causes to be mastered rather than persons to be treated does not stem from post-Enlightenment developments but rather lies within the beginnings of Western medicine itself, in what I call the anatomical rationality. I follow the development of this rationality through Hippocrates, the beginnings of anatomical dissection in Aristotle and Herophilus, and the theological translation of anatomy by Galen. I further show how this anatomical rationality that arises from medicine then transforms into dissective analysis that applies to theological and philosophical discourse, as seen paradigmatically in Nestorianism and the ontological logic of Avicenna. I argue that this anatomical rationality is a totalizing approach to knowing that creates new dualisms, such that nothing can escape the dissective gaze, God and man included. I suggest that the way to overcome the totalizing effects of the anatomical rationality is turning to the Incarnation of Christ, the God-man, who provides both the metaphysical ground and imagination for paradox and mystery, thereby protecting the integrity of God and man.

Sexual harassment against women represents aggressive behaviour that is often enacted instrumentally, in response to a threatened sense of masculinity and male identity (cf. Maass & Cadinu, 2006). To date, however, empirical and theoretical attention to the social-cognitive processes that regulate workplace harassment is scant. Drawing on Social Cognitive Theory (Bandura, 1986), the current thesis utilises the theoretical concept of moral disengagement in order to address this important gap in the literature. According to Bandura (1990, 1999), moral standards and self-sanctions (i.e., negative emotions of guilt or shame) can be selectively deactivated through various psychosocial mechanisms. The use of these moral disengagement strategies enables a person to violate their moral principles, and perpetrate injurious behaviour without incurring self-censure. This thesis investigates the general hypothesis that moral disengagement facilitates and perpetuates workplace sexual harassment. A new conceptual framework is presented, elucidating the self-regulatory role of moral disengagement mechanisms in sexual harassment perpetration at work. Eight empirical studies are reported in this thesis. Studies 1 to 3 present the development and preliminary validation of the Moral Disengagement in Sexual Harassment Scale (MDiSH); a self-report measure of moral disengagement in the context of hostile work environment harassment. These studies document the excellent psychometric properties of this new scale. The MDiSH exhibited positive correlations with sexual harassment myth acceptance, male gender identification, and hostile sexism. In Study 3, participants were exposed to a fictitious case of hostile work environment harassment. The MDiSH attenuated moral judgment, negative emotions (guilt, shame, and anger), sympathy, and endorsement of prosocial behavioural intentions (support for restitution) associated with the harassment case. Conversely, the MDiSH increased positive affect (happiness) about the harassment, endorsement of avoidant behavioural intentions, and attribution of blame to the female complainant. Using the amalgamated samples of Studies 1 and 2, the MDiSH was winnowed down to create a short form of the scale (MDiSH-S). The analyses reported in Chapter 3 attest to the strong psychometric properties of this measure. Study 4 explores the influence of social identification on the relationship between moral disengagement and judgments of hostile work environment harassment. U.S. participants were presented with a harassment case in which the perpetrators were described as being either in-group or out-group members. Moral disengagement (as measured using the MDiSH) neutralised judgments of the harassing behaviour. However, participants were not more inclined to justify and positively re-appraise harassment that was committed by in-group perpetrators. Study 5 reveals that moral disengagement leads people to make more favourable judgments about the perpetrators of hostile work environment harassment. The neutralising effects of moral disengagement on judgments of the harassing conduct were partially mediated by a positive evaluation of the harassers (but not social identification with them). The final three studies (Studies 6, 7, and 8) investigate the role of moral disengagement in accounting for men’s self-reported proclivity to commit quid pro quo harassment and hostile work environment harassment. These studies examine the causal pathway between moral disengagement and harassment proclivity, and the psychological mechanisms (emotions and moral judgment) that underlie this relationship. Taken together, the results suggest that moral disengagement mechanisms are important social cognitions that people use to deny, downplay, and justify workplace sexual harassment. The findings of this thesis also provide preliminary support for the notion that moral disengagement is a self-regulatory process in sexual harassment perpetration at work (cf. Page & Pina, 2015). The thesis concludes with a discussion of theoretical implications of the findings, methodological limitations, practical implications, and suggestions of future research avenues.

