Darbo tikslas: Įvertinti operacinės slaugytojų susižeidimų adatomis ir kitais aštriais instrumentais riziką. Tyrimo objektas - operacinės slaugytojų susižeidimų adatomis ir kitais aštriais instrumentais rizika. Darbo uždaviniai: 1. Įvertinti operacinės slaugytojų susižeidimų adatomis ir kitais aštriais instrumentais dažnumą, pobūdį bei susižeidimų priežastis. 2. Išanalizuoti saugią operacinės darbo aplinką lemiančius veiksnius. 3. Ištirti operacinės slaugytojų požiūrį į susižeidimų adatomis ir kitais aštriais instrumentais pranešimą ir jų registraciją. Tyrimo metodika: Tyrimas atliktas 2013 metų sausio – balandžio mėnesiais Vilniaus ir Kauno miestų tretinio lygio ligoninėse. Tyrimui panaudota vokiečių mokslininkės dr. Sabine Wicker sudarytos anketos: „Atsitiktinis susižeidimas“ (‚,Ein stich stecktan“) ir „Sumažinti pavojų užsikrėsti – vengti adatos dūrio“ (,,Infektionsrisiken senken – Nadelstichverletzungen vermeiden“). Anketos išverstos į lietuvių kalbą. Viso buvo išdalinta 200 anketų, grižo 185 anketos, iš jų nepilnai atsakytos 10. Statistinei analizei buvo naudotos 175 užpildytos anketos. Statistiniam duomenų apdorojimui naudoti SPSS 17.0 ir Microsoft Excel programų paketai. Statistinis duomenų reikšmingumas tikrintas pagal chi kvadrato (χ2) kriterijų ir statistinį reikšmingumą (p). Duomenų skirtumas reikšmingas, kai p<0,05. Tyrime naudotas faktorinės analizės metodas. Rezultatai ir išvados: Analizuojant tyrimo duomenis, nustatyta, kad tarp apklaustųjų nebuvo nei vieno... [toliau žr. visą tekstą] / Research aim: to assess the risk of operating room nurses injuries with needles and other sharp instruments. Research object: operating room nurses injuries with needles and other sharp instruments. Research objectives: 1. To asses frequency, type and reasons of operating room nurses injuries with needles and other sharp instruments. 2. To analyse influencing causes for safe operating room environment. 3. To analyse the operating room nurses attitudes towards registration and reporting of injuries inflicted by needles and other sharp instruments. Research methodology: Research was done in January–April 2013 in Vilnius and Kaunas 3rd level hospitals. For this research two types of questionnaires, written by German scientist Dr. Sabine Wicker, were used: „Incidental Injury“ („Ein stich Stecktan“) and „Minimizing the danger of infection – prevent the needle puncture“ (,,Infektionsrisiken senken – Nadelstichverletzungen vermeiden“). Questionnaires were translated to Lithuanian language. There were 200 questionnaires distributed in total, 185 of them were returned and 10 were not fully answered. 175 fully answered questionnaires were used for statistical analysis. SPSS 17.0 and Microsoft Excel programs were used for statistical data analysis. Statistical data meaningfulness was verified by chi quadrant (χ2) criteria and statistical meaningfulness. Data difference is meaningful when p<0,05. Factor analysis method was used for the research. Results and conclusions: During the... [to full text]

This thesis aimed to describe the epidemiology of HCV in South Australian prisons - prevalence, transmission and risk factors. This thesis also aimed to determine the impact of incarceration on reported risk behaviours. A related objective was to evaluate the epidemiological effectiveness of the ELISA - 3 HCV antibody test using PCR as the gold standard. Finally, this thesis aimed to explore the potential for minimising HCV risk in the South Australian prison population. Methods: Two case note audits were conducted at each of eight publicly operated SA prisons ( in summer and winter ) to identify any documented HCV - antibody test results. Prisoners recruited at entry to prison were offered tests for HCV - antibody and completed a pre - entry risk factor survey. Participants completed additional risk factor surveys and ( if HCV - negative at last test ) underwent further antibody tests at three - monthly intervals for up to 15 months. A sample of participants also provided blood specimens for HCV - RNA testing. Limited stakeholder consultations with prison officers and nurses were also conducted. Quantitative data were analysed using univariate and multivariate techniques. Results: 1347 case notes were audited in summer, and 1347 in winter and an overall HCV prevalence of 42 % was estimated. In both univariate and multivariate analyses, HCV prevalence was significantly higher in female prisoners ( 65 % ), those aged above 28 years ( 48 % ), and in Indigenous prisoners originating from metropolitan areas ( 56 % ). Indigenous prisoners originating from remote areas had significantly lower HCV prevalence ( 20 % ). 