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Abstract INTRODUCTION: Visceral leishmaniasis (VL) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-infection has been a research topic of interest worldwide. In Brazil, it has been observed that there is a relative underreporting and failure in the understanding and management of this important association. The aim of this study was to analyze epidemiological and clinical aspects of patients with VL with and without HIV/AIDS. METHODS: We conducted an observational and analytical study of patients with VL followed in a Reference Service in the State of Maranhão, Brazil from 2007-2013. RESULTS: In total 126 patients were enrolled, of which 61 (48.4%) were co-infected with HIV/AIDS. There were more males among those with HIV/AIDS (85.2%, P>0.05) or with VL only (81.5%, P>0.05). These findings significantly differed based on age group (P<0.003); the majority of patients were aged 31-40 years (41.0%) and 21-30 years (32.3%) among those with and without HIV/AIDS co-infection, respectively. The incidence of diarrhea and splenomegaly significantly differed between the two groups (P=0.0014 and P=0.019, respectively). The myelogram parasitic examination was used most frequently among those with HIV/AIDS (91.8%), followed by those with VL only (69.2%). VL recurrences and mortality were significantly higher in the HIV/AIDS co-infected patients (P<0.0001 and P=0.012, respectively). CONCLUSIONS: Patients with VL with or without HIV/AIDS co-infection were mostly adult men. Diarrhea was more frequent in HIV/AIDS co-infected patients, whereas splenomegaly was more common in patients with VL only. In the group of HIV/AIDS co-infected patients, there was a higher rate of VL recurrence and mortality.

https://doi.org/10.1590/0037-8682-0494-2017 1810 downloads

Osteoporosis in primary care: an opportunity to approach risk factors
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Costa, Angra Larissa Durans

; Silva, Marcos Antonio Custódio Neto da

; Brito, Luciane Maria Oliveira

; Nascimento, Anna Cyntia Brandão

; Barbosa, Maria do Carmo Lacerda

; Batista, José Eduardo

; Bezerra, Geusa Felipa de Barros

; Viana, Graça Maria De Castro

; Muniz Filho, Walbert Edson

; Vidal, Flávia Castello Branco

; Nascimento, Maria do Desterro Soares Brandão

Revista Brasileira de Reumatologia

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apr 2016, Volume 56 N. 2 Pages 111 - 116

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: As mulheres no climatério estão suscetíveis a uma série de mudanças, entre elas a osteoporose. A osteoporose é uma doença caracterizada por uma baixa massa óssea e susceptibilidade à fratura. Atualmente, essa doença é um problema de saúde pública e é necessário reconhecer seus fatores de risco. Objetivos: Identificar os fatores de risco relacionados com a osteoporose em mulheres atendidas pelo Programa de Práticas de Integralidade em Saúde (Propis)/Proex/UFMA, traçar uma caracterização sociodemográfica e considerar o estilo de vida da comunidade. Material e métodos: Trata-se de um estudo transversal retrospectivo clínico com uma abordagem quantitativa, feito entre março e junho de 2013, em São Luís (MA), com 107 mulheres atendidas pelo Programa de Práticas de Integralidade em Saúde (Propis). O estudo foi aprovado pelo Comitê de Ética do Hospital Universitário da UFMA, sob parecer nº 362/07. Os dados foram tabulados e analisados com o software epidemiológico Epi-Info®, versão 3.4.1. Resultados: A etnia parda foi predominante, a união estável mostrou ser um fator protetor e a baixa escolaridade foi um fator de risco. A idade média do grupo com menopausa foi de 54,1 anos e a do sem menopausa de 31,3 anos (p < 0,0001). A idade média da menopausa foi de 43,7 anos. O ciclo menstrual irregular foi um fator protetor. O número médio de gestações foi de 4,56 para o grupo com menopausa e 2,45 para o grupo sem menopausa, com a maior parte dos partos normal (p < 0,0001). O tabagismo, a inatividade física e o consumo de cafeína foram fatores de risco, enquanto a ausência de alcoolismo e de ingestão de refrigerante foram fatores de proteção para a doença. Conclusão: Os pacientes seguiram o perfil socioeconômico e demográfico do Maranhão. A maior parte teve a menarca e a menopausa em períodos apropriados, não apresentava antecedentes familiares de osteoporose, não costumava ingerir bebida alcoólica, era sedentária e consumia uma elevada quantidade de cafeína.