This thesis is an in-depth critical analysis of the nature of the science/religion relationship. The purpose of this project is to expose the problems associated with the many fallacies related to these phenomena, and to evaluate the reasons behind certain perceptions. It outlines the damage done through years of misconceiving and misunderstanding the concepts of science and religion, and to address what led to such inadequacies in interpretation, emphasizing the use of insufficient and archaic methodologies. A number of the methodological problems that will be assessed are the following: Chapter One will focus primarily on the issues related to the definition of religion and will evaluate how this was/is a contributing factor in how ‘religion’ is received and recognized in the academic community as well as in more popular circles. The main emphasis here will be on the false conception that ‘religion’ is a stagnant concept rather than a dynamic one, and will be examined through an appraisal of its chromatic history. This will be followed by an examination of the primarily Christocentric and Western ideologies that are endemic to this field of study, and will demonstrate how these beliefs are related to the Western construction of ‘religion’ and are tied strongly to the spread of imperialism throughout the world. Chapter Two will build on these issues, through highlighting the Western conceptualizations of religion and science, especially the erroneous belief that these phenomena are universally shared. Similarly evaluated in this chapter will be a number of other factors: (1) The subjective approaches taken by some scholars who insist on making ‘science’ sound more like ‘religion’ through the use of clever machinations. (2) Related to this is the concept of inclusivism, which will call attention to the negative effects that Western biases (in academia) have on non-Western practices, mainly denuding them of their cultural uniqueness. (3) Furthermore, this chapter will examine the over simplification of complex cultural phenomena in academia and will evaluate the inefficacy of certain works in dealing with these phenomena. This will be garnished with a critical assessment of this scholarship and will gauge how years of misinformation and negligence (within the academy) has led to a troubling relationship between science and religion. This will be proceeded by a case-study of the ‘scientific movement’ known as transhumanism as a means to demonstrate the long lasting and problematic effects that years of misinterpretation has had on the popular understanding of the science/religion phenomena, from at least one perspective. This will be concluded with an examination of the future of this evolution. Evidenced here through the use of SF film, is how transhumanism, because of its relationship to science and religion and its communion with popular transcultural SF ideas, has the potential to become a site for a belief system that translates well cross-culturally and incorporates both of these phenomena.

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências de Saúde, Programa de Pós-Graduação em Farmácia, Florianópolis, 2014. / Made available in DSpace on 2015-02-05T20:33:26Z (GMT). No. of bitstreams: 1 327703.pdf: 3101411 bytes, checksum: f8c60d47a43ee28b03d37f24f32ff1f7 (MD5) Previous issue date: 2014 / As infecções pelo HIV e pelo HBV são preocupantes problemas de saúde pública, sendo que, a infecção pelo HBV se constitui no principal problema mundial de saúde pública; estima-se que existam 350 milhões de portadores crônicos do HBV no mundo. No Brasil, a prevalência do HBV em geral é moderada (2% a 7%), com baixa taxa de infecção no Sul, média taxa de infecção no Nordeste e Sudeste e uma alta prevalência na região Amazônica, Espírito Santo e no oeste de Santa Catarina. O Brasil registrou 608.230 casos de AIDS desde 1980, o que representa uma prevalência média de 0.6% da população adulta. No início de 2014 poucos