666 prisoners were recruited at entry, and 42 % were estimated to be HCV - antibody positive. Three seroconversions were noted in 151 initially HCV - seronegative negative individuals followed up for a median time of 121 days - a rate 4.6 per 100 person years - but community exposure could not be ruled out. Overall agreement between HCV - antibody and HCV - RNA assays was 86 % ( 100% in the HCV negative samples ) - kappa = 0.71. Injecting history was highly prevalent in prison entrants ( 70 % ) and both community and prison injecting ( but not tattooing ) were independent predictors of entry HCV status. Prison history was also independently associated with entry HCV status. Injecting in prison during the study was infrequently reported, but significantly more likely in those testing HCV - antibody positive at prison entry ( risk ratio = 2.48, P = 0.046 ). Stakeholders were most supportive of strategies to increase education and to minimise risks associated with hair clippers, but did not support most other suggested preventive strategies. Other issues related to communicable diseases and infection control were explored in the stakeholder interviews. Conclusions: HCV prevalence in South Australian prisoners is extremely high and may have contributed to a ' ceiling effect ' , minimising the seroconversion rate observed in this population. Injecting is relatively infrequently reported in prison, but more likely in those already infected with HCV. Thus, contaminated injecting equipment represents a significant threat to other prisoners and prison staff. Strategies aimed at reducing HCV risk in prisons, which address the concerns of those expected to implement them, are proposed in this thesis. / Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2006.

This thesis aimed to describe the epidemiology of HCV in South Australian prisons - prevalence, transmission and risk factors. This thesis also aimed to determine the impact of incarceration on reported risk behaviours. A related objective was to evaluate the epidemiological effectiveness of the ELISA - 3 HCV antibody test using PCR as the gold standard. Finally, this thesis aimed to explore the potential for minimising HCV risk in the South Australian prison population. Methods: Two case note audits were conducted at each of eight publicly operated SA prisons ( in summer and winter ) to identify any documented HCV - antibody test results. Prisoners recruited at entry to prison were offered tests for HCV - antibody and completed a pre - entry risk factor survey. Participants completed additional risk factor surveys and ( if HCV - negative at last test ) underwent further antibody tests at three - monthly intervals for up to 15 months. A sample of participants also provided blood specimens for HCV - RNA testing. Limited stakeholder consultations with prison officers and nurses were also conducted. Quantitative data were analysed using univariate and multivariate techniques. Results: 1347 case notes were audited in summer, and 1347 in winter and an overall HCV prevalence of 42 % was estimated. In both univariate and multivariate analyses, HCV prevalence was significantly higher in female prisoners ( 65 % ), those aged above 28 years ( 48 % ), and in Indigenous prisoners originating from metropolitan areas ( 56 % ). Indigenous prisoners originating from remote areas had significantly lower HCV prevalence ( 20 % ). 666 prisoners were recruited at entry, and 42 % were estimated to be HCV - antibody positive. Three seroconversions were noted in 151 initially HCV - seronegative negative individuals followed up for a median time of 121 days - a rate 4.6 per 100 person years - but community exposure could not be ruled out. Overall agreement between HCV - antibody and HCV - RNA assays was 86 % ( 100% in the HCV negative samples ) - kappa = 0.71. Injecting history was highly prevalent in prison entrants ( 70 % ) and both community and prison injecting ( but not tattooing ) were independent predictors of entry HCV status. Prison history was also independently associated with entry HCV status. Injecting in prison during the study was infrequently reported, but significantly more likely in those testing HCV - antibody positive at prison entry ( risk ratio = 2.48, P = 0.046 ). Stakeholders were most supportive of strategies to increase education and to minimise risks associated with hair clippers, but did not support most other suggested preventive strategies. Other issues related to communicable diseases and infection control were explored in the stakeholder interviews. Conclusions: HCV prevalence in South Australian prisoners is extremely high and may have contributed to a ' ceiling effect ' , minimising the seroconversion rate observed in this population. Injecting is relatively infrequently reported in prison, but more likely in those already infected with HCV. Thus, contaminated injecting equipment represents a significant threat to other prisoners and prison staff. Strategies aimed at reducing HCV risk in prisons, which address the concerns of those expected to implement them, are proposed in this thesis. / Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2006.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / "May 2008." Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0911. Adviser: Lu-Yu Hwang. Includes bibliographical references (leaves 54-62).