ABSTRACT Introduction: Climacteric women are susceptible to a number of changes, among them osteoporosis. Osteoporosis is a disease characterized by low bone mass and susceptibility to fracture. Currently, this disease is a public health issue, being necessary to recognize its risk factors. Objectives: Identify risk factors related to osteoporosis in women attending Propis/Proex/UFMA, tracing a socio-demographic characterization and considering community lifestyles. Material and methods: This is a transversal retrospective clinical with a quantitative approach study conducted between March and June 2013 in São Luís (MA) with 107 women treated at the Programa de Práticas de Integralidade em Saúde (Propis - Integrality Health Practice Program). The study was approved by the University Hospital Ethics Committee of UFMA under opinion no. 362/07. Data were tabulated and analyzed in the epidemiological Epi-Info® software, version 3.4.1. Results: The brown color was predominant, consensual relationships proved to be a protective factor and low education was a risk factor. The average age of the group with menopause was 54.1 years and without menopause was 31.3 years (p < 0.0001). The average age of menopause was 43.7 years. The irregular menstrual cycle was a protective factor. The average number of pregnancies was 4.56 for the group with menopause and 2.45 for the group without menopause, with most births occurring normally (p < 0.0001). Smoking, physical inactivity and caffeine intake were risk factors, while the absence of alcoholism and of soda intake were protective factors for the disease. Conclusion: The patients followed the socioeconomic and demographic profile of Maranhão. Most had menarche and menopause in appropriate periods, showed no positive family history of osteoporosis, did not usually drink alcohol, were sedentary and the caffeine intake was high.

https://doi.org/10.1016/j.rbre.2015.07.014 8351 downloads

DIVERSITY AND INFECTIVITY POTENTIAL OF EMERGING FUNGI IN AN AREA OF BABAÇU TREES IN THE STATE OF MARANHÃO, BRAZIL
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NASCIMENTO, Maria do Desterro Soares Brandão

; LEITÃO, Valéria Maria Sousa

; SILVA, Marcos Antonio Custódio Neto da

; NASCIMENTO, Anna Cyntia Brandão

; BEZERRA, Geusa Felipa de Barros

; VIANA, Graça Maria de Castro

Revista do Instituto de Medicina Tropical de São Paulo

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oct 2015, Volume 57 N. 5 Pages 458 - 460

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/S0036-46652015000500018 923 downloads

Endemic transmission of HTLV-2 in blood donors from São Luís do Maranhão, northeastern Brazil: report of two asymptomatic individuals
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Viana, Graça Maria de Castro

; Silva, Marcos Antonio Custódio Neto da

; Souza, Victor Lima

; Lopes, Natália Barbosa da Silva

; Nascimento, Maria do Desterro Soares Brandão

Revista Brasileira de Hematologia e Hemoterapia

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apr 2015, Volume 37 N. 2 Pages 130 - 131

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjhh.2014.11.003 1039 downloads

Gaucher disease in a family from Maranhão
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Oi, Samira Shizuko Parreão

; Nicolau, Dario Itapary

; Santos, Sebastião Kelson Alves dos

; Silva, Marcos Antonio Custódio Neto da

; Viana, Graça Maria de Castro

; Nascimento, Maria do Desterro Soares Brandão

Revista Brasileira de Hematologia e Hemoterapia

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oct 2014, Volume 36 N. 5 Pages 373 - 378

