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Background: Commuting accidents might have serious consequences for the health of workers, in addition to considerable financial impacts on the national health system and the social security administration., Objective: To describe the epidemiological profile and calculate the incidence of commuting accidents in Brazil in the period from 2009 to 2016., Methods: Retrospective and descriptive study with time series analysis (2009-2016) based on official secondary data obtained from Social Security Statistical Yearbooks. Information on the economically active population was retrieved from the National Household Sample Survey. Annual incidence rates were calculated per 100,000 economically active population. Simple temporal linear regression analysis was performed with software Statistical Package for the Social Sciences. The significance level was set to p<0.05., Results: The epidemiological profile of workers involved in commuting accidents corresponded to men, aged 20 to 29 and with leg/ankle fractures, which represented 24.78% of the total population of involved workers. The incidence of commuting accidents increased from 88.17 to 105.88 in the analyzed period, which represents an variation rate of 20.08% (R 2 =0.715; p=0.008)., Conclusion: The detected rise in the incidence and number of commuting accidents point to the need for the government to formulate prevention plans targeting high-risk groups.

Background: The association between infection with Helicobacter pylori and different gastroduodenal diseases is related to bacterial, host and environmental factors. Studies have demonstrated an association between the genetic diversity of H. pylori, especially in the vacA and cagA genes, and the development of digestive diseases such as peptic ulcer and gastric cancer. In addition, the nature of the host inflammatory response may explain these different manifestations of infection caused by this microorganism. In this respect, host factors that regulate the immune and inflammatory responses involving the functional interaction of H. pylori infection with different components of the immune system, particularly T cells, in gastroduodenal diseases still need further investigation., Objective: To characterize the immune response, including immunity induced by infection with H. pylori, especially virulent strains (vacA alleles and cagA gene), by analyzing the cytokine profile and T-cell population present in gastroduodenal diseases in a Brazilian population., Methods: In a prospective study, gastric biopsies were collected from 554 patients with different gastroduodenal diseases for histological analysis and for the determination of bacterial genotype and cytokine production (IL-4, IL-10, IFN-γ and IL-12) by ELISA., Results: The predominant genotype of the H. pylori strains isolated from the patients studied was s1m1cagA+, which was more common among patients with gastric ulcer, duodenal ulcer and gastric cancer. A significant association was observed between the s1m1cagA+ genotype and a higher degree of inflammation, higher neutrophil activity and the development of intestinal metaplasia. The gastric concentrations of IFN-γ and IL-12 were significantly higher in patients infected with H. pylori than in uninfected individuals. Higher levels of these cytokines were detected in patients with gastric ulcer and cancer, while the levels of IL-4 and IL-10 in the gastric mucosa were lower in these patients. In addition, IFN-γ and IL-12 concentrations in gastric biopsies were higher in patients infected with the virulent s1m1cagA+ genotype. In contrast, IL-4 and IL-10 levels were higher in tissue infected with s2m2cagA in gastric biopsies., Conclusion: Our study shows that the interaction between the type of infectious strain and the Th1 immune response can influence and perpetuate gastric inflammation, and thus contributes to the development of the different clinical manifestations of H. pylori infection.

The exploitation of resources by closely related species with similar niches may be mediated by differences in activity patterns, which may vary in nycthemeral scale and seasonal scale. Piranhas Serrasalmus gibbus and Serrasalmus rhombeus are Neotropical predators that occur sympatrically in many environments of the Amazon basin. To evaluate the strategies adopted by these two species in a restricted environment (a reservoir), nycthemeral and seasonal samples were made, identifying the composition of the diet and their activity patterns. A total of 402 specimens were collected: 341 S. gibbus and 61 S. rhombeus . Both species fed themselves primarily on fish, with some seasonal variation being found in S. gibbus during the flood season, when plant material was consumed. There was considerable temporal overlap in the foraging behavior of the two species, although S. rhombeus presented a bimodal pattern of abundance over the 24-hour cycle. S. rhombeus was more active during the nighttime, between dusk and early morning, whereas S. gibbus was active throughout the nycthemeral cycle. These findings indicate low levels of competition between the two species, which allowed for a considerable overlap in nighttime foraging, following distinct nycthemeral patterns of foraging activity and allowing their coexistence.