Thesis (Ph. D.)--University of Virginia, 2008. / Title from title page. Includes bibliographical references. Also available online through Digital Dissertations.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The Schistosomiasis is a parasitic disease, severe, chronic waterborne and development, whose etiologic agent is Schistosoma mansoni. It occurs in 74 countries with 207 million people infected and 700 million in risky areas. In Brazil, data indicate a prevalence of eight million. The Schistosomiasis can be exacerbated when patients are carriers of the Hepatitis B Virus (HBV) and C (HCV), resulting in simultaneous evolution of both pathologies. In Brazil, the prevalence of co-infection with HBV/HCV and S. mansoni found in studies ranged from 13.6% to 40% for HBV and 0.5% to 19.66% for the HCV. On this basis, this research aimed to identify the prevalence of serological markers of HBV and HCV and risky factors in individuals carrying the S. mansoni in the Santa Maria neighborhood, Aracaju, state of Sergipe. We conducted a cross-sectional epidemiological study. Data were collected for each patient by means of a questionnaire investigation. This questionnaire included variables identifying the subject of the research participants and variables that included the epidemiological risky factors for infection with HBV or HCV. We collected serum samples of research participants and forwarded to the laboratory testing to identify serological markers of hepatitis B and C: Total Anti-HBc IgG, Anti-HBs, HBsAg and Anti-HCV. All procedures performed using the technique of chemiluminescence immunoassay using the ARCHITECT assay for each serological marker following the protocols established by the laboratory equipment manufacturer SYSTEM ARCHITECT. In addition, we carried out the analysis of spatial distribution of co-infection in the district through the program using the TerraView Kernel intensity estimation. It was found that 16 individuals had contact with HBV (9.41%), one of these was positive for HBsAg. Only Thirty-two samples (18.82%) were positive for the marker Anti-HBs. Three samples were positive for anti-HCV (1.76%), and also a positive for Anti-HBc. The main risks of HBV and HCV infection were related to parenteral interventions of health services, as well as sexual activity without condom use in the case of HBV. Spatial analysis of cases of co-infection (Schistosomiasis and Hepatitis) allowed the visualization of areas of higher concentration of these infections, as well as those that are exposed to different degrees of risk of transmission. The survey results allow to offer, the municipal health services, a tool to facilitate the understanding of the spatial distribution of schistosomiasis and hepatitis (B and C) in Santa Maria neighborhood. Although our values are above the estimated prevalence for the Brazilian population and the Northeast, we can t infer that the individuals with Schistosomiasis are more susceptible to infection with HBV or HCV, since the risky factors were the means of risky transmission of causative agents of hepatitis and not infected with S. mansoni. / A Esquistossomose Mansônica é uma doença parasitária grave, de veiculação hídrica e evolução crônica, cujo agente etiológico é o Schistosoma mansoni. Ocorre em 74 países, com 207 milhões de pessoas infectadas e 700 milhões em áreas de risco. No Brasil, dados indicam uma prevalência de oito milhões. A Esquistossomose pode ser agravada quando os pacientes são portadores dos Vírus das Hepatites B (VHB) e C (VHC), resultando na evolução simultânea de ambas as patologias. No Brasil, As prevalências da co-infecção VHB/VHC e S. mansoni encontradas nos estudos realizados variaram de 13,6% a 40% para o HBV e de 0,5% a 19,66% para o HCV. Com base nisso, esta pesquisa objetivou identificar a prevalência de marcadores sorológicos do VHB e VHC e os fatores de risco em indivíduos portadores do S. mansoni no Bairro Santa Maria, Aracaju/SE. Foi realizado um estudo epidemiológico do tipo transversal. Coletaram-se dados de cada paciente por meio de um questionário investigativo. Este questionário