Abstract: En | Text: En | PDF: En

Background: Gaucher disease is an inborn, autosomal recessive error of the metabolism which belongs to the group of lysosomal storage disorders. Objective: This work reports on the treatment of Gaucher disease in several members of the same family from the countryside of Maranhão. Methods: This was an observational, retrospective and prospective, descriptive case study about the efficacy of enzyme replacement therapy. Results: The results showed that women were more affected (80% of patients) by the disease, age at diagnosis ranged from 24 to 33 years, the predominant ethnicity was mulatto (80%) and all cases were classified as type 1. The diagnosis of these patients was performed by measuring the levels of glucocerebrosidase and chitotriosidase enzymes and confirmed by genotyping. All patients suffering from Gaucher disease had low glucocerebrosidase levels. Before replacement therapy, hepatosplenomegaly was the most common clinical manifestation (100%) and osteopenia was seen in 80% of the cases. Regarding hematological manifestations, anemia and leukopenia were found in 40% of patients at diagnosis; however the hemoglobin and leukocyte levels were normalized after four years of therapy. Thrombocytopenia, observed in 20% of cases, was normalized after the second year of treatment. Conclusion: In these cases, despite gaps in the treatment as the family resides in the rural region of the state, the patients with Gaucher disease showed satisfactory therapeutic response over time.

https://doi.org/10.1016/j.bjhh.2014.07.011 1733 downloads

INTERFERON BETA-1A TREATMENT IN HTLV-1-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS: A CASE REPORT
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Viana, Graça Maria de Castro

; Silva, Marcos Antonio Custódio Neto da

; Souza, Victor Lima

; Lopes, Natália Barbosa da Silva

; Silva, Diego Luz Felipe da

; Nascimento, Maria do Desterro Soares Brandão

Revista do Instituto de Medicina Tropical de São Paulo

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sep 2014, Volume 56 N. 5 Pages 443 - 445

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Descreve-se caso de mielopatia associada ao HTLV-1/paraparesia espástica tropical tratada com interferon beta-1a em paciente jovem de 21 anos e com história de dermatite infecciosa na infância. Foi estabelecida clinicamente paraparesia espástica tropical (HAM/TSP), confirmada laboratorialmente pela presença de anticorpos para HTLV-1 no LCR e excluídas caxumba, citomegalovirus, Epstein-Barr, esquistossomose, herpes virus 1 e 2, rubéola, sarampo, toxoplasmose varicela-zoster, hepatite, HIV e sífilis por sorologias. Foi diagnosticada bexiga neurogênica, com quadro clínico de nictúria, urgência urinária, parestesia no membro inferior esquerdo e discreta redução de força muscular nos membros superiores, mais acentuada nos membros inferiores. Na 4a semana de tratamento com interferon beta-1a houve desaparecimento da urgência urinária e da parestesia e melhora da clínica motora.

Here a young patient (< 21 years of age) with a history of infective dermatitis is described. The patient was diagnosed with myelopathy associated with HTLV-1/tropical spastic paraparesis and treated with interferon beta-1a. The disease was clinically established as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and laboratory tests confirmed the presence of antibodies to HTLV-1 in the cerebrospinal fluid (CSF). Mumps, cytomegalovirus, Epstein-Barr virus, schistosomiasis, herpes virus 1 and 2, rubella, measles, varicella-zoster toxoplasmosis, hepatitis, HIV, and syphilis were excluded by serology. The patient was diagnosed with neurogenic bladder and presented with nocturia, urinary urgency, paresthesia of the lower left limb, a marked reduction of muscle strength in the lower limbs, and a slight reduction in upper limb strength. During the fourth week of treatment with interferon beta-1a, urinary urgency and paresthesia disappeared and clinical motor skills improved.

https://doi.org/10.1590/S0036-46652014000500013 3469 downloads

Diversity and dynamics of airborne fungi in São Luis, State of Maranhão, Brazil
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Bezerra, Geusa Felipa de Barros