dados estão disponíveis sobre a prevalência dos marcadores de infecção e imunidade para hepatite B em indivíduos soropositivos para o HIV. Objetivos: Estabelecer a prevalência dos marcadores de infecção, de imunidade para o vírus da hepatite B e a cobertura vacinal contra HBV em indivíduos adultos HIV soropositivos confirmados residentes na região metropolitana de Florianópolis. População: Participaram deste estudo, realizado no período de outubro de 2012 a março de 2013, 300 voluntários, comprovadamente soropositivos para o HIV. Dados sócios demográficos como a idade, gênero, etnicidade, escolaridade, renda mensal, tempo do diagnóstico do HIV, tempo de terapia antirretroviral, forma mais provável da infecção pelo HIV e o resultados de carga viral do HIV e contagem de linfócitos T CD4, foram obtidos dos pacientes. Resultados: A prevalência dos marcadores HBsAg, anti-HBc foi de 2,3% e 29,3%, respectivamente. O marcador de imunidade anti-HBs, apresentou prevalência de 56,7% nos pacientes estudados; 43,3% dos pacientes estudados apresentavam título menor que 2,0 mUI/mL, em 9,7% o título estava entre 2,1 e 10,0 mUI/mL e em 47,0% o título era maior que 10,1 mUI/mL. A cobertura vacinal foi de 57,4%. Dos pacientes vacinados, se verificou que 15,3%, 7,7% e 34,3% apresentavam título de anti-HBs < 2,1 mUI/mL, de 2,1 a 10,0 mUI/mL e >10,1 mUI/mL, respectivamente. Conclusões: A prevalência dos marcadores HBsAg e anti-HBc apresentou uma redução expressiva, quando comparados aos resultados verificados em 1999, em estudo feito na mesma região e população alvo. A cobertura vacinal da população estudada, de 57,4% é significante, mas a disponibilidade da vacina pode ser ainda melhor divulgada e intensificada/ampliada pelo Ministério da Saúde.<br> / Abstract : Introduction: HIV infection and HBV are two troubling public health problems, and that HBV infection is the main global public health problem, it is estimated that there are 350 million chronic carriers of HBV. In Brazil, the prevalence of HBV is generally moderate (2 % to 7 %), with low infection rate in the South, the average rate of infection in the Northeast and Southeast and a high prevalence in the Amazon, the Espírito Santo and the western region of Santa Catarina. There are in Brazil registered 608,230 cases of AIDS since 1980, representing an average prevalence of 0.6 % of the adult population. There are currently few data are available on the prevalence of markers of infection and immunity to hepatitis B in HIV-seropositive individuals. Objectives: To determine the prevalence of markers of infection, immunity to hepatitis B virus and HBV vaccination coverage in adults confirmed HIV seropositive residents in the metropolitan region of Florianópolis. Population: The study, was conducted from October 2012 to March 2013, 300 volunteers, proven HIV seropositive. Demographic social data such as age, gender, ethnicity, education, income, time of HIV diagnosis, duration of antiretroviral therapy, most likely form of HIV infection and the results of HIV viral load and CD4 counts were obtained from patients. Results: The prevalence of HBsAg, anti-HBc was 2.3% and 29.3%, respectively. The marker of immunity anti-HBs, showed a prevalence of 56.7% in the patients studied, 43.3% of patients had a lower title than 2.0mIU/mL, in 9.7% the title was between 2.1 and 10.0mIU/mL and 47.0% greater than the title was 10.1mIU/mL. Vaccination coverage was 57.4%. Of the vaccinated patients, it was found that 15.3%, 7.7% and 34.3% had a titer of anti-HBs < 2.1mIU/mL, 2.1 to 10.0mIU/ml and > 10.1mIU/mL, respectively. Conclusions: The prevalence of HBsAg and anti-HBc showed a significant reduction when compared to those recorded in 1999, in a study done in the same area and target population results. The vaccination coverage of the population studied, 57.4% is significant, but the availability of the vaccine may be even better publicized and intensified / amplified by the Brazilian Ministry of.