contemplou variáveis de identificação do sujeito participante da pesquisa e variáveis epidemiológicas que incluíram os fatores de risco para infecção pelo HBV ou HCV. Foram coletadas alíquotas de soro dos participantes da pesquisa e encaminhadas para a realização das análises laboratoriais para identificação de marcadores sorológicos dos Vírus das Hepatites B e C: Anti-HBc Total IgG, Anti-HBs, HBsAg e Anti-HCV. Todos os procedimentos realizados utilizaram a técnica de Imunoensaio Quimioluminescente através do Ensaio ARCHITECT para cada marcador sorológico seguindo os protocolos de análises laboratoriais estabelecidos pelo fabricante do equipamento ARCHITECT SYSTEM. Além disso, realizou-se a análise espacial da distribuição da co-infecção no bairro através do programa TerraView utilizando o estimador de intensidade Kernel. Constatou-se que 16 indivíduos tiveram contato com o HBV (9,41%), desses um foi positivo para HBsAg. Apenas Trinta e duas amostras (18,82%) foram positivas para o marcador Anti-HBs. Três amostras foram positivas para Anti-HCV (1,76%), sendo uma também positiva para Anti-HBc. Os principais riscos de infecção pelo HBV e HCV foram relacionados às intervenções parenterais dos serviços de saúde, assim como à atividade sexual sem uso de preservativo, no caso do HBV. A análise espacial dos casos de co-infecção (Esquistossomose e Hepatite) permitiu a visualização de áreas de maior concentração dessas infecções, assim como as que são expostas a diferentes graus de risco de transmissão. Os resultados da pesquisa possibilitam oferecer, aos serviços municipais de saúde, um instrumento que facilite a compreensão da distribuição espacial da Esquistossomose e Hepatites (B e C) no bairro Santa Maria. Embora nossos valores sejam acima da prevalência estimada para a população brasileira e da região nordeste, não podemos inferir que os indivíduos portadores da Esquistossomose são mais susceptíveis à infecção pelo HBV ou HCV, uma vez que, os fatores de risco foram as vias de risco de transmissão de agentes causadores de hepatite e não a infecção pelo S. mansoni.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2014-10-21T12:18:38Z No. of bitstreams: 3 Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 3924004 bytes, checksum: d7ba7c1ee906d0c858ef16bd5981e6f6 (MD5) Anexos - Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 6385883 bytes, checksum: fb90963b122614948d1d35bfe7554d6e (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Rejected by Luciana Ferreira (lucgeral@gmail.com), reason: Cássia, o nome do arquivo, segundo as instruções deve ser: : Dissertação - Maria Flores Silva - 2014”, “Tese - Maria Flores Silva - 2014. Você está esquecendo de colocar o traço após Tese ou Dissertação. Na citação está faltando a data final. ex. PIMENTEL, Tatiane Dias. Entre a televisão e a internet: o jornalismo e o exercício da cidadania. 2012. 150 f. Dissertação (Mestrado em Comunicação) - Universidade Federal de Goiás, Goiânia, 2012. on 2014-10-23T11:29:29Z (GMT) / Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2014-11-06T11:25:56Z No. of bitstreams: 3 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 3924004 bytes, checksum: d7ba7c1ee906d0c858ef16bd5981e6f6 (MD5) Anexos - Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 6385883 bytes, checksum: fb90963b122614948d1d35bfe7554d6e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-11-06T11:36:06Z (GMT) No. of bitstreams: 3 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 3924004 bytes, checksum: d7ba7c1ee906d0c858ef16bd5981e6f6 (MD5) Anexos - Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 6385883 bytes, checksum: fb90963b122614948d1d35bfe7554d6e (MD5) / Made available in DSpace on 2014-11-06T11:36:06Z (GMT). No. of bitstreams: 3 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 3924004 bytes, checksum: d7ba7c1ee906d0c858ef16bd5981e6f6 (MD5) Anexos - Tese Karlla Antonieta Amorim Caetano - 2014.pdf: 6385883 bytes, checksum: fb90963b122614948d1d35bfe7554d6e (MD5) Previous issue date: 2014-07-22 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Estimates indicate a total of 240 million