; Gomes, Silvio Monteiro

; Silva, Marcos Antonio Custódio Neto da

; Santos, Ramon Moura dos

; Muniz Filho, Walbert Edson

; Viana, Graça Maria de Castro

; Nascimento, Maria do Desterro Soares Brandão

Revista da Sociedade Brasileira de Medicina Tropical

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jan 2014, Volume 47 N. 1 Pages 69 - 73

Abstract: En | Text: En | PDF: En

Introduction: This study aimed to identify airborne fungi in São Luis, Maranhão, Brazil, to determine the prevalent genera and to correlate these genera with the area and season. Methods: In total, 1,510 colony-forming units (CFUs) of airborne fungi were isolated from the north, south, east and west sides and from the center of the city from January to December 2007. The samples were collected on Petri dishes that were exposed to the fungi by the gravitational method. Results: Twenty genera of fungi were isolated; the most common were Aspergillus (33.5%), Penicillium (18.8%), Cladosporium (14.2%), Curvularia (10.6%) and Fusarium (7.6%). The CFUs of the fungi were statistically significant (p < 0.0001). Fungal biological diversity was present all year, without any large seasonal variations but with slight increases in May, August and September. Conclusions: The fungal genera identified in this study were correlated with natural systems and could be useful when evaluating the impact of environmental changes on the region.

https://doi.org/10.1590/0037-8682-0229-2013 2635 downloads

Eco-epidemiologic study of emerging fungi related to the work of babaçu coconut breakers in the State of Maranhão, Brazil
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Nascimento, Maria do Desterro Soares Brandão

; Leitão, Valéria Maria Sousa

; Silva, Marcos Antonio Custódio Neto da

; Maciel, Leonardo Bezerra

; Muniz Filho, Walbert Edson

; Viana, Graça Maria de Castro

; Bezerra, Geusa Felipa de Barros

Revista da Sociedade Brasileira de Medicina Tropical

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jan 2014, Volume 47 N. 1 Pages 74 - 78

Abstract: En | Text: En | PDF: En

Introduction: There are more than 300,000 extractors using the babaçu coconut as a source of income in the States of Maranhão, Pará, Tocantins and Piauí, and this activity is associated with fungal infections. The objective of this study was to examine the occurrence of emergent fungi in the conjunctiva, nails and surface and subcutaneous injuries of female coconut breakers in Esperantinópolis, Maranhão. Additionally, soil samples and palm structures were collected. Methods: The obtained samples were cultured in Petri dishes containing potato-dextrose-agar and chloramphenicol. The etiological agent was confirmed by a direct mycological exam and growth in culture. Results: In total, 150 domiciles were visited, and samples were collected from 80 patients. From the ground, the most frequently isolated fungus was Aspergillus niger (53. 8%). the most frequently detected fungus in babaçu coconut was Aspergillus niger (66.7%). Conjunctival fungal growth occurred in 76.3% of the women. The ocular fungal microbiota consisted of filamentous fungi (80.6%), and yeasts were present in 19.4% of cases. Onychomycosis was diagnosed in 44% (11/25) of the women. Conclusions: The identification of the genera Neosartorya, Rhizopus and Curvularia in onychomycoses shows that emergent filamentous fungi can be isolated. Aspergillus sp., Penicillium sp. and Scedosporium sp. were the predominant genera found in the babaçu coconut. From ocular conjunctiva, Candida spp. were the most prevalent species isolated, and Fusarium sp. was present only in one woman. The nearly permanent exposure of coconut breakers to the external environment and to the soil is most likely the reason for the existence of a mycotic flora and fungal infections, varying according to the individual's practices and occupation.

https://doi.org/10.1590/0037-8682-0237-2013 2291 downloads

10.