Made available in DSpace on 2012-05-07T14:43:57Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 000032.pdf: 4330648 bytes, checksum: bd80b9612f7455644b3a3466bb6b9b7e (MD5) Previous issue date: 2007 / As infecções pelo vírus dengue têm se tornado um problema crescente de Saúde Pública em regiões tropicais e subtropicais do mundo. O vírus pertence à família Flaviviridae com quatro sorotipos antigenicamente distintos (DENV-1 a DENV-4). Uma possível estratégia para evitar a patogenia associada com uma vacina para o dengue (que deve ser tetravalente), seria a construção de uma vacina quimérica composta de epítopos críticos selecionados dos quatro sorotipos. A maioria dos epítopos envolvidos na neutralização do vírus está presente na glicoproteína E do envelope, que é a maior proteína de superfície da partícula viral. O objetivo deste trabalho foi identificar epítopos de célula B na glicoproteína E do vírus dengue sorotipo 3. Para o mapeamento de epítopos imunodominantes, noventa e cinco peptídeos (15-mers cada, sobreposição de 10) foram sintetizados (Synpep, California-USA), a partir da sequência de 490 aminoácidos da glicoproteína E do envelope do DENV-3, de cepa circulante no Brasil. Estes peptídeos foram testados por ELISA contra um pool de soros de pacientes positivos e negativos para dengue, coletados durante a fase de convalescença da infecção por DENV-3. Os resultados mostraram que os soros de humanos reagiram com onze, dos noventa e cinco peptídeos testados, distribuídos em 5 regiões com aminoácidos na posições 51-65 (peptídeo 11), 71-90 (peptídeos 15 e 16), 131-170 (peptídeos 27, 28, 29, 30, 31 e 32), 196-210 (peptídeo 40) e 246-260 (peptídeo 50). A análise da curva ROC mostrou que, dentre os peptídeos identificados, nove seriam capazes de diferenciar entre pacientes com DENV-3 de pacientes não-dengue e três capazes de diferenciar a infecção por DENV-3 daquelas por outros sorotipos virais (DENV-1 e DENV-2). Os epítopos imunodominantes aqui descritos, junto com outros epítopos bem documentados, são potencialmente relevantes para o desenho de uma vacina para o vírus dengue e para o desenvolvimento de kits de diagnóstico específicos

Made available in DSpace on 2012-05-07T15:02:16Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 000004.pdf: 872019 bytes, checksum: b8e894b7b58911018e4a590c0266cbe1 (MD5) Previous issue date: 2010 / Fundação Oswaldo Cruz. Instituto Nacional de Controle de Qualidade em Saúde / A bactéria Haemophilus da espécie influenzae, pode causar no homem diversas infecções, invasivas ou não. O H. influenzae do tipo b (Hib), antes da introdução da vacina conjugada contra Hib, associava-se a infecções como epiglotite, artrite séptica, bacteriemia, pneumonia septicemia e meningite, principalmente em crianças. As outras espécies tipáveis (a,c,d,e,f) e não tipáveis estavam associadas a infecções do trato respiratório adquiridas na comunidade. Após a introdução dessa vacina, houve redução expressiva das doenças causadas pelo Hib em diversas partes do mundo, inclusive no Brasil. Atualmente, outros tipos da espécie H. influenzae (Hi) que não o Hib estão sendo isoladas não somente em crianças, causando infecções graves. O ressurgimento de casos por Hib, em crianças vacinadas, tem sido reportado como possível falha vacinal. Esses fatos preocupam a Saúde Pública no mundo, demonstrando que mudanças epidemiológicas podem estar ocorrendo devido à seleção de cepas após a introdução da vacina. Neste estudo, mudanças genéticas na região capsular do Hi foram encontradas em cepas isoladas nos períodos pré e pós-vacinal de três estados brasileiros. Através do estudo de susceptibilidade foram encontradas cepas produtoras de β-lactamase (BLA+) e não produtoras resistentes a ampicilina (BLNAR). A análise de redução da susceptibilidade às quinolonas foi avaliada utilizando-se o ácido nalidíxico como marcador, confrontando-se a resistência deste antibiótico com os marcadores moleculares das regiões determinantes de resistência a quinolonas (QRDRs) através do sequenciamento dos genes gyrA e parC que codificam a síntese das proteínas GyrA e ParC. Os resultados obtidos demonstraram que o ácido nalidíxico é o antibiótico mais indicado desse grupo para detectar a redução da sensibilidade. / The bacteria specie Haemophilus influenzae can cause several infections on men, either invasive or not. Before the