chronic hepatitis B carriers worldwide. In Brazil, rural settlements present adverse life conditions that favor the acquisition of health problems, such as the hepatitis B virus (HBV). The objective of the present study was to investigate the epidemiology of the infections caused by the hepatitis B and D viruses in people living in settlements in the southwest region of the state of Goiás. This is an observational, analytical, cross-sectional study, with a subsequent cohort of susceptible subjects for vaccination against HBV, assessment of adherence and vaccine response. In the period from May to July of 2011, 467 subjects were selected from seven settlements in the southwest of Goiás. All subjects were interviewed and tested for the detection of the serological markers HBsAg, anti-HBc and anti-HBs, by means of the enzyme-linked immunosorbent assay (ELISA). Reactive HBsAg samples were tested for total anti-HDV and IgM, by means of the ELISA, submitted to the detection of the HBV DNA by semi-nested PCR and genotyped by sequencing. Chemiluminescent microparticle immunoassay was used for the quantitative determination of anti-HBs. The research proposal was approved by the Research Ethics Committee of the Federal University of Goiás. Of the total sample, 52.2% were men, 57.8% were married and 49% had less than five years of education. Most subjects were from cities in the midwest region (81.6%) and were older than 19 years of age (73.7%). Overall prevalence for infection by the HBV was 10.9% (51/467), being 0.8% (4/467) for HBsAg, 7.9% (37/467) for anti-HBc and anti- HBs, and 2.1% (10/467) for anti-HBc. Moreover, 19.3% of the people living in settlements presented isolated positivity for the anti-HBs marker, which indicates they were previously vaccinated against hepatitis B. The four reactive HBV DNA samples were classified as subgenotype A1 (3/4) and D3 (1/4). The male gender (adjusted OR: 2.65; p= 0.007), age (adjusted OR: 1.07; p= 0.000), history of transfusion (adjusted OR: 2.52; p= 0.025) and greater period of time living in the settlements (adjusted OR: 1.10; p= 0.026) were variables associated with the HBV. A total of 181 subjects susceptible to the infection started vaccine against hepatitis B, but only 106 (58.6%; 106/181) completed the vaccine scheme. Of these, it was possible to assess the vaccine response in 77 subjects, and 68.8% (53/77) presented protective titers of anti-HBs. Of those subjects living in the settlements who did not respond to the vaccine, a greater proportion was male, had more than 40 years and was smokers (p< 0.001). No subject presented positivity for the anti-HDV marker. The results of this study evidence the need for effective strategies to prevent hepatitis B in the studied settlements, emphasizing vaccine against hepatitis. In light of the low vaccine response against this infection in older subjects, more immunogenic schemes are suggested, so as to induce a protective vaccine response. / Estima-se em 240 milhões o número de portadores crônicos de hepatite B. No Brasil, as comunidades rurais de assentamentos apresentam condições de vida adversas que favorecem a aquisição de agravos, como do HBV. O objetivo do presente estudo foi investigar a epidemiologia das infecções pelos vírus das hepatites B e D em assentados do sudoeste de Goiás. Trata-se de um estudo observacional, analítico, de corte transversal, em que posteriormente foi formada uma coorte de indivíduos suscetíveis para a vacinação contra HBV, avaliação da adesão e resposta vacinal. No período de maio a julho de 2011, foram recrutados 467 indivíduos de sete assentamentos do sudoeste goiano. Todos foram entrevistados e testados para a detecção dos marcadores sorológicos HBsAg, anti- HBc e anti-HBs pelo ensaio imunoenzimático (ELISA). As amostras HBsAg reagentes foram testadas para o anti-HDV total e IgM, pelo ELISA, submetidas à detecção do HBV DNA por semi-nested PCR e genotipadas por sequenciamento. Para a determinação quantitativa do anti-HBs empregou-se o imunoensaio de micropartículas por quimioluminescência. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Goiás. Do total, 52,2% eram do sexo masculino, 57,8% casados e 49% possuía menos de cinco anos de estudo. A maioria era natural de municípios da Região Centro-Oeste (81,6%) e possuía mais de 19 anos de idade (73,7%). A prevalência global para a infecção pelo HBV foi de 10,9% (51/467), sendo 0,8% (4/467) para HBsAg, 7,9% (37/467) para anti-HBc e anti-HBs, e 2,1% (10/467) para anti-HBc. Também, 19,3% dos assentados apresentaram positividade isolada para o marcador anti-HBs, indicando vacinação prévia contra hepatite B. As quatro amostras HBV DNA reagentes foram classificadas como subgenótipo A1 (3/4) e D3 (1/4). Observou-se que sexo masculino (OR ajustado: 2,65; p= 0,007), idade (OR ajustado: 1,07; p= 0.000), história de transfusão (OR ajustado: 2,52; p= 0,025) e maior tempo de moradia nos assentamentos (OR ajustado: 1,10; p= 0,026) foram variáveis associadas ao HBV. Um total de 181 assentados suscetíveis à infecção iniciaram a vacinação contra hepatite B, mas apenas 106 (58,6%; 106/181) completaram o esquema vacinal. Desses, em 77 foi possível avaliar a resposta vacinal, sendo que 68,8% (53/77) apresentaram títulos protetores de anti-HBs. Verificou-se uma proporção maior de não respondedores nos assentados do sexo masculino, com mais de 40 anos e tabagistas (p< 0,001). Nenhum indivíduo apresentou positividade para o marcador anti-HDV. Os resultados evidenciam a necessidade de estratégias efetivas de prevenção da hepatite B nos assentamentos estudados, com ênfase na vacinação contra hepatite. Ainda, diante da baixa resposta vacinal contra esta infecção em indivíduos mais velhos, sugere-se esquemas mais imunogênicos, que induzam uma resposta vacinal protetora.

O café uma é das bebidas mais consumidas no mundo e seus efeitos benéficos são objetivo do estudo durante anos. O café, por ser uma bebida antioxidante, pode inibir as enzimas hepáticas diminuindo a lesão de hepatócitos e com isso temos um efeito hepatoprotetor. Esta melhora no fígado é relacionado diretamente à ingestão de café. Portanto, este estudo tem como objetivo avaliar o efeito do consumo de café em grupos de portadores de hepatite B crônica e de hepatite C crônica supondo que o café pode retardar a progressão da lesão hepática. Métodos: Um total de 1169 pacientes com doenças hepáticas crônicas foram selecionados do banco de dados do ambulatório de hepatologia do Hospital das Clínicas de São Paulo, sendo 514 (44%) com o vírus da hepatite B (HBV) e 655 (56%) com hepatite C (HCV). Foram consideradas as variáveis como tabagismo, etilismo, consumo de café, exames laboratoriais (ALT, AST, GGT, INR, plaquetas, bilirrubina total, bilirrubina direta e bilirrubina indireta, albumina e creatinina), APRI e FIB4 para avaliar fibrose e o grau de lesão hepática. Resultados: Através da análise descritiva dos dados observamos que 758/1169 (65%) pacientes consumiam café. Pacientes que consumem café apresentam menores índices de AST (p=0,004), APRI (p=0,002) e FIB4 (p=0,003). Ao se analisar por etiologia observou-se que pacientes portadores de hepatite crônica C que consumem café apresentam menores índices de ALT (p=0,021), AST (p=0,005), APRI (p=0,013) e FIB4 (p=0,013) e maiores níveis de albumina (p=0,006). O mesmo não foi observado para os portadores de hepatite crônica B. Conclusões: A ingestão de café está associada com a redução das enzimas do fígado e parece estar diretamente ligada a diminuição dos valores de APRI e FIB4 em pacientes portadores de hepatite crônica C. O mesmo não é observado para hepatite crônica B / Coffee is one of the most consumed beverages in the world and its beneficial effects are objective of study for years. Coffee is considered an antioxidant drink and can inhibit injury of hepatocytes decreasing liver enzymes, thus having a hepatoprotective effect. This improvement in the liver is directly related to coffee intake. Therefore, this study aims to evaluate the consumption of coffee in groups of chronic hepatitis B and C patients assuming that coffee can slow the progression of liver damage. Methods: 1169 patients with chronic liver disease were consecutively selected in our clinic hepatology