Seroprevalence of HTLV-1/2 among blood donors in the state of Maranhao, Brazil
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Viana, Graca Maria de Castro

; Nascimento, Maria do Desterro Soares Brandao

; Oliveira, Rodrigo Artur Souza de

; Santos, Alessandro Carvalho dos

; Galvao, Carolina de Souza

; Silva, Marcos Antonio Custodio Neto da

Revista Brasileira de Hematologia e Hemoterapia

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jan 2014, Volume 36 N. 1 Pages 50 - 53

Abstract: En | Text: En | PDF: En

Background: Infection with human T-lymphotropic virus 1 or 2 (HTLV-1/2) is a major health problem. There is a public health policy defining measures for state hematology and hemotherapy centers in Brazil, in order to avoid virus transmission through blood donors. Objective: This study aimed to evaluate the seroprevalence of HTLV -1/2 in blood donors in the State of Maranhão, Brazil, during routine blood unit screening. Methods: Screening tests of blood donors using the enzyme-linked immunosorbent assay (ELISA) to detect seropositivity for HTLV-1/2 performed at the Hematology and Hemotherapy Center of the State of Maranhão (HEMOMAR) between July of 2003 and December of 2009 were retrospectively evaluated. Results: Of the 365,564 blood donors, 561 (0.15%) were HTLV-1/2-positive, of whom 72 (12.8%) performed the confirmatory test (Western blot). In donors who had a confirmatory test, 53 (73.6%) were positive. The ages of the infected individuals ranged from 18 to 65 years; 305 (54%) were aged over 40 years. Among the infected individuals, 309 (55%) were male, 399 (71%) were mixed-race, and 259 (46%) were single. Co-infections were frequently found, especially with hepatitis B (in 68.6% of the cases). Conclusion: The results obtained will contribute to the planning and implementation of control measures by the epidemiological surveillance agency of Maranhão, and will also contribute to reducing morbidity. The high seropositivity in a small sample in donors who had confirmatory tests indicates the need for confirmatory tests for all donors who initially test as seropositive.

https://doi.org/10.5581/1516-8484.20140013 2343 downloads

11.

Spatial dynamics of urban populations of Lutzomyia longipalpis (Diptera: Psychodidae) in Caxias, State of Maranhão, Brazil
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Nascimento, Maria do Desterro Soares Brandao

; Silva, Maria Helena

; Viana, Graca Maria de Castro

; Leonardo, Francisco Santos

; Bezerra, Geusa Felipa de Barros

; Guimaraes e Silva, Antonia Suely

; Soares, Valeria Cristina Pinheiro

; Pereira, Silma Regina Ferreira

; Rebelo, Jose Manuel Macario

; Brazil, Reginaldo Pecanha

Revista da Sociedade Brasileira de Medicina Tropical

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sep 2013, Volume 46 N. 5 Pages 555 - 559

Abstract: En | Text: En | PDF: En

Introduction In this paper, we report the ecology of Lutzomyia longipalpis in Caxias City, located in the eastern part of State of Maranhão, Brazil and highlight its seasonal and geographical distribution by environment. In addition, we discuss natural Leishmania infection and its relationship with visceral leishmaniasis. Methods Between September 2007 and August 2009, the collection of sandflies was performed using Center for Disease Control (CDC) light traps from 15 houses in 5 selected neighborhoods. Results Lutzomyia longipalpis was present in all zones of the city. We also found that Lu. longipalpis was regularly detected both inside and around the house, predominantly in outdoor areas. In urban areas, Lu. longipalpis was present in both the dry and rainy seasons, with a higher density present in the latter. One female specimen of Lu. longipalpis was observed to have natural Leishmania infection. Conclusions The presence of Lu. longipalpis was observed throughout the year during 2 seasonal periods, with a predominance in the rainy season. A low rate of natural Leishmania infection was observed in urban areas during the rainy season.

https://doi.org/10.1590/0037-8682-0150-2013 1984 downloads

12.