introduction of conjugated vaccine against type b H. influenzae (Hib), it was associated to infections like epiglottitis, septic arthritis, bacteremia, pneumonia, septicemia and meningitis, occurring mostly in children. The other typeable species (a,c,d,e,f) and not typeable (NT) were associated to infections of respiratory trait acquired in the community. After introducing this vaccine, expressive reduction of diseases caused by Hib has been observed worldwide, including Brazil. Recently, different types of H. influenzae species other than Hib have been isolated in children and adults, causing severe infections. The reemergence of Hib cases in vaccinated children has been reported as a possible vaccine failure. These facts are a concern to public health departments around the world showing that epidemiologic changes may happen due to the selection of strains after vaccine introduction. In this study, genetic changes in the capsular region of Hi were found in isolated strains in the pre and post vaccinal periods in three Brazilian states. Through susceptibility studies, β-lactamase producer strains were found as well as non producer resistant to ampicilin (BLNAR). Analysis of susceptibility reduction to quilonones was evaluated by using nalidixic acid as a marker, and comparing the resistance to this antibiotic to molecular markers of the determining regions of resistance to quilonones (QRDRs) through sequencing of gyrA and parC genes that codify the synthesis of GyrA and ParC proteins. The results show that nalidixic acid is the most suitable antibiotic of this group able to detect sensibility reduction to quinolones. This study shows that there is a need for routine and research laboratories to evaluate and develop simple and quick methods to indicate possible capsule changes and emergence of resistant strains, to help epidemiological and sanitary surveillance.

Made available in DSpace on 2012-09-06T01:11:22Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 741.pdf: 636766 bytes, checksum: ebcacbc95bfd2876cf0f02916348e3c5 (MD5) Previous issue date: 2004 / (...) Foi realizado um estudo com o objetivo de verificar o perfil clínico-epidemiológico e a distribuição espacial de casos conhecidos de hepatites B e C na cidade de Manaus. Foram analisados retrospectivamente um mil, quinhentos e nove pacientes infectados pelo HBV e HCV, entre 1997 e 2001, atendidos no Ambulatório Araújo Lima e na Fundação de Medicina Tropical do Amazonas. Duzentos e trinta e um casos foram submetidos à análise para estudo do perfil clínico-epidemiológico. Os casos de hepatite estavam associados ao HBV em 72,7 por cento, em 12,1 por cento estavam associados ao HCV e 15,2 por cento dos casos apresentavam associação dos dois vírus. O estudo do perfil clínico-epidemiológico destes pacientes mostrou predominância absoluta das formas crônicas. As formas clínicas encontradas foram predominantemente as formas avançadas da doença Hepatite Crônica (26,8 por cento, 28,6 por cento e 45,7 por cento) e Cirrose Hepática (54,8 por cento, 64,3 por cento e 42,9 por cento). O sexo mais acometido foi o masculino (67,9 por cento) e o feminino 32,1 por cento. Em todas as faixas etárias houve predominância de casos de hepatite B. Mediana da idade de ocorrência da hepatite B significativamente menor do que a mediana da idade de ocorrência da hepatite C. Ocorrência elevada de casos de hepatite C e de casos de hepatite com associação HBV/HCV nas faixas acima de 40 anos. Ocorrência nula de casos de hepatite C nas faixas etárias até 19 anos. Os fatores de risco mais fortemente associados à ocorrência da hepatite B foram: uso de drogas injetáveis, história de cirurgia prévia e de transfusão sanguínea. Os fatores de risco mais fortemente associados à ocorrência da hepatite C foram história prévia de cirurgia e transfusão sanguínea. Com relação à transmissão sexual, o estudo mostrou que tanto as relações homossexuais quanto as relações heterossexuais são fatores de risco para ocorrência das hepatites B e C, havendo necessidade de investigação sobre multiplicidade de parceiros e a prática de sexo desprotegido. A distribuição espacial das hepatites virais em Manaus não mostrou um padrão regular, ocorrendo de forma aleatória nos bairros; não foi identificado nenhum fator comum entre eles que estivesse determinando a ocorrência tanto da hepatite B quanto da hepatite C.