database of the Hospital das Clinicas in Sao Paulo. There were 514 (44%) patients with hepatitis B virus (HBV) and 655 (56%) with hepatitis C virus (HCV). Variables such as smoking, alcohol consumption, coffee consumption, laboratory tests (ALT, AST, GGT, INR, platelet, total bilirubin, direct bilirubin and indirect bilirubin, albumin and creatinine), APRI and FIB4 were analyzed to assess fibrosis and degree of liver injury. Results: Through descriptive analysis, we found that 758/1169 (65%) patients consumed coffee. Patients who consume coffee have lower levels of AST (p = 0.004), APRI (p = 0.002) and FIB4 (p = 0.003). When analyzed by etiology it was observed that patients with chronic hepatitis C who consume coffee have lower levels of ALT (p = 0.021), AST (p = 0.005), APRI (p = 0.013) and FIB4 (p = 0.013) and higher albumin level (p = 0.006). The same was not observed for patients with chronic hepatitis B. Conclusions: Coffee intake is associated with reduced liver enzymes and appears to be directly linked to the reduction of APRI and FIB4 values in patients with chronic hepatitis C. The same is not observed for chronic hepatitis B

Submitted by Jaqueline Silva (jtas29@gmail.com) on 2014-12-08T18:55:27Z No. of bitstreams: 1 Tese-Fabiana Perez Rodrigues Bergamaschi-2013.pdf: 1509408 bytes, checksum: 1b6be1fa7ceb346e9969b51d59359bb3 (MD5) / Rejected by Jaqueline Silva (jtas29@gmail.com), reason: on 2014-12-08T20:24:13Z (GMT) / Submitted by Jaqueline Silva (jtas29@gmail.com) on 2014-12-12T19:33:49Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Tese-Fabiana Perez Rodrigues Bergamaschi-2013.pdf: 1509408 bytes, checksum: 1b6be1fa7ceb346e9969b51d59359bb3 (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-12-16T09:22:58Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Tese-Fabiana Perez Rodrigues Bergamaschi-2013.pdf: 1509408 bytes, checksum: 1b6be1fa7ceb346e9969b51d59359bb3 (MD5) / Made available in DSpace on 2014-12-16T09:22:58Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Tese-Fabiana Perez Rodrigues Bergamaschi-2013.pdf: 1509408 bytes, checksum: 1b6be1fa7ceb346e9969b51d59359bb3 (MD5) Previous issue date: 2013-12-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Hepatitis B virus (HBV) infection has been responsible for the largest number of chronic hepatitis illness throughout the world as well as its sequelae: cirrhosis and hepatocellular carcinoma. In Brazil, a low endemic country for hepatitis B, the most of the information on this infection has been limited to urban populations. Data about hepatitis B epidemiology in rural settlement are rare. Thus, the aim of this study was to investigate the epidemiological profile of hepatitis B virus infection in individuals living in a rural settlement (Itamarati I) from Mato Grosso do Sul, Brazil. Initially a cross-sectional study was carried out. Then HBV susceptible individuals were vaccinated against HBV and their vaccine response were evaluated. Participants were recruited following a random selection of their families. All family member aged ≥ 2 years who agreed to take part into the study was recruited by signing an Informed Consent Form. Then, 10-ml-blood sample was taken for detecting HBV markers: HBsAg, anti-HBs and total anti-HBc by using commercial kits. HBsAg positive samples were retested for HBeAg and anti-Hbe markers. Hepatitis B vaccine was offered to all individuals who were identified as susceptible to infection, and quantitative detection of anti-HBs was measured after the third vaccine dose. Statistical Package for the Social Sciences – SPSS for Window 15.0 was used for processing and analyzing data. The present project was approved by the Ethics Committee from Universidade Federal de Mato Grosso do Sul – UFMS. Of all participants, 54.4% were female. The majority (59.7%) were up to 40 years old, 62.7% were married and 78.3% self-declared white. Serological markers of HBV infection were identified in 110 settlers, resulting in an overall prevalence of 24.1% (95% CI: 20.4 to 28.2). Twelve subjects (2.6%) were HBsAg-positive. In 139 (30.5%) individuals were detected only