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publicado em 02/06/2009 às 20h20:00
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Chagas Disease A century of hardship, challenges and achievements

* Luiz Fernando Junqueira Jr. is Professor of Clinical Medicine, Cardiology and Cardiovascular Physiology, Faculty of Medicine, University of Brasilia. He has a Ph.D. in Clinical Medicine and Cardiology, Master in Physiology, a specialist in Internal Medicine and Cardiology, Bachelor of Biomedical Sciences and graduated in medicine from the Faculty of Medicine of Ribeirao Preto. Coordinates the Cardiovascular Laboratory and Department of Cardiology, University Hospital (HUB).

 
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Exactly a century, in 1909, the Brazilian physician Carlos Ribeiro Justiniano Chagas, then 30 years old, would unveil a new and serious infectious parasitic disease that would honor his name - Chagas disease, which represented remarkable feat Brazilian doctor . He identified the causative agent, the vector insect and disease resulting initially detected in children in the rural mining town Lassance where Carlos Chagas fighting malaria, as a physician do Instituto Oswaldo Cruz.

Attempts of denial followed by several years, much of the medical community of the time. Carlos Chagas warm suffered smear campaign, but nevertheless was twice nominated for the Nobel Prize - the only Brazilian to have this indication, Laura was not granted by the interference of his fellow opponents. Over time, several cases were confirmed by Brazilian and other Latin American countries.

Chagas disease is a common endemic disease that affects individuals living in rural areas under poor socioeconomic conditions in countries of Central and South America. It is chronically debilitating or crippling and often lethal when it affects the heart. The causative agent is the protozoan parasite Trypanosoma cruzi (Chagas so named in honor of the Oswaldo Cruz, who contributed greatly to the discovery of the disease), which is transmitted by blood-sucking insects known as barber, boll weevil, or chupança hickey. Manifests itself in an acute form, which follows, after years of a chronic form.

In the chronic indeterminate, individuals have nothing and appear perfectly healthy, with excellent prognosis. Other chronic forms are those that involve the heart and digestive system, alone or in combination. May occur enlarged heart, arrhythmias, heart failure, pulmonary or cerebral embolism, dilation of the esophagus or intestine, changes in the nervous control of the heart and other disorders.

It is estimated that about 10-14 million chronic Chagas disease still exist, of which 50-60% have an indeterminate form and the other 40-50% are the cardiac, digestive or both. Of the latter, about 10% exhibit severe progressive impairment of the heart, resulting inevitably in death. In Brazil, between 5 and 8 million individuals have the disease in its chronic forms, which corresponds to 3-4% of the population. Thus, it continues killing or disabling and socially degrading young adults in the most productive of their lives.

However, a program to eliminate the main vector insect (Triatoma infestans) control and blood transfusion in many countries of the Southern Cone (Argentina, Bolivia, Brazil, Chile, Paraguay and Uruguay), nearly canceling the appearance of new cases of acute reducing the number of chronic cases. Brazil was declared free of new cases in June 2006 by the Pan American Health Organization (PAHO / WHO), joining the other of those countries already certified. If this achievement is maintained, we can predict that in a few decades no longer see patients with Chagas disease.

Advances in treatment and diagnosis and understanding of different disorders also occurred, offering a significant improvement of living and better prognosis for Chagas disease, with progressive decrease in the rate of morbidity and mortality and the number of hospitalizations. But as the causal agent persists, other species of insect vectors, animal reservoirs and the precariousness social, educational, and economic health of the population, the disease will always be a big challenge medical, scientific, social and political health, demanding some sort of treatment, preventive measures and health surveillance, and great efforts of many researchers for their full understanding and combat.

Our School of Medicine stands out for almost 40 years, nationally and internationally in the study of disease, with dozens of theses and hundreds of articles and communications published. Among researchers who retired or died more dedicated to it are the teachers Aluízio Silver Vanize Macedo, Phillip Marsden and Liana Pires, all of the Center for Tropical Medicine. Currently, studies are held by teachers and Cleudson Castro Celeste Silveira (tropical medicine), Luiz Paulo Junqueira and Jesus (Cardiology), César Cuba-Cuba (parasitology), Jaime Antonio Teixeira and Santana (immunopathology).

Source: UnB AGÊNCIA
   Palavras-chave:   Luiz Fernando Junqueira Jr.    Chagas    IOC    Nobel    Barber    WHO   
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