RESUMO
Enteroparasites are related to gastrointestinal alterations among patients with HIV/AIDS, some causing severe manifestations in the period before the institution of the highly active antiretroviral therapy (HAART). The prevalence of enteroparasitoses in patients with HIV/AIDS seen at two hospitals in Ceará , Brazil, was compared in the pre-HAART (Group 1; n = 482) and HAART (Group 2; n = 100) eras. Fecal parasitologic examinations (FPE) were performed using the direct, Lutz, Baermann-Moraes and modified Ziehl-Neelsen methods. The following parasites were detected in Groups 1 and 2, respectively: Strongyloides stercoralis--30.1% and 11% (p<0.0001), Ascaris lumbricoides--15.6% and 2% (p<0.0001), hookworms--3.7% and 2% (p<0.0001), Trichuris trichiura--13.1% and 1% (p<0.0001), Hymenolepis nana--0 and 1% (p = 0.1718), Giardia duodenalis--7.9% and 1% (p = 0.0076), Entamoeba histolytica/dispar--3.3% and 1% (p = 0.3301), Isospora belli--4.8% and 1% (p = 0.0993), Cryptosporidium sp.--8.1% and 0 (p = 0.0007), and non-pathogenic protozoans as well. There was a significant reduction in the prevalence of enteroparasites between the eras (63.9% to 24%; p<0.0001). In the HAART era, the following observations were made: greater frequency of enteroparasites in patients without antiretroviral therapy (p = 0.0575), as in those with AIDS (p = 0.08), and diarrhea (36% of the patients); lack of association with positive FPE (p = 0.626); and non-detection of Cryptosporidium sp. Strongyloides stercoralis showed an elevated prevalence in the two eras and was more frequent in men (32.41%) than women (19.04%) of Group 1 (p = 0.018), a finding suggesting the transmission of the helminth through sodomy. The advent of the HAART modified the profile of opportunistic infections, including parasites, probably due to the reconstitution of cellular immunity and the direct action of HAART on the parasites.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Terapia Antirretroviral de Alta Atividade , Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Infecções por Protozoários/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Adolescente , Adulto , Idoso , Anti-Helmínticos/uso terapêutico , Antiprotozoários/uso terapêutico , Brasil/epidemiologia , Fezes/parasitologia , Feminino , Helmintíase/tratamento farmacológico , Helmintíase/parasitologia , Humanos , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Infecções por Protozoários/tratamento farmacológico , Infecções por Protozoários/parasitologia , Estudos Retrospectivos , Adulto JovemRESUMO
Enteroparasites are related to gastrointestinal alterations among patients with HIV/AIDS, some causing severe manifestations in the period before the institution of the highly active antiretroviral therapy (HAART). The prevalence of enteroparasitoses in patients with HIV/AIDS seen at two hospitals in Ceará , Brazil, was compared in the pre-HAART (Group 1; n = 482) and HAART (Group 2; n = 100) eras. Fecal parasitologic examinations (FPE) were performed using the direct, Lutz, Baermann-Moraes and modified Ziehl-Neelsen methods. The following parasites were detected in Groups 1 and 2, respectively: Strongyloides stercoralis - 30.1 percent and 11 percent (p<0.0001), Ascaris lumbricoides - 15.6 percent and 2 percent (p<0.0001), hookworms - 13.7 percent and 2 percent (p<0.0001), Trichuris trichiura - 13.1 percent and 1 percent (p<0.0001), Hymenolepis nana - 0 and 1 percent (p = 0.1718), Giardia duodenalis - 7.9 percent and 1 percent (p = 0.0076), Entamoeba histolytica/dispar - 3.3 percent and 1 percent (p = 0.3301), Isospora belli - 4.8 percent and 1 percent (p = 0.0993), Cryptosporidium sp. - 8.1 percent and 0 (p = 0.0007), and non-pathogenic protozoans as well. There was a significant reduction in the prevalence of enteroparasites between the eras (63.9 percent to 24 percent; p<0.0001). In the HAART era, the following observations were made: greater frequency of enteroparasites in patients without antiretroviral therapy (p = 0.0575), as in those with AIDS (p = 0.08), and diarrhea (36 percent of the patients); lack of association with positive FPE (p = 0.626); and non-detection of Cryptosporidium sp. Strongyloides stercoralis showed an elevated prevalence in the two eras and was more frequent in men (32.41 percent) than women (19.04 percent) of Group 1 (p = 0.018), a finding suggesting the transmission of the helminth through sodomy. The advent of the HAART modified the profile of opportunistic infections, including parasites, probably due...
