https://repositorio.ufba.br/handle/ri/10118 2026-05-03T03:57:05Z https://repositorio.ufba.br/handle/ri/43938 Título: A obesidade e o tecido adiposo na patogênese e gravidade da Leishmaniose cutânea Autor(es): Nassri, Kelly Morais Lima Primeiro Orientador: Carvalho Filho, Edgar Marcelino de Abstract: Obesity is associated with worse clinical outcomes in cutaneous leishmaniasis (CL). Here, we evaluated the influence of obesity on the systemic, dermal, and adipose tissue immune responses in CL. A total of 39 obese and 43 individuals with normal BMI with ulcerated CL caused by Leishmania braziliensis confirmed by PCR were enrolled, along with 8 healthy subjects (HS), 4 with normal BMI and 4 obese. Peripheral blood mononuclear cells (PBMC) were cultured for 72 hours in the presence or absence of soluble Leishmania antigen (SLA, 5 μg/mL). Skin and adipose tissue biopsies were analyzed histologically, and cytokines and adipokines were quantified after 72-hour incubation. All patients were treated with meglumine antimoniate. The cure rate was lower in obese patients (41%) compared to those with normal BMI (70.4%) (p < 0.05). No significant differences in proinflammatory cytokine production were observed in PBMC supernatants. However, cytokines (IL-1β, IL-17, Granzyme B) and leptin were significantly higher in skin biopsies of obese compared to normal BMI CL patients (p < 0.05), and leptin levels correlated directly with these cytokines in both groups. Adipose tissue was infiltrated by inflammatory cells, with larger inflammatory areas in obese CL patients (p < 0.05). Cytokines were largely undetectable in adipose tissue, except for elevated CCL2. Notably, leptin and adiponectin levels were markedly increased in CL patients compared to HS, suggesting infection-driven modulation of adipocyte function. These findings demonstrate that CL enhances adipokine production and that obesity amplifies local inflammatory responses, contributing to greater disease severity and therapeutic failure in obese individuals. Editora / Evento / Instituição: UNIVERSIDADE FEDERAL DA BAHIA Tipo: Dissertação 2025-01-01T00:00:00Z https://repositorio.ufba.br/handle/ri/40035 Título: Descrição do uso de antibióticos em infecções respiratórias agudas em pacientes menores de 4 anos internados em um hospital Autor(es): Magenta, Aline da Silva Torres Primeiro Orientador: Nascimento-Carvalho, Cristiana Maria Abstract: Background: Acute respiratory infection (ARI) is a persistent public health problem in several countries, especially in developing countries, as it is an important cause of death in children (Li et al, 2021). Methodology: A retrospective cohort study was carried out, in which records of hospitalizations at Hospital Santo Antônio for children under 4 years of age in 2019 were studied. The nursing record book containing the patient's name, medical record number and hospitalization diagnosis was analyzed. The data researched were: sex (female or male), dates of birth, hospitalization, discharge, runny nose, cough, nasal obstruction, fever reported by the guardian, vomiting, diarrhea, rash, difficulty breathing, cyanosis, comorbidity, use of corticosteroids , use and suspension of antibiotics, bronchodilators, outcome (discharge, transfer, death).. Result: 494 medical records were included in the study, 22 medical records were excluded due to erroneous registration in the nursing record book. In none of the records analyzed did the patients die. Of the 472 medical records included in the study, the majority of children were less than 1 year old 269 (57%) and there were more male patients 254 (53.8%) than female 218 (46.2%), the time average length of stay was 5.9 days ((25% percentile 2.2 days and 75% percentile 7 days). The most prevalent symptoms were cough (366;77.5%), fever (294;62.3%), difficulty breathing (278;58.9%). The least frequent symptoms were rash (4;0.8% ), odynophagia (4;0.8%), cyanosis (6;1.3%). When prescribed, the most used antibiotics upon hospital admission were crystalline penicillin (65; 13.8%), ceftriaxone (50; 10.6%), amoxicillin with clavulonate (37; 7.8%). Antibiotic suspension was observed in 123 medical records. The most frequently suspended antibiotic was ceftriaxone (85.18%), followed by azithromycin (14.3%), crystalline penicillin (11.2.3%). The suspension of bronchodilators (151;31.8%) and corticosteroids (159;33.7%) was also observed. Discussion: The results presented draw attention to the excessive use of antibiotics, since the main etiological agent of HAIs are viral infections. The antibiotic most suspended upon hospital admission was ceftriaxone, this data may reflect the excessive use of this as it is not the first choice in the treatment of respiratory infections, with penicillins prevailing Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2024-06-12T00:00:00Z https://repositorio.ufba.br/handle/ri/39923 Título: Avaliação da capacidade imunomoduladora do antígeno recombinante rSm29 na hanseníase Autor(es): Vieira, Thaillamar Primeiro Orientador: Castellucci, Léa Cristina de Carvalho Abstract: Leprosy is a chronic, insidious infectious disease that is difficult to