Relationship between rainfall and temperature: observations on the cases of visceral leishmaniasis in São Luis Island, State of Maranhão, Brazil
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Viana, Graça Maria de Castro

; Nascimento, Maria do Desterro Soares Brandão

; Rabelo, Érica Milena Fernandes

; Diniz Neto, João Arnaud

; Binda Júnior, José Roberto

; Galvão, Carolina de Souza

; Santos, Alessandro Carvalho dos

; Santos Júnior, Onildo Martins

; Oliveira, Rodrigo Artur Souza de

; Guimarães, Rafael Silva

Revista da Sociedade Brasileira de Medicina Tropical

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dec 2011, Volume 44 N. 6 Pages 722 - 724

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

INTRODUÇÃO: A leishmaniose visceral por ser um importante problema de saúde pública mundial requer estratégias de controle, notadamente em relação a fatores que possam intervir na redução da incidência dessa endemia. A densidade pluviométrica e a temperatura são aqui correlacionadas com a incidência de casos humanos em uma área endêmica de calazar na Ilha de São Luis do Maranhão, nordeste brasileiro. MÉTODOS: Utilizou-se notificações dos casos humanos pela Fundação Nacional de Saúde/Coordenação Regional do Maranhão (FUNASA/COREMA) durante o período de 2002 a 2010. Os dados ecológicos (temperatura e densidade pluviométrica) foram cedidos pela Universidade Estadual do Maranhão. RESULTADOS: Associação significante foi verificada entre o número de casos e a pluviometria, o que não foi verificado com a temperatura média. CONCLUSÕES: Esses dados sugerem que as ações de controle na leishmaniose visceral devem ser executadas durante o período chuvoso em nosso Estado, ou seja, no primeiro semestre do ano.

INTRODUCTION: Visceral leishmaniasis is a serious public health problem that requires global control strategies, especially with respect to factors that may intervene in reducing the incidence of endemicity. In this work, rainfall density and temperature were correlated with the incidence of human cases in an area endemic for leishmaniasis in São Luis do Maranhão, Northeastern Brazil. METHODS: Notification of human cases by the National Health Foundation/Regional Coordination of Maranhão (FUNASA/COREMA) from 2002 to 2010 was used. Ecological data (mean temperature and rainfall density) were provided by the Meteorological Office of State. RESULTS: A significant association was verified between the number of VL cases and rainfall rate but not in the analysis concerning mean temperatures. CONCLUSIONS: These data suggest that the control actions in visceral leishmaniasis should be performed during rainy season in the State of Maranhão, which is in the first half of the year.

3865 downloads

13.

Evaluation of laboratory markers of progression of HIV disease to death
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Viana, Graça Maria de Castro

; Nascimento, Maria do Desterro Soares Brandão

; Ferreira, Aila de Menezes

; Rabelo, Érica Milena Fernandes

; Diniz Neto, João Arnaud

; Galvão, Carolina de Souza

; Santos, Alessandro Carvalho dos

; Santos Júnior, Onildo Martins

; Oliveira, Rodrigo Artur Souza de

; Binda Júnior, José Roberto

Revista da Sociedade Brasileira de Medicina Tropical

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dec 2011, Volume 44 N. 6 Pages 657 - 660