anti-HBs, suggesting previous vaccination. Multiple regression analysis showed that age, social movements and sharing personal hygiene objects were independently associated to HBV. HBV DNA was found in four samples, being classified as genotypes D (3/4) and A (1/4). From those 207 individuals identified as susceptible to HBV infection, 84 received the first vaccine dose, but only 44 complied with the full vaccine regimen. In 28 of them (63.6%) vaccine response was evaluated, and 57.1% showed protective anti-HBs titers. The results of the present study show a high prevalence of hepatitis B in the settlers studied, compared to the urban population in the Midwest Region, and difficulties for vaccination against hepatitis B in this population. These findings ratify the need of the relationship between agricultural and health services and leaders of social movements of settlers for the creation and implementation of health strategies specific to this slice of rural Brazil. / A infecção pelo vírus da hepatite B (HBV) é ainda hoje responsável pelo maior número de casos em todo mundo de doença hepática crônica e suas seqüelas: cirrose e carcinoma hepatocelular. No Brasil, um país considerado de baixa endemicidade para hepatite B, a maioria das informações sobre esta infecção tem se limitado a populações urbanas. Dados sobre a epidemiologia da hepatite B em populações rurais são raros. Assim, o objetivo deste estudo foi investigar o perfil epidemiológico da infecção pelo vírus da hepatite B em indivíduos assentados do Assentamento Itamarati I, Mato Grosso do Sul. Inicialmente, realizou-se um estudo transversal, e a seguir, formou-se uma coorte de indivíduos suscetíveis ao HBV para vacinação contra hepatite B e avaliação da resposta vacinal. Os participantes foram recrutados por meio de sorteio aleatório simples de suas famílias. Em cada domicílio foram entrevistados todos os membros da família com idade ≥ dois anos que concordaram em participar do estudo mediante a assinatura do Termo de Consentimento Livre Esclarecido. Em seguida foram coletados 10 mL de sangue, para a detecção dos marcadores sorológicos do HBV: HBsAg, anti-HBs e anti-HBc Total, utilizando-se kits comerciais. As amostras HBsAg reagentes foram retestadas para os marcadores HBeAg e anti-HBe. A vacina contra hepatite B foi oferecida aos indivíduos identificados como suscetíveis para hepatite B, e a detecção quantitativa do anti-HBs foi realizada após a terceira dose da vacina. Para o processamento e análise dos dados, foi empregado o pacote estatístico SPSS for Windows versão 15.0. O projeto foi aprovado pelo Comitê de Ética da Universidade Federal de Mato Grosso do Sul – UFMS. Do total de participantes, 54,4% era do sexo feminino. A maioria possuía até 40 anos de idade (59,7%), casada/união consensual (62,7%) e se auto-declarou de cor branca (78,3%). Os marcadores sorológicos da infecção pelo HBV foram identificados em 110 assentados, resultando em uma prevalência global de 24,1% (IC 95%: 20,4 - 28,2). Doze indivíduos (2,6%) foram HBsAg positivos. Em 139 assentados (30,5%) detectou-se apenas o anti-HBs, sugerindo vacinação prévia. A análise de regressão múltipla revelou que idade, movimentos sociais e compartilhamento de objetos de higiene pessoal foram independentemente associados ao HBV. Entre as amostras reagentes para o HBsAg, o HBV DNA foi detectado em quatro, sendo identificado os genótipos D (3/4) e A (1/4). Dos 207 indivíduos identificados como susceptíveis a hepatite, 84 receberam a primeira dose da vacina e apenas 44 completaram o esquema vacinal. Destes 28 (63,6%) realizaram o anti-HBs quantitativo, dos quais 57,1% foram respondedores a vacina. Os resultados deste estudo evidenciam uma elevada prevalência para hepatite B nos assentados estudados, comparados a população urbana do Centro-Oeste, e dificuldades para a vacinação contra a hepatite B nesta população; sinalizando, assim, a necessidade da articulação entre serviços agrários e de saúde com lideranças de movimentos sociais de assentados para a criação e implantação de estratégias de saúde específicas para essa fatia da população rural brasileira.