treat, especially in its reactional forms, which has prompted the development of new drugs, especially immunobiologicals for its treatment. The antigen (rSm29) has been shown to have an immunoregulatory function, by immunoregulatory function, through the induction of IL-10 and capable of modulating inflammatory responses with a Th1 and Th2 profile, demonstrated in diseases such as asthma, leishmaniasis and HTLV-1. In order to understand how this antigen might behave in leprosy, this study sought to evaluate the modulatory role of rSm29 in the disease. A cross-sectional pilot study was carried out with 17 leprosy patients. After blood collection, the PSMCs were separated and incubated for 72 hours in four groups categorized according to different stimuli: No stimulus, M. leprae, M. leprae+rSm29 and rSm29. RNA was then extracted using TRIzol, converted to cDNA and PCR conversion to cDNA and real-time PCR (qRT-PCR) using the Taqman® method for the target genes (TLR2, TLR4, IL-10 and TNF) and the Bioplex® immunoassay to measure important immunological markers of the disease. Gene expression of the TLR2 gene was higher in the group co-stimulated with M. leprae + rSm29 compared to M. leprae and significant when compared to the non-stimulated group (medium) (p = 0.0317). On the other hand On the other hand, the expression of TLR4 was higher in cultures in the presence of the M. leprae antigen compared to unstimulated (p = 0.0159) and co-stimulated (p = 0.0317) cultures. We also observed that the expression of the IL10 gene was higher in cultures in the presence of the antigens and presence of the antigens and significant when comparing M. leprae + rSm29 with cultures (p = 0.0159). There was no significant variation in TNF expression between the groups. between the groups. The results show significant differences in concentrations of the markers in the supernatants co-stimulated with the two antigens compared to M. leprae sonicated in the PB group observed in G-CSF, GM-CSF, IFN-γ, TNF-α. 17.In addition to the significant differences observed in the mediators of the response mediators, the cytokines and chemokines IL-1β, IL-2, IL-4, IL-5, IL-, significant differences were also observed in the stimulation of the PB group. a significant difference was also observed when stimulated with the recombinant antigen alone versus the antigen alone versus the M. leprae + rSm29 condition in the PB group, the addition of the rSm29 antigen to M. leprae in a culture of leprosy patients contributed to the development of a Th1-type cellular response. This response could help leprosy patients to better control their mycobacterial infection, thus favoring the milder form of the disease. Editora / Evento / Instituição: UNIVERSIDADE FEDERAL DA BAHIA Tipo: Dissertação 2020-08-27T00:00:00Z https://repositorio.ufba.br/handle/ri/38861 Título: Fatores associados a sintomas depressivos em profissionais de saúde da atenção básica: um estudo transversal Autor(es): Nardes, Bárbara Oliveira Primeiro Orientador: Merces, Magno Conceição das Abstract: Background: Depression is a pathology that affects a large proportion of healthcare professionals, where the prevalence of depressive symptoms has been higher in this category. This work environment seems to create a place of permanent stress and illness. Objective: To track the presence of depressive symptoms in Primary Care health professionals. Methods: Cross-sectional, exploratory population study in 14 Family Health Units in the State of Bahia, Brazil. 162 Primary Care health professionals participated in the study, where the PHQ-9 questionnaire was used to track factors associated with depressive symptoms. Data analysis included descriptive statistics characterizing the sample and estimating the prevalence of the outcome in absolute and relative frequencies. In the bivariate analysis, the association between the outcome and the independent variables was verified, based on Prevalence Ratios (PR), 95% confidence intervals (CI) and p values using Pearson's chi-square test and Fisher's exact test. Exploratory Poisson logistic regression was conducted using the backward method whose parameter adopted in the model was p values≤0.25. The final multivariate model included variables associated with depressive symptoms that presented a p-value≤0.05. Results: The prevalence of depressive symptoms was 34.0%, with a higher occurrence among women, with a poor self-assessment of quality of life, poor self-perception of health and who did not practice physical or leisure activities, as well as among professionals who reported a noisy work environment, with an inadequate temperature, that they had suffered some type of 79 violence at work and felt personal insecurity at work. In the multivariate logistic regression model, depressive symptoms remained positively associated with self perceived health and quality of life variables and those of a work nature (violence at work and noisy work environment). Conclusion: The findings indicate the existence of depressive symptoms in Primary Health Care professionals. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2023-10-26T00:00:00Z