Background: The hepatitis C virus has been recognized as the leading cause of chronic liver disease in the world. Host genetic factors have been implicated in the persistence of hepatitis C virus infection. Single nucleotide polymorphisms at positions -607 C/A (rs1946518) and -137 G/C (rs187238) in the IL-18 gene promoter have been suggested to be associated with delayed hepatitis C virus clearance and persistence of the disease., Objective: Identify these polymorphisms in a population infected with hepatitis C virus from the Brazilian Amazon region., Methods: In a cross-sectional analytical study conducted in Belém, Pará, Brazil, 304 patients infected with hepatitis C virus were divided into two groups: group A, patients with persistent infection; group B, patients with spontaneous clearance. The control group consisted of 376 volunteers not infected with hepatitis C virus. Samples were analyzed by RT-PCR for the detection of viral RNA and by RFLP-PCR to evaluate the presence of the -137 G/C and -607 C/A IL-18 gene promoter polymorphisms., Results: Comparison of polymorphism allele frequencies between the patient and control groups showed a higher frequency of allele C at position -607 among patients (P=0.02). When the association between the polymorphisms and viral infection was analyzed, patients carrying genotype C/A at position -607 were found to be at higher risk of persistent hepatitis C virus infection (P=0.03)., Conclusion: The present results suggest a possible role of the -607 IL-18 gene promoter polymorphism in the pathogenesis of hepatitis C virus infection.

Introduction: The genomic heterogeneity of hepatitis C virus (HCV) influences liver disorders. This study aimed to determine the prevalence of HCV genotypes and to investigate the influence of these genotypes on disease progression., Methods: Blood samples and liver biopsies were collected from HCV-seropositive patients for serological analysis, biochemical marker measurements, HCV genotyping and histopathological evaluation., Results: Hepatitis C virus-ribonucleic acid (HCV-RNA) was detected in 107 patients (90.6% with genotype 1 and 9.4% with genotype 3). Patients infected with genotype 1 exhibited higher mean necroinflammatory activity and fibrosis., Conclusions: HCV genotype 1 was the most prevalent and was associated with greater liver dysfunction.

The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92-7.46, and P = 0.002). A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation.

The prevalence of antibodies to HCV varies among Brazilian regions at rates of 8-16%. Since this virus is transmitted by the parenteral route through blood and blood products, patients receiving maintenance hemodialysis therapy are at an increased risk of infection. The study was conducted in seven dialysis centers in Belém, Pará, northern Brazil. Blood samples were collected from 798 patients with chronic renal disease treated by hemodialysis. The samples were tested for antibodies against HCV and the viral genotype was identified. Sixty-seven (8.4%) of the 798 patients studied were anti-HCV positive by ELISA, ranging from 4% to 14% in different centers. Viral RNA was detected in 5.3% (43/798) of the patients; of these, 42 also had anti-HCV antibodies. HCV genotyping revealed genotype 1 as the most common, detected in 86.1% (37/43) of the patients, followed by genotype 2 in 11.6% (5/43) and genotype 3 in one patient (2.3%). The findings of this study highlight the importance of control strategies for hepatitis C in hemodialysis patients. Molecular biology methods need to be available in these centers to screen for HCV on admission in order to establish effective infection control measures., (Copyright © 2013 Wiley Periodicals, Inc.)

Context: Although more than half of the world's population is colonized with Helicobacter pylori, it remains unknown why this organism is able to produce severe disease in some hosts and be innocuous in others. The clinical outcome of infection is determined by several factors, including differences in the host response to bacterial stimulation, specific virulence factors of the organism and environmental influences, or a combination of these factors., Objectives: This study compared the prevalence of H. pylori infection and risk factors (infection with CagA+ strains, excessive alcohol consumption, smoking, and inadequate eating habits) between patients with different gastrointestinal disorders and associated these risk factors with the histopathological findings., Methods: In a prospective study, samples were collected from 442 patients and a standardized questionnaire regarding lifestyle habits (excessive alcohol consumption, smoking, and eating habits) was applied. The presence of H. pylori and of the cagA gene was investigated by polymerase chain reaction (PCR). Gastric biopsies were obtained for histological assessment., Results: The frequency of alcohol consumption, smoking, inadequate diet and infection with CagA+ H. pylori was higher among patients with peptic ulcer and adenocarcinoma when compared to those with gastritis. Gastric inflammation was more pronounced in patients infected with CagA+ strains., Conclusion: We conclude that infection with CagA+ H. pylori strains, excessive alcohol consumption, smoking and inadequate eating habits increase the risk of developing peptic ulcer and gastric carcinoma.

Introduction: This study compares virulence markers of Helicobacter pylori isolated from patients in 2 cities in the Brazilian Amazon., Methods: The study analyzed 168 patients with chronic gastritis from Belém and 151 from Bragança, State of Pará, Brazil. Levels of bacterial DNA associated with cagA and vacA alleles were checked by PCR, and hematoxylin-eosin staining was used for histologic diagnosis., Results: In Bragança 87% of patients were genotype s1m1 cagA-positive (s1m1 cagA+), compared with 76% in Belém. In samples from patients in both cities, there was an association between s1m1 cagA+ strains and gastric mucosal damage., Conclusions: Both cities have a high frequency of s1m1 cagA+ strains of H. pylori.