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Terapia Antirretroviral de Alta Atividade , Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Infecções por Protozoários/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Anti-Helmínticos/uso terapêutico , Antiprotozoários/uso terapêutico , Brasil/epidemiologia , Fezes/parasitologia , Helmintíase/tratamento farmacológico , Helmintíase/parasitologia , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Prevalência , Estudos Prospectivos , Infecções por Protozoários/tratamento farmacológico , Infecções por Protozoários/parasitologia , Estudos Retrospectivos , Adulto JovemAssuntos
Feminino , Humanos , Aleitamento Materno , Aleitamento Materno/psicologia , Desmame , PsicologiaRESUMO
Objetiva estimar a prevalência de sífilis, gonorréia, chlamydia e tricominíase em gestantes de dois municípios do Ceará
Assuntos
Humanos , Feminino , Gravidez , Infecções Sexualmente Transmissíveis/prevenção & controle , Complicações na GravidezRESUMO
Since 1995, in the State of Ceará, in Northeast Brazil, there is a public health project focusing on training and continuing education of health reference teams taking care of patients with sexually transmitted diseases (STD). An information system including a patient's form was worked out and established. The characteristics of the patients seen at consultation in 1999 are described. Ten units provided 1,478 filled forms. Women are more present than men (72% vs 28%). Multipartnership during the last three months is more frequent among males (52%) than among females (5%). Taking antibiotics prior to the first medical advice was frequent in the male population (17%). The main syndromes presented by women were vaginal discharge (81%) and genital warts (19%), whereas with men genital warts (47%) and urethral discharge (43%) were more frequent. The frequency of positive serology for syphilis and HIV among patients presenting an STD syndrome was 7.9% and 1.3%, respectively. It was higher among males (12% and 3%) than among females (7% and 1%). The way the referral facilities are used is different according to sex, the women corning more often spontaneously. The need for accurate etiologic data for each STD syndrome was identified. The analysis of the data resulting from these STD referral units allowed to produce relevant information whose follow-up will be of great interest for both health professionals and decision-makers.
Assuntos
Saúde Pública , Infecções Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Fatores Etários , Análise de Variância , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Criança , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Masculino , Prontuários Médicos , Fatores Sexuais , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/prevenção & controle , Sífilis/diagnóstico , Sífilis/epidemiologia , Sífilis/prevenção & controleRESUMO
A linguagem sobrevém da necessidade de conservar o objeto além da satisfação da necessidade, sendo, portanto, resultado da atividade pulsional. Nesse processo, o objeto da pulsão invocante e o da pulsão alimentar se substituem um ao outro. A articulação da psicolingüística com a psicanálise ajuda a compreender melhor como isso acontece na medida em que uma observa os comportamentos e a outra supõe desejos subjacentes a esses comportamentos, revelando que todos os comportamentos do bebê são o reflexo de sua atividade pulsional e de sua entrada progressiva na linguagem. A palavra faz com que os objetos perdurem e que possam ser reconhecidos(AU)
Language arises from the need to maintain the object beyond necessity, thus being consequence of drive activity. In this process, the object of the invoking drive and the nourishing drive replaces one another. The articulation of psycholinguistics with psychoanalysis helps to understand how this takes place, since the first observes behaviors and the latter supposes underlying desires to these behaviors, unveiling that all the baby's behavior is reflection of its drive activity and of its gradual ingress into language. The word allows objects to last and to be recognized(AU)
Assuntos
Humanos , Psicanálise , Linguística , InstintoRESUMO
A linguagem sobrevém da necessidade de conservar o objeto além da satisfação da necessidade, sendo, portanto, resultado da atividade pulsional. Nesse processo, o objeto da pulsão invocante e o da pulsão alimentar se substituem um ao outro. A articulação da psicolingüística com a psicanálise ajuda a compreender melhor como isso acontece na medida em que uma observa os comportamentos e a outra supõe desejos subjacentes a esses comportamentos, revelando que todos os comportamentos do bebê são o reflexo de sua atividade pulsional e de sua entrada progressiva na linguagem. A palavra faz com que os objetos perdurem e que possam ser reconhecidos.
Language arises from the need to maintain the object beyond necessity, thus being consequence of drive activity. In this process, the object of the invoking drive and the nourishing drive replaces one another. The articulation of psycholinguistics with psychoanalysis helps to understand how this takes place, since the first observes behaviors and the latter supposes underlying desires to these behaviors, unveiling that all the baby's behavior is reflection of its drive activity and of its gradual ingress into language. The word allows objects to last and to be recognized.