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

INTRODUÇÃO: Uma das importantes dificuldades atuais na infecção HIV/AIDS é estabelecer parâmetros epidemiológicos e laboratoriais prognósticos no seguimento dos pacientes. Esse trabalho objetivou analisar a evolução dos exames laboratoriais: contagem de linfócitos CD4, carga viral, dosagem de hemoglobina (Hb), de aspartato aminotransferase (AST), de alanino aminotransferase (ALT) e as variáveis epidemiológicas: sexo e idade, como fatores prognósticos de sobrevida na evolução para o óbito em pacientes com AIDS. MÉTODOS: Foi realizado um estudo retrospectivo a partir da análise de prontuários e um prospectivo por seguimento de pacientes portadores de HIV/AIDS, no Serviço Ambulatorial da referência assistencial em HIV/AIDS, no Estado do Maranhão, durante 24 meses. Os pacientes analisados tinham faixa etária compreendida entre 10 e 60 anos, apresentavam quadro clínico manifesto e não faziam uso de antirretroviral ou ainda o faziam há menos de 5 anos. Para análise estatística, foi adotado o teste qui-quadrado. RESULTADOS: A amostra compreendeu 100 pacientes, dos quais 57 se encontravam em tratamento ambulatorial e 43 já tinham ido a óbito. Variáveis como carga viral (p= 0,726), ALT (p=0,314), sexo (p=0,687) e faixa etária (p=0,742) foram analisadas e nenhuma evidência de associação entre elas com o pior prognóstico foi verificada. CONCLUSÕES: Constatou-se uma significante relação entre baixos níveis de Hb (p=0,000) e de CD4 (p=0,000) com menor sobrevida.

INTRODUCTION: One of the important current problems in HIV/AIDS infection is the establishment of epidemiological and laboratorial prognostic parameters during patient follow-up. This study aimed at analyzing the evolution of laboratory tests: CD4 lymphocyte count, viral load, hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the epidemiological variables sex and age as prognostic factors for survival in progression to death among AIDS patients. METHODS: A retrospective study was conducted using analysis of medical records, and prospective 24-month follow-up of patients with HIV/ AIDS attended at the President Vargas Hospital Outpatient Clinic, a reference center in HIV/ AIDS attendance in the State of Maranhão, Brazil. The study analyzed patients aged 10 to 60 years old, who manifested AIDS and who were not using antiretroviral therapy or had used it for less than 5 years. The Chi-square test was used for statistical analysis. RESULTS: The sample included 100 patients - 57 were current outpatients, and 43 had died. The variables viral load (p=0.726), ALT (p=0.314), sex (p=0.687), and age (p=0.742) were analyzed, and no evidence of association between them and worst prognosis was observed. CONCLUSIONS: A significant relation was verified between low Hb levels (p=0.000) and CD4 (p=0.000) and shorter survival.

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14.

Avaliação ambiental de um programa de educação em asma: relação dos fungos do ar e os níveis de IgE em crianças e adultos
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Bezerra, Geusa Felipa de Barros

; Nascimento, Maria do Desterro Soares Brandão

; Costa, Maria do Rosário da Silva Ramos

; Viana, Graça Maria de Castro

; Sousa, Marcos Davi Gomes de

Jornal Brasileiro de Pneumologia

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apr 2011, Volume 37 N. 2 Pages 281 - 282

Abstract: Pt | Text: Pt | PDF: Pt

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Association of HTLV-I with Arnold Chiari syndrome and syringomyelia
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Viana, Graça Maria de Castro

; Diniz Neto, João Arnaud

; Furtado, Igor de Sousa

; Binda Júnior, José Roberto

; Tanaka, Bárbara Neiva

; Nascimento, Maria do Desterro Soares Brandão

Brazilian Journal of Infectious Diseases

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dec 2008, Volume 12 N. 6 Pages 536 - 537

Abstract: En | Text: En | PDF: En

HTLV-I is associated with a broad spectrum of manifestations, including tropical spastic paraparesis and adult T-cell leukemia/lymphoma. Arnold Chiari syndrome is a condition characterized by herniation of the cerebellar tonsils through the foramen magnum. This condition should be suspected in all patients with headache and impaired motor coordination. Syringomyelia is a developmental anomaly that leads to the formation of an intramedullary cavity. Its clinical presentation is classically characterized by syringomyelic dissociation of sensation, with suspended distribution in the proximal portion of the trunk and upper limbs and preservation in other regions. We report here a case of association of the three diseases, which is rare in clinical practice, illustrating the difficulty in the diagnosis and therapeutic management of these conditions.

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