Epidemiologically, the relevance of infection caused by hepatitis viruses is related mainly to their wide geographic distribution and the large number of infected individuals in all parts of the world. In this study, 668 residents from the islands around the Tucuruí Dam were selected. Blood samples were collected for investigation of serological markers (HBsAg, total anti-HBc, anti-HBS, and anti-HCV) by enzyme immunoassays. HCV-positive subjects were tested using RT-PCR and RFLP for the identification of viral genotypes. Among the 668 subjects studied, 1.9% were HBsAg positive, 28% were total anti-HBc positive, and 41.9% were anti-HBs positive. The anti-HBs marker alone (vaccine response) was detected in 25.7% of the volunteers. Anti-HCV antibody was detected in 2.2% of the subjects and genotype 1 was the predominant genotype (70%). The results indicate an intermediate level of HBV and HCV endemicity in the region studied, as well as low HBV vaccination coverage., (Copyright © 2012 Wiley Periodicals, Inc.)

Introduction: Viral hepatitis is a major public health concern in Brazil. There are few past studies on this issue, especially among riparian communities. This study aims at determining the seroprevalence of viral hepatitis B and C in the riparian community of Pacuí Island, within the Cametá municipality of Pará State, Brazil. Moreover, this study aims to investigate the principal risk factors that this community is exposed to., Methods: The current study has accessed blood samples from 181 volunteers who have answered an epidemiological questionnaire. Analyses on serological markers have been tested with commercial ELISA kits for detecting HBsAg, total anti-HBc, anti-HBs, and anti-HCV. Within seroreactive patients for HCV, RT-PCR and line probe assay have been performed to identify the viral genotype., Results: In the serological marker analysis for hepatitis B, no reactivity for HBsAg, rate of 1.1% for total anti-HBc, and rate of 19.3% for anti-HBs have been observed. On hepatitis C, 8.8% seroprevalence has been found, in which 62.5% have gotten viral RNA. Among the risk factors studied, the following have been highlighted: non-use of condoms, sharing of cutting instruments, use of illicit drugs, and reports of family disease with HBV or HCV., Conclusions: The vaccination coverage against HBV is low, and the high prevalence of HCV within this community has been observed.

Aim: To investigate the ABH and Lewis antigen expression in erythrocytes, saliva and gastric epithelium, as well as the association between H pylori and the presence of gastric epithelial lesions., Methods: The distribution of ABH and Lewis blood group antigens in erythrocytes, saliva and gastric mucosa of H pylori-infected gastric ulcer patients was analyzed. Forty-two patients with gastric ulcer were studied, and fifty healthy individuals were used as control group. The blood group antigens were determined by direct hemagglutination, dot-ELISA and immunohistochemical methods in erythrocytes, saliva and gastric mucosa specimens, respectively. Diagnosis for H pylori infection was performed by conventional optical microscopy and ELISA., Results: A higher seroprevalence of IgG H pylori specific antibodies was observed in gastric ulcer patients (90%) compared to the control group (60%). We observed a significant increase of phenotypes O, A2 and Lewis b in H pylori-infected patients. The expression of these antigens had progressive alterations in areas of ulcerous lesions and intestinal metaplasia., Conclusion: ABH and Lewis blood group antigens are a good indicator for cellular alterations in the gastric epithelium.

We have examined the prevalence of gene cagA and vacA alleles in 129 patients, 69 with gastritis and 60 with peptic ulcer diseases from North Brazil and their relation with histopathological data. vacA and cagA genotype were determined by polymerase chain reaction. Hematoxylin-eosin staining was used for histological diagnosis. 96.6% of the patients were colonized by Helicobacter pylori strains harboring single vacA genotype (nont-mixed infection). Among them, 11.8% had subtype s1a, 67.8% had subtype s1b, and 17% subtype s2. In regard to the middle region analysis, m1 alleles were found in 75.4% and m2 in 21.2% of patients. The cagA gene was detected in 78% patients infected with H. pylori and was associated with the s1-m1 vacA genotype. The H. pylori strains, vacA s1b m1/cagA-positive, were associated with increased risk of peptic ulcer disease and higher amounts of lymphocytic and neutrophilic infiltrates and the presence of intestinal metaplasia. These findings show that cagA and vacA genotyping may have clinical relevance in Brazil.